• Quality Improvement in Health Care
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• v.12 no.1
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• pp.18-39
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• 2006

Background : This study was carried out to examine the changes of job stress after adoption of order communication system(OCS) and its related factors. Methods : Two hundreds and twenty one employees in a university hospital were surveyed 4 months before and 1 year after the OCS had been adopted. Author used Korean version of Karasek's job content questionnaire(K-JCQ) to evaluate job stress. The questionnaire developed by Doll's was used to assess the satisfaction for the OCS. Result : With the adoption of OCS, the scores of skill discretion increased significantly from 29.9 to 30.8 that meant job stress was decreased. In use of OCS, direct user group showed significant increase of skill discretion, whereas the indirect user group showed significant increase in psychological job demand, and it was statistically significant when compared to direct user group(p<0.05). Among the changes in job stress, skill discretion score change was significantly different by age(p<0.05). This study revealed that there was statistically significant relationship between the change of skill discretion score and time computer use, level of satisfaction for content of provided information(p<0.05). And psychological job demand score change was significantly different by time of computer use(p<0.05). Conclusion : Adoption of OCS into hospital may increase job stress, but when it is adopted wisely and appropriately, it may enhance skill discretion of each individual, and decision authority while reducing psychological job demand.

• Tuberculosis and Respiratory Diseases
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• v.54 no.1
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• pp.71-79
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• 2003

Background : A bronchoalveolar lavage(BAL) is useful in diagnosing the etiology of bilateral pulmonary infiltrations, but may worsen the oxygenation and clinical status in severely hypoxemic patients. This study assessed the safety and efficacy of the continuous positive airway pressure(CPAP) using a conventional mechanical ventilator via a face mask as a tool for maintaining the oxygenation level during BAL. Methods : Seven consecutive patients with the bilateral pulmonary infiltrates and severe hypoxemia ($PaO_2/FIO_2$ ratio ${\leq}200$ on oxygen 10 L/min via mask with reservoir bag) were enrolled. The CPAP 5-6 $cmH_2O(F_IO_2\;1.0)$ was delivered through an inflatable face mask using a conventional mechanical ventilator. The CPAP began 10 min before starting the BAL and continued for 30 min after the procedure was completed. A bronchoscope was passed through a T-adapter and advanced through the mouth. BAL was performed using the conventional method. The vital signs, pulse oxymetry values, and arterial blood gases were monitored during the study. Results : (1) Median age was 56 years(male:female=4:3). (2) The baseline $PaO_2$ was $78{\pm}16mmHg$, which increased significantly to $269{\pm}116mmHg$(p=0.018) with CPAP. After the BAL, the $PaO_2$ did not decrease significantly but returned to the baseline level after the CPAP was discontinued. The $SpO_2$ showed a similar trend with the $PaO_2$ and did not decrease to below 90 % during the duration of the study. (3) The $PaCO_2$ increased and the pH decreased significantly after the BAL but returned to the baseline level within 30 min after the BAL. (5) No complications directly related to the BAL procedure were encountered. However, intubation was necessary in 3 patients(43 %) due to the progression of the underlying diseases. Conclusion : In severe hypoxemic patients, CPAP using a face mask and conventional mechanical ventilator during a BAL might allow minimal alterations in oxygenation and prevent subsequent respiratory failure.

• Journal of Periodontal and Implant Science
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• v.37 no.1
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• pp.91-102
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• 2007

The long term success of periodontal treatment is dependent upon the effectiveness of the main-tenance care program after active treatment. The purpose of this study was to evaluate whether nutraceutical containing PRF-K2 as natural product from plant and seaweed has beneficial effects on clinical parameters, gingival crevicular fluid (GCF) volume and GCF cytokine levels during main- tenance phase after periodontal treatment. Among the generally healthy and non-smoking. moderate to severe chronic periodontitis patients during maintenance phase in Department of Periodontics, Chonnam National University Hospital, twenty eight patients took nutraceutical containing PRF-K2 (Oscotec Inc. Cheonan, Korea) for 3 months as experimental group and sixteen patients received only maintenance care as control group. Clinical examination and GCF collection were performed at baseline, 1, 2 and 3 months of experiment. Total amounts and concentrations of GCF IL-1{\beta}, IL-1ra and $PGE_2$ were evaluated using ELISA kit. In probing pocket depth, experimental group showed the tendency of more reduction than control group after 3 months of experiment. Sulcus bleeding index (SBI) and GCF volume were significantly decreased in experimental group(p<0.05), whereas they were increased in control group. GCF IL-1{\beta} level tended to decrease in both experimental and control group and IL-1ra concentration tended to increase in experimental group and to decrease in control group. IL-1ra/IL-1{\beta} ratio tended to increase in experimental group and to decrease in control group during experimental period. GCF $PGE_2$ amount did not show any change in experimental group and tended to increase in control group. These results suggest that nutraceutical supplement which contain PRF-K2 could improve perio-dontal condition during maintenance phase after periodontal therapy.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.376-386
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• 2001

I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.

