• Women's Health Nursing
• /
• v.3 no.1
• /
• pp.5-27
• /
• 1997

This study was carried out to identify the difference between nursing needs and levels of satisfaction of primiparae during the early postpartum period. The goal of the study was to obtain data needed to develope maternal education programs and to improve the nursing quality for primipara. The subjects were 111 primiparae who had normal delivery at 2 general hospitals in the Seoul area. The data was gathered using an 81 items questionnaire which was developed by the researcher from Nov. 30, 1995 to Feb. 5, 1996. Results found are as follows : 1. The characteristics of subjects : The majority of subjects were aged 26-30yrs(60.4%), high school graduated(49.5%), jobless(52.3%), had no religion(49.5%), no antenatal(74.5%), and postnatal education on self and infant care(55.9%). A large proportion of primiparae intended to feed breast milk(49.5%) but in fact only 7.2% fed breast milk while in the hospital. Many subjects perceived that they had reasonable self confidence about self care(46.8%), and infant care(36%). 2. The level of nursing needs of overall nursing care was relatively high(Mn 3.98) but the level of satisfaction was of average level(Mn 3.09). Therefore, difference between the level of nursing needs and satisfaction was significant(p=0.0001). 3. The nursing needs by category of nursing care the highest need was on the education of infant care(4.29), the lowest was on physical care(3.80). The level of satisfaction was higher on environmental care(3.40) and physical care(3.32). But the category that showed the lowest satisfaction was education of infant care(2.67). Hence, difference of categories between the level of nursing needs and satisfaction was significant(p=0.0001). 4. Among items of physical care, observation of primiparas' conditions(4.21), accurate medication and treatment(4.18), care of breast engorgement(4.07) and control of postpartal hemorrage(4.01) showed high nursing needs. On the other hand, only the level of satisfaction was higher on accurate medication and treatment(3.82). The rest of items revealed only average level of satisfactions. Difference of items between the level of nursing needs and satisfaction was significant(p=0.0001) except items of dietary care. 5. Among items of psychological care, 8 items of nursing needs were high(3.72-4.29), expecially detailed explanation on which mothers want to know(4.29), treatment and nursing care they receive(4.23), kind and faithful care(4.22), early contacts with their baby(4.20), and adequate draping during the care and treatment(4.18). Among items of psychological care higher satisfactions were shown on items of kind and faithful care(3.80), personal treatment(3.70), and detailed explanation to mothers, but the least satisfied items was early contact with baby(2.13). Difference between the level of nursing needs and satisfaction was significant(p=0.0001). 6. Among items of environmental care, the highest level of need and satisfaction was on the items of neat bedding and pajamas(3.54). The difference was significant (p=0.0001). 7. Among the items of educational needs on self care, all of 22 items revealed higher educational needs(3.50-4.33) but the levels of satisfaction varied with a range of 2.63-3.42. Among the items the satisfactions were high on items of breast care including massages(3.42), perineal care(3.36) and expression of breast milk(3.32). Less satisfied items were drugs not be taken by breast milk feeder(2.63), maintenance of breast figure(2.76) and postpartum exercise(2.80) and so on. The difference was significant(p=0.0001). maintain 8. Among the items of educational needs on infant care, 19 items revealed higher educational needs(3.28-4.54). And the highest need were on the 3 items of normal growth and development of infant, safety and emergency care, symptoms of sick(4.45) and the meaning of crying of the baby(4.52). The level of satisfaction among items of education of infant care ranged from 2.47 to 3.16. Most satisfied items were buriping(3.16), bathing(3.11) and diapering(3.09). The items of which the mother's needs were high revealed the lowest satisfaction level. The difference was significant (p=0.0001). 9. Relationship between nursing needs and levels of satisfaction among primiparae of different characteristics were as follows : 1) Nursing needs of physical and psychological areas were significantly different among different age levels but no relationship was found on other categories regardless of the level of satisfaction. 2) With regard to different levels of education, some relationship was found in nursing needs of psychological area(p=0.007), educational needs on infant care(p=0.04) and environmental care(p=0.01). Also, the difference of satisfaction level was significant. 3) Working mothers had higher nursing needs and were more satisfied on items of physical care(p=0.05), education on self care and infant care. Difference were significant between nursing needs and level of satisfaction. 4) With regards to different religion a moderate relation was found between nursing needs of environmental care infant care education but no relationship was found on levels of satisfaction. 5) With regards to antenatal education, the mothers who have had no antenatal education revealed higher nursing needs on physical care but those who had antenatal education were more satisfied with education on self care and infant care. The difference was significant. (p=0.0001). 6) With regards to postpartum education, the mothers who have had some sort of postpartum education revealed higher nursing needs on physical and self care. And they were more satisfied with nursing of every category except infant care than mothers who had not any postpartum education. Differences was significant between the nursing needs and levels of satisfaction.(p=0.0001). 7) With regards to breast feeding experience during the hospitalization, those who had no experience of breast feeding revealed higher nursing needs on physical care in contrast to breast feeders, who had higher educational needs on infant care. And breast feeder were more satisfied with all categories. Differences was significant(p=0.0001). 8) With regards to perception of self confidence on self care and infant care, no relationship was found on nursing needs and level of satisfaction in every category of nursing.

