• Journal of Nutrition and Health
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• v.51 no.5
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• pp.386-399
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• 2018

Purpose: This study examined whether the supply of healthy Korean diets for 12 weeks is effective in improving the risk factors related to serum GGT and cardiovascular diseases in patients with hypertension and diabetes. Methods: This study selected 41 patients, who were treated with hypertension and diabetes. The Korean diet was composed of cooked-rice, soup, kimchi, and various banchan with one serving called bapsang, which emphasize proportionally high consumption of vegetables and fermented foods, moderate to high consumption of legumes and fish, and low consumption of animal foods. The control group was instead instructed to "eat and exercise as usual" while following the Korean Diabetes Association's dietary guidelines with an intake that can assist in glycemic control, maintain adequate weight, and meet the nutritional requirements. The Korean diet group (21 patients) were served three healthy Korean meals a day for 12 weeks, and the control group (20 patients, who trained in the diet guideline of diabetes) maintained their usual diabetic diet. The serum GGT, blood pressure, heart rate, glycemic control data, cardiovascular risk indicators, and changes in diet measured at the four visits (week 0, 4, 8, and 12) during the course of 12 weeks were compared and evaluated. Results: The serum GGT (p < 0.001), HbA1c (p = 0.004), heart rate (p = 0.007), weight (p = 0.002), Body Mass Index (p = 0.002), body fat mass (p < 0.001), body fat (%) (p < 0.001), and free fatty acid (p = 0.007) in the Korean diet group decreased significantly after the dietary intervention compared to the control group. The amount of intake of rice, whole grains, green vegetables, Kimchi, and soybean fermented food were increased significantly compared to the control group (p < 0.001). The Korean diet group showed significant decreases (p < 0.001) in the intake of animal protein, lipid, and cholesterol derived from animal foods compared to the control group but significant increases (p < 0.001) in the intake of total calories, folic acid, dietary fiber, sodium, potassium, and vitamins A, E, and C. Conclusion: In patients with hypertension and diabetes, it was confirmed that regular eating of a healthy Korean diet helps improve the risk factors for GGT and cardiovascular diseases.

• KDI Journal of Economic Policy
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• v.12 no.3
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• pp.153-172
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• 1990

The present paper investigates the potential value of strategic antitrust policy in an oligopolistic international market. The market is characterized by a non-cooperative Cournot-Nash equilibrium and by asymmetry in costs among firms in the world market. The model is useful for two reasons. First, it is important in the context of policy-making to examine the conditions under which it may be beneficial to relax antitrust law to enhance competitiveness. Second, the explicit derivation of the level of cost-saving required for a gain in total domestic surplus provides an empirical rule for excluding industries that do not satisfy the requirements for a socially beneficial antitrust exemption. Results of the analysis include a criterion that tells how the cost-saving and concentration effects of a merger offset each other. The criterion is derived from fairly general assumptions on demand functions and is simple enough to be applied as a part of the merger guidelines. Another interesting policy implication of our analysis is that promoting mergers would not be a beneficial strategy in a net importing industry where cost-saving opportunities are thin. Cost-saving domestic mergers are more likely to increase national welfare in exporting industries. The best candidate industries for application of strategic antitrust policy are those with the following characteristics: (i) a large potential for efficiency enhancement; (ii) high market concentration at the world but not the domestic level; (iii) a high ratio of exports to imports. Recently, many policymakers and economists in Korea have also come to believe that the appropriate antitrust policy in an era of increased foreign competition may actually be to encourage rather than to prohibit domestic mergers. The Industry Development Act of 1986 and the proposed bill for Mergers and Conversions in the Financial Industry of 1990 reflect this changing perspective on antitrust policy. Antitrust laws may burden domestic firms in the sense that they have a more constrained strategy set. Expenditures to avoid antitrust attacks could also increase costs for domestic firms. But there is no clear evidence that the impact of antitrust policy is significant enough to harm the competitiveness of domestic firms. As a matter of fact, it is necessary for domestic financial institutions to become large in scale in this era of globalization. However, the absence of empirical evidence for efficiency enhancement from mergers suggests caution in the relaxation of antitrust standards.

• Korean Journal of Environment and Ecology
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• v.34 no.1
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• pp.72-84
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• 2020

The purpose of this study is to provide a reference for the development of forest therapy programs for subfertile women. This exploratory study identifies the emotional characteristics of subfertile women and the demands for forest therapy according to the emotional characteristics and provides basic data for the development and operation of forest therapy programs. This study surveyed 200 subfertile women who visited a subfertility hospital in Seoul on 33 items of subfertile women's emotional characteristics and requirements of forest therapy programs. We conducted the frequency analysis, cross-analysis, and one-way ANOVA to determine the correlation and importance between the emotional characteristics of subfertile women and the demands for forest therapy programs using the SPSS 21.0 program. Emotional traits of subfertile women included pressure on pregnancy, anxiety/fear, depression, hopelessness, helplessness, loneliness, sadness, shame/guilt, impatience/frustration, and anger/hypersensitivity. Of these traits, pressure on pregnancy, depression, hopelessness, helplessness, loneliness, sadness, anger/hypersensitivity, and anxiety/fear were particularly high among subfertile women. The demands for forest therapy programs also differed according to the emotional characteristics of subfertile women. There was a significant difference in the operation mode of the subfertile couple's forest therapy program according to the pressure, shame, and guilt of pregnancy. There was a significant difference in the experience of participating in a program according to anxiety and fear and in the reason for not being able to participate in the forest therapy program according to depression, hopelessness, helplessness, loneliness, and sadness. There was a significant difference in couples participating the in the forest therapy program according to impatience and frustration. There was a significant difference in the experience of participating in the forest therapy program and the effect of self-help groups through the forest therapy program for subfertile women according to anger and hypersensitivity. We expect that the results of this study would be useful as the reference data for developing forest therapy programs for the improvement of the mental health of subfertile women.

