• Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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• 제5권4호
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• pp.267-272
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• 2007

Various kinds of RI wastes are discharged from licensed organizations of radioisotopes les such as hospitals and clinic organizations, educational organizations, research institutions, and public organizations. Radioiodines such as $^{125}I\;and\;^{131}I$ are radioisotopes mainly used in nuclear medicine and industry. A method for the determination of radioiodines in RI wastes has been applied to measure low level activity using acid decomposition method and HPGe gamma ray spectrometer. Prior to analysis of real samples, $^{131}I$ reference solution and 10 g of yellow tissue paper was added to flask in mantle and was heated in 100 mL of 0.4 N $K_2Cr_2O_7$ and 100 mL of 9 M $H_2SO_4$, and then distilled after adding 10 mL of 30% $H_2PO_3$ and 1 mL of 30% $H_2O_2$. The condensed iodine by circulator was extracted into $CCl_4$, then back-extracted into the aqueous phase with 10 mL of 5% $K_2SO_2$ solution. Finally, $^{131}I$ was measured at 364.48 keV using HPGe gamma ray spectrometer after precipitation and filtration. Chemical yield of three steps such as acid decomposition process, chemical separation process, and precipitation and filtration process was more han 94% respectively, MDA(Minimum Detectable Activity) of $^{131}I$ at this analytical condition was 0.6 Bq/g.

• Journal of Korean Academy of Nursing
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• 제27권1호
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• pp.228-241
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• 1997

Today's healthcare environment is changing, driven by demographic, environmental, social, political and technological forces. These rapidly changing healthcare environment and increasingly professional nursing practice indicate that identifying leadership characteristic of nursing leaders and executives is a vital importance in today's time and also mandate innovative leadership for nursing service. Therefore, the purpose of this study is to examined the transformational, transactional leadership styles of the Nurse Administrators. Also described are the relationships between these leadership styles and the job satisfaction. the organizational commitment of their subordinates. The sample consisted of sixteen mid-level nurse administrators, fifty head nurses and one hundred aid fifty-three staff nurses of 4 public & private University Hospitals and 1 General Hospital. Data for this study was collected from Sep. 20 to Oct. 5 by Questionnaire(Bass' MLQ, Job Satisfaction scale developed by Paula(1978), Organizational Commitment scale by Peter et at(1979). The data was analyzed by frequency, percentage, one-way ANOVA, Pearson's Correlation Coefficient with SPSS PC/sup ＋/ program. Major findings are as follows : Appropriate one-way ANOVA tests revealed that the differences for transformational and transactional leadership styles of nurse executives. mid-level nurse administrators, head nurses as perceived by their immediate subordinates were statistically significant(P<.05), The scores of transformational and contingent reward behaviors were declined of the mid-level nurse administrators, nurse executives. The transactional scores of nurse administrators were lower than trans- formational ones, which is a desirable findings. The result of this study, the head nurses were perceived as the highest transformational leader by their subordinates, and second was the mid-level nurse administrators. The nurse executives received the lowest transformational leadership scores from their subordinates. These results were opposit to the previous studies. And significant positive correlations were founded between transformational leadership including charisma, intellectual stimulation, individual consideration and contingent reward of nurse administrators and the job satisfaction, the organizational commitment of their subordinates. From the data, it can be concluded that transformational leadership style of nurse administrators promotes the job satisfaction, the organizational commitment of thier staff nurses. Therefore leader looks for potential motives in subordinates, seeks to satisfy higher need, and engages the full person of the subordinate resulting in a relationship of mutual stimulation and elevation.

• Research in Community and Public Health Nursing
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• 제10권1호
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Journal of the Korea Convergence Society
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• 제9권8호
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• pp.77-85
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• 2018

Dementia among the diseases occurring in the old age is recognized as a disease to be solved at the national level and systematic management is being carried out. However, the awareness and response of the mild cognitive disorder, which is the middle stage of normal aging and dementia, are insufficient and social costs are increasing every year. The subjects of the study were 303 hospitalized patients whose primary diagnosis was mild cognitive impairment (F067) in a nursing hospital located in one district in 2016. The number of days of hospitalization was shorter in autumn and longer in winter or in hospital discharge. The cost of treatment for patients with mild cognitive impairment is lower in autumn and higher in winter or in 'discharge' of medical treatment results. The total cost of medical treatment was high in the winter by season in the ADL 6-12 and ADL 13-20 groups. Difference in the cost of medical treatment according to the characteristics of medical treatment, the medical expenses were the highest when the number of corporal disease was 5 ~ 8. In the medical treatment results, the ADL 6-12 point group and the ADL 13-20 point group had high medical expenses in 'continue'. Considering the clinical characteristics of mild cognitive impairment and considering that 10-15% of the patients with mild cognitive impairment progress to dementia every year, early detection and treatment of mild cognitive impairment is an effective and potentially important task for reducing potential social and dementia patients.

