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A Study of Effectiveness of Outpatient Treatment Orders and Compliance with Outpatient Treatment (외래치료 명령제의 실효성과 외래 치료 순응도에 관한 연구)

  • Jang, Seung-Ho;Park, In-Hwan;Lee, Sang-Yeol;Roh, Suhee;Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.46-55
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    • 2017
  • Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

Development of nutrition quotient for Korean preschoolers (NQ-P): Item selection and validation of factor structure (취학전아동 대상 영양지수 개발 : 평가항목 선정과 구성 타당도 검증)

  • Lee, Jung-Sug;Kang, Myung-Hee;Kwak, Tong-Kyung;Chung, Hae Rang;Kwon, Sehyug;Kim, Hye-Young;Hwang, Ji-Yun;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.49 no.5
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    • pp.378-394
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    • 2016
  • Purpose: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). Methods: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. Results: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. Conclusion: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.

Agency Costs of Clothing Companies with Famous Brand (유명 의류 상호 기업의 대리인 비용에 관한 연구)

  • Gong, Kyung-Tae
    • Management & Information Systems Review
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    • v.36 no.4
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    • pp.21-32
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    • 2017
  • Motivated by the recent cases of negligent social responsibility as manifested by foreign luxury fashion brands in Korea, this study investigates whether agency costs depend on the sustainability of different types of corporate governance. Agency costs refer either to vertical costs arising from the relationship between stockholders and managers, or to horizontal costs associated with the potential conflicts between majority and minority stockholders. The firms with luxury fashion brand could spend large sums of money on maintenance of magnificent brand image, thereby increasing the agency cost. On the contrary, the firms may hold down wasteful spending to report a gaudily financial achievement. This results in mitigation of the agency cost. Agency costs are measured by the value of the principal component. First, three ratios are constructed: asset turnover, operating expense to sales, and earnings before interest, tax, and depreciation. Then, the scores of each of these ratios for individual firms in the sample are differenced from the ratios for the benchmark firm of S-OIL. S-OIL was designated as the best superior governance model firm for 2013 by CGS. We perform regression analysis of each agency cost index, luxury fashion brand dummy and a set of control variables. The regression results indicate that the agency costs of the firms with luxury fashion brand exceed those of control group in the fashion industry in the part of operating expenses, but the agency cost falls short of those of control group in the part of EBITD, thus the aggregate agency costs are not differential of those of the control group. In sensitivity test, the results are same that the agency cost of the firms are higher than those of the matching control group with PSM(propensity matching method). These results are corroborated by an additional analysis comparing the group of the companies with the best brands with the control group. The results raise doubts about the effectiveness of management of the firms with luxury fashion brand. This study has a limitation that the research has performed only for 2013 and this paper suggests that there is room for improvement in the current research methodology.

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A Study on Curriculum Improvement of the Korea Army Nursing Academy (국군간호사관학교 교육과정 개선을 위한 기초 연구)

