• Tuberculosis and Respiratory Diseases
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• v.69 no.2
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• pp.75-80
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• 2010

The year of 2009~2010 brought a number of concepts and new ideas were evaluated with promising results. However, some studies that challenged many beliefs. In acute respiratory distress syndrome (ARDS), recent clinical studies took into consideration of pathophysiologic changes of respiratory system compliance. Meta-analysis of positive end-expiratory pressure trials showed survival benefit of high positive end-expiratory pressure in ARDS. Until now, prone positioning did not show survival benefit in patients with ARDS. Extracorporeal membrane oxygenation (ECMO) based management improved survival in patients with severe ARDS. ECMO can be a management option in severe ARDS. Sedation is a standard practice in critically ill patients needing mechanical ventilation. However, Danish group reported less sedation of critically ill patients receiving mechanical ventilation was associated with an increase in days without ventilation. Although this single center study has some limitations, the overall results are promising. Use of maximal sterile barrier precautions (mask, sterile gown, sterile gloves, and large sterile drapes) with chlorhexidine-impregnated dressing reduced central venous catheter related infection. Selective oropharyngeal decontamination (application of topical antibiotics in the oropharynx) reduced the mortality rate of an intensive care unit (ICU) population. Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial reported intensive glucose control increased mortality among adults in the ICU. Some of the results of above papers are promising. However, some ideas may need for more frequent individual assessment and increase the workload of ICU staffs. Before implementation of new practice in ICU, we should take into consideration of individual hospital situation including human and material resources.

• Nutrition Research and Practice
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• v.12 no.3
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• pp.215-221
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• 2018

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

• Korean Journal of Construction Engineering and Management
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• v.20 no.5
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• pp.95-103
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• 2019

While the Design for Safety (DFS) system has been introduced to Korea, the ordering parties and designers who are implementing this system still have a very low awareness of it. Most ordering parties and designers have a negative view of this system due to a variety of reasons, including the additional workload and their lack of professional manpower. The purpose of this study is to suggest measures to improve the DFS work performance by standardizing the DFS work process and analyzing the level of work performance in each business carried out by ordering parties and designers in order to ensure the efficient execution of DFS business. In conclusion, to improve the DFS work performance of ordering parties and designers, the development of a business support system is suggested, which supports key works such as the identification of risk factors, the provision of measures to reduce such factors, and risk assessment, and provides relevant information to allow ordering parties and designers to prepare the DFS report smoothly.

• Journal of the Korean Society of Safety
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• v.38 no.4
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• pp.32-38
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• 2023

Job stress factors are factors that induce biological, psychological, and behavioral responses in individuals when they encounter mental and physical stimuli in the workplace. According to occupational safety and health standards, employers are responsible for the health consequences of job stress when workers engage in activities that result in high levels of physical fatigue and mental stress. Such activities include long working hours, shift work (including night shifts), driving vehicles, and operating precision machinery. Therefore, precautionary measures should be implemented. Following the COVID-19 epidemic, the logistics industry in Korea has experienced rapid growth owing to the shift from offline to online platforms facilitated by advanced digital infrastructure. Consequently, this study conducted a survey to analyze job stress factors among delivery workers. The survey utilized a Korean job stress factor assessment tool comprising 43 items and analyzed job stress factors considering the work characteristics of the courier business field obtained from responses provided by 421 courier workers nationwide. The survey analysis revealed that the physical environment, job demands, and job autonomy exhibited higher stress indices among Korean workers. Furthermore, the younger the age, the higher the stress on job demands, whereas the higher the age, the higher the stress on relationship conflict, job instability, and workplace culture. In addition, daytime delivery work was associated with higher stress levels in job demands and job instability compared with nighttime delivery work. These findings can serve as foundational data for reducing and preventing job stress among courier workers, whose workload has increased owing to the growth of the logistics industry.

• 한국벤처창업학회:학술대회논문집
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• 2006.04a
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• pp.167-201
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• 2006

