• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.97-114
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• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• Journal of Nutrition and Health
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• v.17 no.2
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• pp.113-125
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• 1984

The long-term effects of vegetable and animal high fat diet on the lipid metabolism were investigated in male weaning rats. The rats were fed one of four semipurified diet ad libitum : control diet supplied 12% of calories as fat(control group), low fat diet supplied 3% of calories as fat(3% F group), 45% corn oil diet supplied 45% calories from corn oil(45% C group) and 45% butter fat diet supplied 45% calories from butte. fat(45% B group). The weights of liver, content of triacylglycerol(TG), total cholesterol and phospholipid(PL) in liver were investigated. The weight of liver of rats, fed 45% corn oil at 12 weeks and fed 45% butter fat for all period of diet were higher than that of control group. The contents of TG in liver of rats, fed 45% corn oil from 8 weeks and fed 45% butter fat for all period of diet were higher than that of control group. The levels of TG in liver of rats fed 45% butter fat were higher than those of rats fed 45% corn oil. The contents of total lipid and cholesterol in liver of rats were increased with similar trend of TG level, but contents of PL in liver had no relation with the levels and types of dietary fat and feeding periods. The liver of rats were observed histochemically by light microscope. Mild to severe level of fatty changes in liver of 45% C and 45% B group were observed at 8 and 12 weeks of diet. The liver of rats in control group appeared to be healthy and normal electron-microscopically, but in fatty degenerated hepatocytes of 45% C and 45% B group, nuclear membranes were irregular and a great number of intracytoplasmic fat vacuoles in cells were variable in size and low in electon density. The numbers of lysosome were increased and secondary lysosomes among them were observed on electron microscope.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• KSBB Journal
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• v.20 no.5 s.94
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• pp.376-382
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• 2005

Avermectin (AVM) $B_{1a}$ produced by Streptomyces avermitilis via polyketide pathway is a secondary metabolite with powerful anthelmintic and insecticidal activities, thus being used as an efficient agent in the field of agriculture and animal health. It has been reported that a precursor for AVM $B_{1a}$ biosynthesis was isoleucine and the biosynthetic pathway of AVM $B_{1a}$ was closely similar to that of fatty acid. Based on understanding of the biosynthetic pathway of AVM $B_{1a}$, we intended to screen various mutants resistant against O-methyl threonine (OMT), an isoleucine-anti metabolite, and/or mutants resistant against p-fluoro phenoxy acetic acid (pFAC), an inhibitor of fatty acid biosynthesis. It was inferred that these mutants could produce AVM $B_{1a}$ more efficiently, due to the acquired capability of not only overproducing isoleucine intracellularly but also channelling metabolized carbon-sources into the polyketide pathway, thus leading to enhanced biosynthesis of AVM $B_{1a}$. The resulting mutant (PFA-1 strain) resistant against 100 ppm of pFAC was able to produce approximately 42 fold higher amount of AVM $B_{1a}$ compared to the parallel mother strain (4,200 vs. 100 units/l). In addition, through the process of continuous strain improvement program carried out by gradually increasing the OMT concentration, it was possible to obtain a more attractive mutant with greater AVM $B_{1a}$ production capacity (9,000 units/l). Notable was that significantly higher producer (12,000 units/l) could be selected through further screening of the resistant mutants, this time, to even higher concentration of PFAC. Meanwhile, through the analysis of AVM Bla production histograms (i.e., number of strains according to their AVM $B_{1a}$ biosynthetic ability) for the earlier strains in comparison with the high producers having the characteristics of resistance to OMT and pFAC, it was found that production stability of the high-yielding producers were remarkably improved, as demonstrated by the fact that larger proportion of the mutated strains had greater capability of AVM $B_{1a}$ biosynthesis ($71\%$ in the range between 5,000 and 7,000 units/L; $47\%$ in the range between 6,000 and 7,000 units/l). Based on these consequences, it was concluded that the rational screening strategy based on the understanding of the biosynthetic pathway of AVM $B_{1a}$ was very effective in obtaining high-yielding mutants with the features of enhanced production stability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.12-25
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• 2003