  • 고자경
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.22-43
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    • 1983
  • 1. Need for and Purpose of the Study. There is an increasing demand for curriculum improvement of the Korean Army Nursing Academy (KANA), since it was upgraded into 4-year institution of higher learning from 3-year one. In particular, it is strongly advocated that the KANA needs the outside expertise for its curriculum improvement-namely not only from the internal military view of points but also from the viewpoints of professional educational society, In line with such a necessity for the study, this study was aimed at 1) analyzing the current actual practices of KANA'S curriculum, 2) investigating the desired practices of KANA'S curriculum, and 3) identifying the discrepancy between the actual and desired practices of curriculum. 2. Problems for the Study This study had 4 problems to be answeared as follows: 1) What are the actual curriculum practices of KANA? 2) What are the desired curriculum practices of KANA? 3) How are the extents of perception of actual and desired curriculum different in four groups (student, faculty & administrator, nurse, and medical doctor in militay hospital) ? 4) What are the restraining forces that impede the change from actual to desired curriculum practices? 5) What are the relationships of curriculum component,』 in actual and desired curriculum practices? 3. Methods and Procedures This study was conducted by means of document analysis in addition to literature review and by means of needs assessment questionnaire which was developed by the researcher. The questionnaire included 62 statments with 7 questions for demographic data collection. The needs assessment questionnaire was managed to a total of 243 subjects (100 students, 46 faculty & administrators, 55 nurses, and 42 medical doctors), The collected data were treated using SPSS computer system so as to calculate mean scores, standard deviations, and correlation coefficients. The significance test was made through t-test and one-way ANOVA. The statistical significance level was set at both .05 and .01 level. 4. Major findings The major findings in this study are as follows: 1) The score of desired practices was significantly greater than that of actual practices, representing a strong need for curriculum betterment. 2) There were significant differences in the perceptions of actual practices as well as desired practices among four groups (student, faculty & administrater, nurse, and medical doctor). 3) The most frequently selected restraining forces were army's inherent character, economical limitation, and educational expertise limitations. 4) Such variables as sex, position attachment to the KANA and grade made a statistically significant effect on the perception of desired curriculum practice, while the variables like marrige, position, and military class made it on the perception of actual curriculum practice. 5) The coefficients among the curriculum components were lower in perception of the actual curriculum practices than those in the desired practices. 5. Conclusions The conclusions based on the major findings of this study are as follows: 1) The current curriculum development procedure of the KANA is not consistent with the theoretical frame of systematic development sarategy of curriculum. 2) There are wide conflicts among the groups who are supposed to participate in curriculnm development, concerning the actual and desired practices of KANN'S curriculum. 3) A great deal of need for curriculum improvement for the KANA is clearly felt, and in particular, in the process of teaching and learning. 4) Each component of curriculum is not intergrated into a whole development procedure, being segregated each other. 5) For better curriculum improvement, such restraining forces as financial and professional limitations should be eliminated. 6. Recommendations 1) For Further Research a. There is a need to replicate this study after in-depth statistical analysis of each item of need assessment questionnaire, and with more representative subjects. b. A study should be conducted which. has its focus on the analysis of restraining forces for the change from actual to desired curriculum practices of the KANA. 2) For KANA'S Curriculum Improvement a. There is a need to promote the professional expertise of the participants in curriculum development and the communication among them. b. It is desirable to establish an institution or section of administration, which is soley in charge of curriculum development. c. To better develop KANA's curriculum not only faculty and administrators but also students should be encouraged to participate in development process, while the military medical doctors' participation should be carefully considered.

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Review of a Plant-Based Health Assessment Methods for Lake Ecosystems (식물에 의한 호수생태계 건강성 평가법에 대한 고찰)

  • Choung, Yeonsook;Lee, Kyungeun
    • Korean Journal of Ecology and Environment
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    • v.46 no.2
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    • pp.145-153
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    • 2013
  • It is a global trend that the water management policy is shifting from a water quality-oriented assessment to the aquatic ecosystem-based assessment. The majority of aquatic ecosystem assessment systems were developed solely based on physicochemical factors (e.g., water quality and bed structure) and a limited number of organisms (e.g., plankton and benthic organisms). Only a few systems use plants for a health assessment, although plants are sensitive indicators reflecting long-term disturbances and alterations in water regimes. The development of an assessment system is underway to evaluate and manage lakes as ecosystem units in the Korean Ministry of Environment. We reviewed the existing multivariate health assessment methods of other leading countries, and discussed their applicability to Korean lakes. The application of multivariate assessment methods is costly and time consuming, in addition to the correlation problem among variables. However, a single variable is not available at this moment, and the multivariate method is an appropriate system due to its multidimensional evaluation and cumulative data generation. We, therefore, discussed multivariate assessment methods in three steps: selecting metrics, scoring metrics and assessing indices. In the step of selecting metrics, the best available metrics are species-related variables, such as composition and abundance, as well as richness and diversity. Indicator species, such as sensitive species, are the most frequently used in other countries, but their system of classification in Korea is not yet complete. In terms of scoring metrics, the lack of reference lakes with little anthropogenic impact make this step difficult, and therefore, the use of relative scores among the investigated lakes is a suitable alternative. Overall, in spite of several limitations, the development of a plant-based multivariate assessment method in Korea is possible using mostly field research data. Later, it could be improved based on qualitative metrics on plant species, and with the emergence of further survey data.

The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

Preoperative Evaluation of Lower Rectal Cancer by Pelvic MR with and without Gel Filling (하부직장암 환자에서 초음파겔 삽입 전후의 골반 자기공명영상의 비교)

  • Kim, Dae Jung;Kim, Joo Hee;Lim, Joon Seok;Chung, Jae-Joon;Yu, Jeong-Sik;Kim, Myeong-Jin;Kim, Ki Whang
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.4
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    • pp.323-331
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    • 2014
  • Purpose : To assess the usefulness of rectal filling using ultrasonographic gel in patients with lower rectal cancer. Materials and Methods: Twenty five patients with lower rectal cancer were enrolled. High resolution pelvic MR was performed twice before and after gel filling. Independently and retrospectively, two radiologists reviewed each set of MR images using five-grade scales for sphincter involvement, CRM (circumferential resection margin) involvement and depiction of the tumor. Same two radiologists retrospectively performed consensus review of each set of MR images for tumor distance from the anal verge and T&N staging. Results: Tumor depiction scores from MR with gel filling were significantly higher than those of MR without distention (p<0.001). Compared to MR without distension, MR with gel filling had no significant differences in prediction of CRM or sphincter involvement (p>0.05). Distance from the anal verge was significantly different between MR with gel filling and rigid endoscopy ($6.8{\pm}1.6cm$ vs. $5.8{\pm}1.6cm$, p=0.001). There were no significant differences between pathological staging and MR staging with or without gel filling. Conclusion: MR with gel filling improved tumor depiction. And also MR with gel filling revealed same ability for the predictions of CRM or sphincter invasion in patients with lower rectal cancer, comparing with MR without gel filling.