• Journal of Distribution Science
• /
• v.9 no.1
• /
• pp.17-27
• /
• 2011

As the world becomes more globalized, business competition becomes fiercer, while consumers' needs for less expensive quality products are on the increase. Business operations make an effort to secure a competitive edge in costs and services, and the logistics industry, that is, the industry operating the storing and transporting of goods, once thought to be an expense, begins to be considered as the third cash cow, a source of new income. Logistics centers are central to storage, loading and unloading of deliveries, packaging operations, and dispensing goods' information. As hubs for various deliveries, they also serve as a core infrastructure to smoothly coordinate manufacturing and selling, using varied information and operation systems. Logistics centers are increasingly on the rise as centers of business supply activities, growing beyond their previous role of primarily storing goods. They are no longer just facilities; they have become logistics strongholds that encompass various features from demand forecast to the regulation of supply, manufacturing, and sales by realizing SCM, taking into account marketability and the operation of service and products. However, despite these changes in logistics operations, some centers have been unable to shed their past roles as warehouses. For the continuous development of logistics centers, various measures would be needed, including a revision of current supporting policies, formulating effective management plans, and establishing systematic standards for founding, managing, and controlling logistics centers. To this end, the research explored previous studies on the use and effectiveness of logistics centers. From a theoretical perspective, an evaluation of the overall introduction, purposes, and transitions in the use of logistics centers found issues to ponder and suggested measures to promote and further advance logistics centers. First, a fact-finding survey to establish demand forecast and standardization is needed. As logistics newspapers predicted that after 2012 supply would exceed demand, causing rents to fall, the business environment for logistics centers has faltered. However, since there is a shortage of fact-finding surveys regarding actual demand for domestic logistic centers, it is hard to predict what the future holds for this industry. Accordingly, the first priority should be to get to the essence of the current market situation by conducting accurate domestic and international fact-finding surveys. Based on those, management and evaluation indicators should be developed to build the foundation for the consistent advancement of logistics centers. Second, many policies for logistics centers should be revised or developed. Above all, a guideline for fair trade between a shipper and a commercial logistics center should be enacted. Since there are no standards for fair trade between them, rampant unfair trades according to market practices have brought chaos to market orders, and now the logistics industry is confronting its own difficulties. Therefore, unfair trade cases that currently plague logistics centers should be gathered by the industry and fair trade guidelines should be established and implemented. In addition, restrictive employment regulations for foreign workers should be eased, and logistics centers should be charged industry rates for the use of electricity. Third, various measures should be taken to improve the management environment. First, we need to find out how to activate value-added logistics. Because the traditional purpose of logistics centers was storage and loading/unloading of goods, their profitability had a limit, and the need arose to find a new angle to create a value added service. Logistic centers have been perceived as support for a company's storage, manufacturing, and sales needs, not as creators of profits. The center's role in the company's economics has been lowering costs. However, as the logistics' management environment spiraled, along with its storage purpose, developing a new feature of profit creation should be a desirable goal, and to achieve that, value added logistics should be promoted. Logistics centers can also be improved through cost estimation. In the meantime, they have achieved some strides in facility development but have still fallen behind in others, particularly in management functioning. Lax management has been rampant because the industry has not developed a concept of cost estimation. The centers have since made an effort toward unification, standardization, and informatization while realizing cost reductions by establishing systems for effective management, but it has been hard to produce profits. Thus, there is an urgent need to estimate costs by determining a basic cost range for each division of work at logistics centers. This undertaking can be the first step to improving the ineffective aspects of how they operate. Ongoing research and constant efforts have been made to improve the level of effectiveness in the manufacturing industry, but studies on resource management in logistics centers are hardly enough. Thus, a plan to calculate the optimal level of resources necessary to operate a logistics center should be developed and implemented in management behavior, for example, by standardizing the hours of operation. If logistics centers, shippers, related trade groups, academic figures, and other experts could launch a committee to work with the government and maintain an ongoing relationship, the constraint and cooperation among members would help lead to coherent development plans for logistics centers. If the government continues its efforts to provide financial support, nurture professional workers, and maintain safety management, we can anticipate the continuous advancement of logistics centers.