Objectives：As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods：Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results：1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion：Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

• Journal of Life Science
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• v.32 no.6
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• pp.447-454
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• 2022

In this study, we confirmed the effect of HK shiitake mushroom mycelium (HKSMM) on immune enhancement in Balb/c mice. Experimental animals were divided into five groups: negative control (NC), positive control (PC; 1,000 mg/100 g; AHCC), T1 (500 mg/100 g; HKSMM), T2 (1,000 mg/100 g; HKSMM), and T3 (2,000 mg/100 g; HKSMM), and dissection was performed at four and six weeks. COX-2 and iNOS concentrations were significantly lower in the six-week experimental group than in the control group, and the NO results were also similar. Results of the confirmation of the factors related to the NF-κB (p-p65 and p-IκBα) and MAPK (pERK, pJNK, and p38) signaling pathways revealed that the HKSMM-fed experimental group significantly decreased compared with the control group. A comparative analysis of the number and size of white pulp in the spleen tissue showed that those of the experimental group were significantly higher than those of the control group in a concentration-dependent manner. These results suggest that HKSMM has both immune-enhancing and anti-inflammatory effects in Balb/c mice, indicating that it can be used as a health functional food ingredient.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.8
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• pp.236-250
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• 2016

This study was conducted to provide baseline data regarding functional cosmetics so that Inula. based cosmetics can increase its competitiveness in the market as well as to understand current trends to enable anticipation of demands for future product development. For this research, general consumers over the age of 20 residing in Seoul and the Gyeonggi district were surveyed. The results show consumers preferred serum-type products among various types of cosmetics, and that they purchased these once every 1-3 months. Consumers also preferred these products in less than 10-30ml capacity, and at costs of less than 30,000-50,000 KRW. For whitening, functional cosmetics consumers also preferred the serum type, in less than 30-50ml capacity and priced less than 30,000-50,000 KRW. Consumers preferred to purchase functional cosmetics in single units. The major purchasing location, with a high preference rate, was cosmetic stores, and the major sources of information, also with high preference rates, were 'experienced reviews from family, friends and acquaintances' and 'TV advertisements'. Respondents selected 'over 50,000 KRW' the most for all items when responding to 'Purchase Intent for Functional Cosmetics containing Inula', and responded that they were willing to pay 10%-30% more for functional cosmetics containing Inula compared to standard functional cosmetics. These results show that businesses in the cosmetics industry need to take consumer demand into account when developing new functional cosmetic products, as well as establish plans to create specialized spaces that provide better quality service and increase word of mouth effect through better utilization of various types of offline media, social media, and blogs. The study also shows a need for businesses to develop products fully utilizing the Inula flower, which has been shown to be effective as a natural skin whitener, wrinkle reducer and skin moisturizer, to appeal to the increasing number of customers interested in health and beauty.

• Journal of Korean Home Economics Education Association
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• v.35 no.4
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• pp.135-149
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• 2023

This study aimed to identify sustainable dietary practices, concepts, and factors that hinder practice from the perspective of high school students and suggest what the current sustainable dietary education should be supplemented. The study utilized photovoice to compare and analyze the differences in sustainable dietary practices based on the implementation of sustainable dietary education among high school students. A group of 7 participants, who did not provide sustainable dietary education, submitted 65 photos, while a group of 8 participants who underwent the education submitted 80 photos. The results of this study showed that the overall awareness of sustainable diet concepts among all participants was highest in the health area (66.54%), followed by the environment (23.74%) and consideration (9.73%). Categorizing the results according to the sustainable dietary area revealed a diverse range of concepts extracted through sustainable dietary education, with an increase in the number of small areas. It was observed that the majority of the research participants were consuming foods with high sugar and sodium content, and they tended to consume more delivery food or dining out rather than cooking meals themselves. Interview results also indicated that while students demonstrated a conceptual understanding of sustainable dietary habits, there were cases where this understanding needed to translate into practical actions. This study is significant in utilizing the qualitative research method of photovoice to uncover the meaning and practical examples of sustainable dietary habits from the perspective of high school students. The results can be utilized to enhance and guide sustainable dietary education programs.