Korean corporations are transforming their vertical operational structure to a team-based structure to compete in the rapidly changing environment and for improved performance. However, a high percentage of the respondents in KBS said that despite the appearance of the present team structure, the organization operates much like a vertically-structured organization. This result can be attributed to the lack of study and implementation toward the goal of empowerment, the key variable for the success of the team-based structure. This study aims to provide policy suggestions on how to implement the process of empowerment, by investigating the conditions that hinder the process and the attitude of the KBS employees. For the cross-sectional study, this thesis examined the domestic and international references, conducted a survey of KBS employees, personal interviews and made direct observations. Approximately 1,200 copies of the Questionnaire were distributed and 474 were completed and returned. The analysis used SPSS 12.0 software to process the data collected from 460 respondents. For the longitudinal-study, six categories that were common to this study and "The Report of the Findings of KBS Employees' View of the Team Structure" were selected. The comparative study analyzed the changes in a ten-month period. The survey findings showed a decrease of 24.2%p in the number of responses expressing negative views of the team structure and a decrease of 1.29%p in the number of positive responses. The findings indicated a positive transformation illustrating employees' improved understanding and approval of the team structure. However, KBS must address the issue on an ongoing basis. It has been proven that the employee empowerment increases the productivity of the individual and the group. In order to boost the level of empowerment, the management must exercise new, innovative leadership and build trust between the managers and the employees first. Additional workload as a result of shirking at work places was prevalent throughout all divisions and ranks, according to the survey data. This outcome leads to the conclusion that the workload is not evenly distributed or shared. And the data also showed the employees do not trust the assessment and rewards system. More attention and consideration must be paid to the team size and job allocation in order to address this matter; the present assessment and rewards system need to be complemented. The type of leadership varies depending on the characteristics of the organization's structure and employees' disposition. KBS must develop and reform its own management, leadership style to suit the characteristics of individual teams. Finally, for a soft-landing of KBS team structure, in-house training and education are necessary.

• Korean Journal of Construction Engineering and Management
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• v.18 no.3
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• pp.63-73
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• 2017

In contemporary society, it is increasingly common to spend more time indoors. As such, there is a continually growing desire to build comfortable and safe indoor environments. Along with this trend, however, there are some serious indoor-environment challenges, such as the quality of indoor air and Sick House Syndrome. To address these concerns the government implements various systems to supervise and manage indoor environments. For example, green building certification is now compulsory for public buildings. There are three categories of green building certification related to indoor air in Korea: Health-Friendly Housing Construction Standards, Green Standard for Energy & Environmental Design(G-SEED), and Indoor Air Certification. The first two types of certification, Health-Friendly Housing Construction Standards and G-SEED, evaluate data in a drawing plan. In comparison, the Indoor Air Certification evaluates measured data. The certification using data from a drawing requires a considerable amount of time compared to other work. A 2D tool needs to be employed to measure the area manually. Thus, this study proposes an automatic assessment process using a Building Information Modeling(BIM) model based on 3D data. This process, using open source Industry Foundation Classes(IFC), exports data for the certification system, and extracts the data to create an Excel sheet for the certification. This is expected to improve the work process and reduce the workload associated with evaluating indoor air conditions.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• Korean Journal of Construction Engineering and Management
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• v.17 no.6
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• pp.40-52
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• 2016

In the 1960s and 1970s when Korea experienced rapid economic growth, a considerable number of buildings were constructed in the country. And since 2000, a large number of sizable and complex buildings have been being built. Specifically, as the operation and maintenance cost alone accounts for 85% of the life cycle cost of a building, efficient Facility Management (FM) is required. However, data needed in the operation and maintenance phase are not sufficiently exchangeable with data created in other phases like the planning, design and construction phases. The upper phase has higher value of data but data exchange rate is low, resulting in inefficiency. To this end, this research derived major business functions for facility management: three categories and 19 detailed functions in classification from owner's perspective. Based on the derived items, this research proposes a methodology to evaluate the 'FM Workload', 'Facility Management (FM) Data', and 'FM Data Created in Engineering and Construction Phases' thereby analyzing plans for efficient operation and maintenance. The applicability of proposed methodology was tested by examining real-world cases of public and private companies.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.119-128
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• 2017

This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.

• Journal of The Korean Association For Science Education
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• v.30 no.5
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• pp.609-620
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• 2010

The purpose of this study was to examine school-level science elective-centered curriculum operation and teachers' perception of their instruction of elective-centered science courses. Data were collected from 12 science teachers in 12 high schools in the metropolitan Seoul area through semi-constructed interviews. The results showed that students were supposed to select science subjects under insufficient guidance and their choices on subject were also restricted due to school administrative processes such as teacher's instructional time allocation. Participants were well-perceived different group characteristics among humanities course and science course students toward science learning, still, they felt difficulties in valuing students' variety by differentiating contents and teaching methodologies due to school assessment system and workload of extra instructional material preparation. Influenced by the current college entrance examination system, low motivation for humanities course students and students' choice concentrated in chemistry and life science for science course students, were pointed out as main problems. As a way to improve science education for 11th - 12th graders, developing customized science curriculum for humanities course and science course respectively, changing of entrance system into increasing importance of science for students who will major in non-science fields, and designations of essential prerequisite science subject for students who will major in engineering & science fields, were suggested.