• Radiation Oncology Journal
• /
• v.26 no.2
• /
• pp.104-112
• /
• 2008

Purpose: To assess the toxicity and tumor response induced by $DCVac/IR^{(R)}$ dendritic cell(DC) immunotherapy combined with irradiation for refractory colorectal cancer patients with multiple liver metastases. Materials and Methods: Between May 2004 and November 2006, applicants from a pool of refractory colorectal cancer patients with multiple liver metastases were enrolled. The patients were registered after having signed the informed consent form, which had been approved by the Institutional Review Board from the Dong-A University and Busan National University Hospital. DCs were obtained from peripheral blood of each patient, and then cultured in vitro. A total of $6{\times}10^6$ DCs were packed into a vial($DCVac/IR^{(R)}$, 0.5 ml) at the convenience of each patient's schedule. On the day before and on the day of each vaccination, each patient received a 4 Gy radiation dose to the target tumor. On the day of vaccination, the indicated dose of autologous DCs was injected into the irradiated tumor using ultrasound-guided needle injection procedures. A total of four vaccinations were scheduled at three 2-week intervals and one 4 week interval at the Dong-A University and Busan National University Hospital. If the tumor status was deemed to be stable or responding to therapy, an additional vaccination dose or two was approved at 4 week intervals beyond the fourth immunization. A tolerance test for DCs was conducted by injecting a range of doses($3{\times}10^6\;to\;12{\times}10^6$ DCs) after the 3rd injection. Moreover, the maximal tolerable dose was applied to additional patients. Treatment safety was evaluated in all patients who had at least one injection. Treatment feasibility was evaluated by the 10th week by assessing the response of patients having at least 4 injections. For systemic toxicities, the evaluation was performed using the National Cancer Institute Common Toxicity Criteria, whereas adverse effects were recorded using common WHO toxicity criteria. Results: Of the 24 registered patients, 22 received the DCs injections. Moreover, of the 14 patients that applied for the tolerance test, only 11 patients completed it because 3 patients withdrew their testing agreement. A grade 3 or more side effect, which was possibly related to the DC injection, did not occur in additional patients. The $12{\times}10^6$ DC injection was identified as the maximum tolerable dose, and was then injected in an additional 8 patients. Patients tolerated the injection fairly well, with no fatal side effects. In order to assess the feasibility of DC immunotherapy, the response was evaluated in other hepatic lesions outside of the targeted hepatic lesion. The response evaluation was performed in 15 of the 17 patients who received at least 4 injections. Stable and progressive disease was found in 4 and 11 patients, respectively. Conclusion: The DC-based immunotherapy and radiotherapy is theoretically synergistic for the local control and systemic control. The $DCVac/IR^{(R)}$ immunotherapy combined with irradiation was tolerable and safe in the evaluated cases of refractory colorectal cancer with multiple liver metastases. Future work should include well designed a phase II clinical trials.

• Korean journal of food and cookery science
• /
• v.30 no.6
• /
• pp.774-784
• /
• 2014