• Korean Journal of Clinical Laboratory Science
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• v.52 no.3
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• pp.284-295
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• 2020

In December 2019, the first coronavirus disease- 2019 (COVID-19) patient was reported in Wuhan, Hubei Province, China. Since then, the number of patients who suffered severe acute respiratory syndrome caused by the novel Coronavirus (SARS-CoV-2 or 2019-nCoV) has increased dramatically in Korea. This new variant virus induces pulmonary diseases, including cough, sore throat, rhinorrhea, dyspnea, and pneumonia. Because SARS-CoV-2 is an RNA virus, real-time reverse-transcriptase PCR has been used widely to diagnose COVID-19. As the Korea Centers for Disease Prevention and Control (KCDC) and Ministry of Food & Drug Safety (MFDS) approved emergency use authorization, clinical specimens collected from COVID-19 patients and even healthy people have been clinically diagnosed by laboratory medicine. Based on a literature search, this paper reviews the epidemiology, symptoms, molecular diagnostics approved by KCDC, a current diagnosis of COVID-19 in the laboratories, the difference between molecular and serological diagnosis, and guidelines for clinical specimens. In addition, the Korean guidelines of biosafety for clinical laboratory scientists are evaluated to prevent healthcare-associated infection. The author's experience and lessons as clinical laboratory scientists will provide valuable insights to protect the domestic and international health community in this COVID-19 pandemic around the world.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.28 no.2
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• pp.202-208
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• 1995

Puksin Bay located in the northwestern pan of Tongyeong, Korea has been contaminated by municipal wastewaters. In Puksin Bay, red tides have occured almost every year since the early 1980's. This experiment was carried out two times in a month in the winter in 1990, the summer' 1991, and the winter in 1994 so as to clarify the distribution marine bacteria and coliform groups in Puksin Bay. The water quality of Puksin Bay was not only move polluted than that of any other costal area around Tongyeong, but also its water quality was investigated to keep going bad. Viable cell counts in Puksin Bay were $4.9\times10^3/ml$ in 1990's winter, $3.6\times10^6/ml$ in 1991's summer, and $2.1\times10^4/ml$ in 1994's winter. The variation of seasonal total and fecal coliform MPN/100ml in Puksin Bay were $6.7\times10^2\;and\;2.6\times10^2$ in 1990's winter, $1.5\times10^4$ and $5.4\times10^3$ in 1991's summer, and $1.5\times10^3$ and $5.6\times10^2$ in 1994's winter, respectively. The changes of stational total coliform MPN/100m1 from station 1 to station 8 in Puksin Bay were 95,000, 1600, 1,000, 182, 151, 94, 43 and 13 in winter, and 110,000, 29,000, 2,400, 4,100, 1,700, 1,700, 810 and 150 in 1991's summer, and 3,381, 1928, 1582, 256, 161, 59 and 23 in 1994's winter. During the study period, the number of viable cell was ranged from $10^4\;to\;10^7/ml$ and 307 bacteria strains were isolated from Puksin Bay. The dominant species were Acinetobacter spp. 86 $(28.3\%)$, Pseudomonas spp. 51 $(16.6\%)$, Flavobacterium spp. 41 $(13.4\%)$, Escherichia coli 36 $(11.7\%)$, and Vibrio spp. 27$(8.8\%)$. The results obtained in this study indicate that this bay is getting to contaminate far more with municipal wastewaters and cultivation of the shellfish and finfish in this bay is not proper. When municiple wastewaters keep flowing into this bay, any other coastal area around Tongyeong may be contaminated.