• Korea Journal of Hospital Management
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• 제14권4호
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• pp.149-162
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• 2009

The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

• Journal of Korean society of Dental Hygiene
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• 제19권6호
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• pp.1025-1036
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• 2019

Objectives: The purpose of this study is to identify the status and opinions of professional oral health care performance in oral cancer patients. Methods: Seven National University Dental Hospitals and the National Cancer Center in Korea surveyed the medical personnel in charge of oral health care for oral cancer patients. The questionnaire consisted of 16 questions, including the status of expert oral health care education and performance for oral cancer patients, etc. A total of 47 questionnaires were retrieved, and the collected data were used in PASW Statistics 23.0 to perform frequency analysis, cross-analysis, and kruskal Wallis tests. Results: A survey of oral health care education found that 29.8% of the medical personnel had received education. The most performed of professional oral health care was found that applying fluoride by dental hygienist, treating stomatitis by dentist, and wiping mouths with sponge by nurse. The assessment of self-performance has shown that applying fluoride by dental hygienists has a statistically significant difference. Only 37.8% of oral health care education for patients was conducted. Most recognized that oral health care in oral cancer patients was important, but it is difficult to provide care due to lack of performance personnel and time, opportunities for performance personnel to be educated. The improvement was found to require an increase in the number of performance personnel, placement of professionals, and practical training to enhance performance capabilities. Conclusions: For oral health care of oral cancer patients, continuous education for medical personnel, establishment of oral health care manual and medical system, research on oral health care of oral cancer patients and public relations campaign will have to be activated. Development of expert care manual analysis and evaluation tools for oral health care in oral cancer patients in the future and development of standardized curriculum will be necessary.

• Journal of Preventive Medicine and Public Health
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• 제41권2호
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• pp.92-99
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• 2008

Objectives : Effective cancer prevention and control measures can only be done when dependable data on the cancer incidence is available. The Seoul Cancer Registry (SCR) was founded to provide valid, comparable and representative cancer incidence data for Koreans. We aimed to compare the cancer incidence in the first (1993-1997) and second term (1998-2002) of the SCR, and we analyzed the annual incidence trend during that 10 years. Methods : The SCR detects potential cancer cases through the Korean Central Cancer Registry (KCCR) data, the health insurance claims, the individual hospital's discharge records and the death certificates. About 87% of the SCR data is registered through the KCCR. The rest of the data is registered by SCR registrars who visit about $70{\sim}80$ mid-sized hospitals in Seoul to review and abstract the medical records of the potential cancer patients. Results: The total number of new cancer cases was higher in $1998{\sim}2002$ than in $1993{\sim}1997$ by 20.6% for men and 18.4% for women, respectively. The age-standardized rate (ASR) of total cancer per 100,000 increased 1% (from 295.4 to 298.3) for men and 5.1% (from 181.5 to 190.7) for women, between the two periods. The commonest cancer sites during 1998-2002 for men were stomach, liver, bronchus/lung, colorectum, bladder and prostate, and the commonest cancer sites for women were breast, stomach, colorectum, cervix uteri, thyroid and bronchus/lung. Compared with the ASRs in 1993, the ASRs in 2002 increased for colorectum (58.4% for men, 27.1% for women), prostate (81.5%), breast (58.3% for women), thyroid (141% for women), and bronchus/lung (15.4% for women). The ASRs for stomach (-18.7% for men, -20.7% for women) and uterine cervix cancer (-39.7%) had decreased. Conclusions : The cancer incidence is increasing in Seoul, Korea, especially for the colorectum and prostate for men, and for the breast, colorectum, bronchus/lung and thyroid for women.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.516-539
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• 1998

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.395-403
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• 1998

To estimate the incidence rate of coronary heart disease in Korea, of all residents in Taegu city aged 25 or above, those who had an acute MI or a fatal coronary event between 1 July 1996 and 30 June 1997 were registered. Seven hundreds and eight patients were registered during the study period(685 were identified at hospital and 23 were autopsy cases). Age-standardized annual incidence rate of men in city area was 93 per 100,000(95% CI; 61-142) and 35% CI; 16-67) in women(100 in men and 20 in women aged 35-64). The incidence was rapidly increased after age 40 in men, however, in women after age 60. Twenty-eight-days case fatality rate was 45% in men and 47% in women. However, in the age group of 45-59 case fatality rate in women was two times higher than that in men. In conclusion, crude annual incidence rate of CHD in city area was 73 per 100,000 in men and 33 in women. The age-standardized annual incidence of CHD in men(93 per 100,000) was 2 times higher than that in women (33 per 100,000) in Korea.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.526-537
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• 1999

Objectives : It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. Methods : Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years' follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. Results : In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of $\geq$ 110 mg/dl compared with $\leq$ 80 mg/dl, Hazard Ratio[HR]:15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI $\geq$ 25.3 compared with $\leq$ 21.3) was 7.19(95% CI=3,75-13.8); of weight change during middle life(>10kg compared with $\leq$ 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper fertile compared with lower fertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). Conclusion : The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.