The purpose of this study was to present management guidelines for critical control points by analyzing microbiological hazardous elements through screening Potentially Hazardous Foods (PHF) menus in an effort improve the microbiological quality of foods prepared by restaurant operations. Steamed spinach with seasoning left at room temperature presents a range of risk temperatures which microorganisms could flourish, and it exceeded all microbiological safety limits in our study. On the other hand, steamed spinach with seasoning stored in a refrigerator had Aerobic Plate Counts of $2.86{\pm}0.5{\log}\;CFU/g$ and all other microbiological tests showed that their levels were below the limit. The standard plate counts of raw materials of lettuce and tomato were $4.66{\pm}0.4{\log}\;CFU/g$ and $3.08{\pm}0.4{\log}\;CFU/g$, respectively. Upon washing, the standard plate counts were $3.12{\pm}0.6{\log}\;CFU/g$ and $2.10{\pm}0.3{\log}\;CFU/g$, respectively, but upon washing after chlorination, those were $2.23{\pm}0.3{\log}\;CFU/g$ and $0.72{\pm}0.7{\log}\;CFU/g$, respectively. The standard plate counts of baby greens, radicchio and leek were $6.02{\pm}0.5{\log}\;CFU/g$, $5.76{\pm}0.1{\log}\;CFU/g$ and $6.83{\pm}0.5{\log}\;CFU/g$, respectively. After 5 minutes of chlorination, the standard plate counts were $4.10{\pm}0.6{\log}\;CFU/g$, $5.14{\pm}0.1{\log}\;CFU/g$ and $5.30{\pm}0.3{\log}\;CFU/g$, respectively. After 10 minutes of chlorination treatment, the standard plate counts were $2.58{\pm}0.3{\log}\;CFU/g$, $4.27{\pm}0.6{\log}\;CFU/g$, and $4.18{\pm}0.5{\log}\;CFU/g$, respectively. The microbial levels decreased as the time of chlorination increased. This study showed that the microbiological quality of foods was improved with the proper practices of time-temperature control, sanitization control, seasoning control, and personal and surface sanitization control. It also presents management guidelines for the control of potentially hazardous foods at the critical control points in the process of restaurant operations.

• The Journal of Korean Society for Radiation Therapy
• /
• v.24 no.2
• /
• pp.157-165
• /
• 2012

Purpose: We evaluated usefulness of abdominal compressor for stereotactic body radiotherapy (SBRT) with unresectable hepatocellular carcinoma (HCC) patients and hepato-biliary cancer and metastatic liver cancer patients. Materials and Methods: From November 2011 to March 2012, we selected HCC patients who gained reduction of diaphragm movement >1 cm through abdominal compressor (diaphragm control, elekta, sweden) for HT (Hi-Art Tomotherapy, USA). We got planning computed tomography (CT) images and 4 dimensional (4D) images through 4D CT (somatom sensation, siemens, germany). The gross tumor volume (GTV) included a gross tumor and margins considering tumor movement. The planning target volume (PTV) included a 5 to 7 mm safety margin around GTV. We classified patients into two groups according to distance between tumor and organs at risk (OAR, stomach, duodenum, bowel). Patients with the distance more than 1 cm are classified as the 1st group and they received SBRT of 4 or 5 fractions. Patients with the distance less than 1 cm are classified as the 2nd group and they received tomotherapy of 20 fractions. Megavoltage computed tomography (MVCT) were performed 4 or 10 fractions. When we verify a MVCT fusion considering priority to liver than bone-technique. We sent MVCT images to Mim_vista (Mimsoftware, ver .5.4. USA) and we re-delineated stomach, duodenum and bowel to bowel_organ and delineated liver. First, we analyzed MVCT images to check the setup variation. Second we compared dose difference between tumor and OAR based on adaptive dose through adaptive planning station and Mim_vista. Results: Average setup variation from MVCT was $-0.66{\pm}1.53$ mm (left-right) $0.39{\pm}4.17$ mm (superior-inferior), $0.71{\pm}1.74$ mm (anterior-posterior), $-0.18{\pm}0.30$ degrees (roll). 1st group ($d{\geq}1$) and 2nd group (d<1) were similar to setup variation. 1st group ($d{\geq}1$) of $V_{diff3%}$ (volume of 3% difference of dose) of GTV through adaptive planing station was $0.78{\pm}0.05%$, PTV was $9.97{\pm}3.62%$, $V_{diff5%}$ was GTV 0.0%, PTV was $2.9{\pm}0.95%$, maximum dose difference rate of bowel_organ was $-6.85{\pm}1.11%$. 2nd Group (d<1) GTV of $V_{diff3%}$ was $1.62{\pm}0.55%$, PTV was $8.61{\pm}2.01%$, $V_{diff5%}$ of GTV was 0.0%, PTV was $5.33{\pm}2.32%$, maximum dose difference rate of bowel_organ was $28.33{\pm}24.41%$. Conclusion: Despite we saw diaphragm movement more than 5 mm with flouroscopy after use an abdominal compressor, average setup_variation from MVCT was less than 5 mm. Therefore, we could estimate the range of setup_error within a 5 mm. Target's dose difference rate of 1st group ($d{\geq}1$) and 2nd group (d<1) were similar, while 1st group ($d{\geq}1$) and 2nd group (d<1)'s bowel_organ's maximum dose difference rate's maximum difference was more than 35%, 1st group ($d{\geq}1$)'s bowel_organ's maximum dose difference rate was smaller than 2nd group (d<1). When applicating SBRT to HCC, abdominal compressor is useful to control diaphragm movement in selected patients with more than 1 cm bowel_organ distance.