An Analysis of the Relationship of Grit, Interest, Task-Commitment, Self-Regulation Ability, and Science Achievement of High School Students (고등학생의 투지, 흥미, 과제집착력, 자기조절능력 및 과학학업성취의 관계 분석)

  • Mun, Kongju;Ham, Eun Hye
    • Journal of The Korean Association For Science Education
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    • v.36 no.3
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    • pp.445-455
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    • 2016
  • The purpose of this study is to identify the structural relationship among students' grit, interest, self-regulation ability, task-commitment and achievement within science learning. Our concern is understanding how grit is related to the other non-cognitive variables, i.e., interest, self-regulation ability, and task-commitment, which are widely known as significant predictors of science achievement. Based on literature review, we evaluated two hypothetical models in the frame of structural equation modeling as follows: first, grit was assumed to mediate relations of interest and self-regulation ability, and interest and task-commitment. Second, grit was assumed to have a direct effect on self-regulation ability and task-commitment independent of interest. In both models, grit was assumed to be indirectly associated with science achievement. A total number of 180 high school students (77 boys, 103 girls) participated in surveys on grit, interest, self-regulation ability, and task-commitment and reported their science test scores on mid-term/final exams. Results revealed that students' grit and interest were indirectly associated with their science achievement with the mediation of their self-regulation and task-commitment. We also found that task-commitment was highly correlated with interest and self-regulation. Furthermore, we found different patterns of correlations within the five variables between female and male students. From these results, we suggested that researchers need to investigate whether students' grit and task-commitment can explain their interest decreasing as they move to higher grade levels, how teachers can help students to maintain their interest in learning science from early childhood, and relationships of these non-cognitive variables and science achievement.

Framework on Soil Quality Indicator Selection and Assessment for the Sustainable Soil Management (지속가능한 토양환경 관리를 위한 토양질 지표의 선정과 평가체계)

  • Ok, Yong-Sik;Yang, Jae-E.;Park, Yong-Ha;Jung, Yeong-Sang;Yoo, Kyung-Yoal;Park, Chol-Soo
    • Journal of Environmental Policy
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    • v.4 no.1
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    • pp.93-111
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    • 2005
  • Defining soil quality in scopes and applications is one of the prerequisite for the sustainable management of soil environment to orient researches, strategies and policies. However, definition of soil quality is controversial depending upon a viewpoint of soil science or soil environment. Soil quality can be, irrespective of the disciplines, defined as the capacity of a soil to function within ecosystem boundaries to sustain biological productivity, maintain environmental quality and promote plant and animal health. Common to all of the soil quality concepts can be summarized as the capacity of soil to function effectively at present and in the future. The OECD includes soil quality as one of the agri-environment indicators. This article intends to i) summarize the current soil quality research, and ii) provide information on protocol of soil quality assessment. A framework for soil quality was divided into three steps: indicator selection as minimum data set (MDS), scoring of the selected indicators, and integration of scores into soil quality index. Korean government suggested possible physical and chemical indicators such as bulk density and organic matter for paddy and upland soils to OECD. The framework of soil quality assessment is not yet implemented in Korea. Countries such as USA, Canada and New Zealand have constructed the framework on soil quality assessment and developed a user-friendly version of soil quality assessment tools to evaluate the integrated effects of various soil management practices. The protocol provided in this review might help policymakers, scientists, and administrators improve awareness about soil quality and understand the way of soil environment management.

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Development of NQ-E, Nutrition Quotient for Korean elderly: item selection and validation of factor structure (노인 대상 영양지수 개발 : 평가항목 선정과 구성 타당도 검증)

  • Chung, Min-Jae;Kwak, Tong-Kyung;Kim, Hye-Young;Kang, Myung-Hee;Lee, Jung-Sug;Chung, Hae Rang;Kwon, Sehyug;Hwang, Ji-Yun;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.51 no.1
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    • pp.87-102
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    • 2018
  • Purpose: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. Methods: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. Results: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. Conclusion: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.