• The Journal of the Korean dental association
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• v.52 no.3
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• pp.153-163
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• 2014

3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.753-762
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• 2020

Objectives: This study was aimed at evaluating the effects of changes in the oral environment of the elderly in long-term care facilities after the intake of Weissella cibaria. Methods: The test group ingested the W. cibaria strain Chonnam Medical University (CMU), and the control group ingested the control food. Of all randomized trial subjects, 62 were analyzed (32 in the experimental group and 30 in the control group). In this 8-week demographic study, we evaluated self-perceived halitosis, changes in halitosis, sensory test results, tongue plaque index scores, saliva buffering capacity, and the salivary flow rate. Results: The W. cibaria CMU intake in the elderly in long-term care facilities during the experimental period did not demonstrate statistically significant changes in the salivary flow rate. However, self-perceived halitosis, organoleptic test results, tongue plaque index scores, and salivary buffering capacity demonstrated statistically significant differences between the experimental and control groups. These findings partially confirmed the beneficial effects of the W. cibaria CMU on the oral environment in the elderly. Conclusions: Research results on the role of probiotics in the oral cavity should be summarized, and utilization plans should be sought to obtain a clearer understanding of the clinical efficacy and related factors. The value of probiotic use may be high in improving the oral health of people by enabling treatment and prevention.

• Journal of Society of Preventive Korean Medicine
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• v.22 no.2
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• pp.25-32
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• 2018

Objectives : This study was conducted to investigate the frequent diseases among the people who had been treated by collaborative treatment of Korean medicine and Western medicine, and to compare their medical use behaviors before and after the collaborative first-stage pilot project between Korean medicine and Western medicine. Methods : 4,467 patients were identified as the patients who are participated in the collaborative first-stage pilot project between Korean medicine and Western medicine during the period between July 15, 2016 and March 31 2017. We used 28,480 records of Korean national health insurance claim data from January 1 2016 to March 31 2017 to analyzed present condition of cooperative medical usage. Also we conducted a paired t test to compare the percentage of collaborative treatment days before and after the pilot project period. Results : We found that the most frequent diseases treated in the pilot project were the diseases of musculoskeletal and nervous system and then 10 major diseases such as H, K, J, C (D), N, L, E, A, H and F disease codes in order. Also it was confirmed that 14 major and 53 medium diseases are included from more than 90% of total patients. As a result of high frequency of medical treatment in Western medicine or Korean medicine is "administration of Korean medicine", which is same as before and within the pilot project. The ratio of utilizing both Western and Korean medical care for the same disease on the same day by both general patients and patients in KCD-7 disease code group C, G, I, M and S had been increased significantly. Conclusions : The pilot project might change the behavior of utilizing the medical care service by increasing the ratio of collaborative treatment of Western medicine and Korean medicine for the same disease on the same day.

• Korean Journal of Ecology and Environment
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• v.38 no.2 s.112
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• pp.207-216
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• 2005

Spawning behaviors of Squalidus gracilis majimae (Cyprinidae) were observed in the laboratory whose environmental factors such as light (D/L = 16 : 8), temperature ($20\;{\sim}\;24\;＾{\circ}C$), and dissolved oxygen (>8 mg $L^{-1}$) were quite regularly controlled. The behavioral patterns were categorized into three stages ofpre-spawning, spawning, and Post-spawning behaviors. In Particular, the pre-spawning stage was specified by 11 specific behavioral patterns of aggressive mating behaviors. During the spawning stage, the male and female performed four distinct spawning behaviors including sexual temptation, stimulation, egg spawning, and the separation, and randomly laid about 200 ${\sim}$ 300 eggs on the bottom substrates through the night. After finishing spawning, two adults separated toward their refuges and showed 3 types of post-spawning behaviors such as the resting, occasional eggs protecting, and the egg eating. The fish was identified as a partial-parental care species after the spawning.

• Journal of Trauma and Injury
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• v.37 no.1
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• pp.6-12
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• 2024

Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.596-603
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• 2006

Purpose. This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. Methods. A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. Results. Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, 'SARS-patient caring would be a new experience', 'during SARS-patient caring, I should be apart from my family', 'after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event' and 'with my SARS-patient caring, patients could recover from SARS' were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, 'SARS-patient caring would be a challenge' 'SARS-patient caring is a professional responsibility', 'tension during the care of SARS patients' and 'support from team members' were the significant determinants of the intentions. Conclusions. Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.