• Journal of Distribution Research
• /
• v.17 no.5
• /
• pp.1-23
• /
• 2012

The conflict between major corporations and small and medium-sized businesses is being aggravated, the trickle down effect is not working properly, and, as the controversy surrounding the effectiveness of the business limiting system continues to swirl, the plan proposed to protect the business domain of small and medium-sized businesses, resolve polarization between these businesses and large corporations, and protect small family run stores is the suitable business type designation system for small and medium-sized businesses. The current status of carrying out this system of selecting suitable business types among small and medium-sized businesses involves receiving applications for 234 items among the suitable business types and items from small and medium-sized businesses in manufacturing, and then selecting the items of the consultative group by analyzing and investigating the actual conditions. Suitable business type designation in the service industry will involve designation with priority on business types that are experiencing social conflict. Three major classifications of the service industry, related to the livelihood of small and medium-sized businesses, will be first designated, and subsequently this will be expanded sequentially. However, there is the concern that when designated as a suitable business type or item, this will hinder the growth motive for small to medium-sized businesses, and designation all cause decrease in consumer welfare. Also it is highly likely that it will operate as a prior regulation, cause side-effects by limiting competition systematically, and also be in violation against the main regulations of the FTA system. Moreover, it is pointed out that the system does not sufficiently reflect reverse discrimination factor against large corporations. Because conflict between small to medium sized businesses and large corporations results from the expansion of corporations to the service industry, which is unrelated to their key industry, it is necessary to introduce an advanced contract method like a master franchise or local franchise system and to develop local small to medium sized businesses through a franchise system to protect these businesses and dealers. However, this method may have an effect that contributes to stronger competitiveness of small to medium sized franchise businesses by advancing their competitiveness and operational methods a step further, but also has many negative aspects. First, as revealed by the Ministry of Knowledge Economy, the franchise industry is contributing to the strengthening of competitiveness through the economy of scale by organizing existing individual proprietors and increasing the success rate of new businesses. It is also revealed to be a response measure by the government to stabilize the economy of ordinary people and is emphasized as a 'useful way' to revitalize the service industry and improve the competitiveness of individual proprietors, and has been involved in contributions to creating jobs and expanding the domestic market by providing various services to consumers. From this viewpoint, franchises fit the purpose of the suitable business type system and is not something that is against it. Second, designation as a suitable business type may decrease investment for overseas expansion, R&D, and food safety, as well negatively affect the expansion of overseas corporations that have entered the domestic market, due to the contraction and low morale of large domestic franchise corporations that have competitiveness internationally. Also because domestic franchise businesses are hard pressed to secure competitiveness with multinational overseas franchise corporations that are operating in Korea, the system may cause difficulty for domestic franchise businesses in securing international competitiveness and also may result in reverse discrimination against these overseas franchise corporations. Third, the designation of suitable business type and item can limit the opportunity of selection for consumers who have up to now used those products and can cause a negative effect that reduces consumer welfare. Also, because there is the possibility that the range of consumer selection may be reduced when a few small to medium size businesses monopolize the market, by causing reverse discrimination between these businesses, the role of determining the utility of products must be left ot the consumer not the government. Lastly, it is desirable that this is carried out with the supplementation of deficient parts in the future, because fair trade is already secured with the enforcement of the franchise trade law and the best trade standard of the Fair Trade Commission. Overlapping regulations by the suitable business type designation is an excessive restriction in the franchise industry. Now, it is necessary to establish in the domestic franchise industry an environment where a global franchise corporation, which spreads Korean culture around the world, is capable of growing, and the active support by the government is needed. Therefore, systems that do not consider the process or background of the growth of franchise businesses and harm these businesses for the sole reason of them being large corporations must be removed. The inhibition of growth to franchise enterprises may decrease the sales of franchise stores, in some cases even bankrupt them, as well as cause other problems. Therefore the suitable business type system should not hinder large corporations, and as both small dealers and small to medium size businesses both aim at improving competitiveness and combined growth, large corporations, small dealers and small to medium sized businesses, based on their mutual cooperation, should not include franchise corporations that continue business relations with them in this system.