• Journal of the Korean Geosynthetics Society
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• v.14 no.4
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• pp.59-77
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• 2015

In order to meet the new requirements for landfill materials, this study planned a study to apply mixed soil of mixing bottom ash and coastal dredged soil to the dredged ground. Coal ash generated from thermal power plant is divided into fly ash and bottom ash. In the case of fly ash, many studies have been conducted because small particles causes permeability coefficient to be small during recycling so no problem has been raised in the environmental area but the utilization of bottom ash has been limited because environmental problems have been raised during recycling due to its larger particle size and greater permeability coefficient. According to recently published studies, however, the results of the study that conducted the water analysis of leachate generated in the ground improvement section using bottom ash showed that heavy metal contamination levels were found to be within the reference value and no significant environmental problems were found so utilization of bottom ash is evaluated to increase significantly in the future. This bottom ash has the particle size of sand and only transportation costs need to be considered when providing materials because the majority has been disposed and it is judged as the most suitable material in dredging landfill in the economic aspect because most thermal power plants are located in the coast and transportation costs can be reduced by ship. Also, research on mixed soil that can maximize the effect of the construction period and construction cost savings than dredged soil is determined as needed because the demand for coastal dredging reclamation is increasing such as Saemangeum project etc. Therefore, we studied self-weight consolidation characteristics depending on sample processing and mixing method of mixed soil by carrying out interior self-weight consolidation experiments on mixed soil of mixing bottom ash and Kaolinite according to the new development needs of recent coastal reclaimed ground and these result findings are expected to be used as basic data when applying the large coastal dredged ground in the future.

• Journal of Korea Spatial Information System Society
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• v.6 no.1 s.11
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• pp.101-117
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• 2004

Standards are essential to facilitate the efficient use of GIS data. International Standards such as ISO TC211's 19100 series and various technical specifications from OpenGIS Consortium are some of the examples of efforts to maintain the interoperability among GIS applications. Marine GIS is no exception to this rule and in this context. developing standards for marine GIS is also in urgent needs. Using the same meaning and definition for the features commonly found in marine GIS applications is one of the ways to increase the interoperability among systems. One of the key requirements for maintaining the standard meanings for features is to build a common feature catalogue. This paper examines the concept of feature catalogue and describe the ways in which the feature catalogue can be organized. To identify the common features found in various marine GIS applications, a comprehensive search has been made to collect and analyze the features used in various applications. To maintain the interoperability with the National GIS (NGIS) system, the features used in various NGIS applications have been analyzed as well. The result of these analyses are used to create a comprehensive list of common features for marine GIS. This paper then explains the common feature catalogue for marine GIS and the provides the appropriate classification and coding systems for the common features. In addition, a registration tool for registering the common features into the standard registry has been developed in this study. This Web-based tool can be used to input features into the feature catalogue by various applications and also to maintain a standard-compliant feature catalogue by standard agencies.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.

• Journal of Korean Society of Environmental Engineers
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• v.27 no.1
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• pp.85-92
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• 2005

The performance of a novel fermentation process, adopting a sludge blanket type configuration for higher hydrolysis/acidogenesis of the municipal primary sludge, was investigated under batch and semi-continuous conditions with various pH and temperature conditions. This acid elutriation slurry reactor provided higher system performance with a short HRT (5 days) and higher acidogenic effluent quality under pH 9 and thermophilic ($55^{\circ}C$) conditions. The hydrolysis of the sludge was revealed to be significantly dependent on seasonal effects for sludge characteristics but with little impact on acidogenesis. Based on the rainy season at the optimum conditions, VFA production and recovery fraction ($VFA_{COD}/COD$) were $0.18\;g\;VFA_{COD}\;g^{-1}\;VSS_{COD}$ and 63%. As byproducts, nitrogen and phosphorus releasing were $0.006\;g\;N\;g^{-1}\;VSS_{COD}$ and $0.003\;g\;P\;g^{-1}\;VSS_{COD}$, respectively. For the mass balance in a full-scale plant($Q=158,880\;m^3\;day^{-1}$) based on the rainy season, the VFA and non-VFA(as COD) production were $3,110\;kg\;VFA_{COD}\;day^{-1}$ and $1,800\;kg\;COD\;day^{-1}$, resulting in an increase of organics of $31\;mg\;COD\;L^{-1}$ and $20\;mg\;VFA_{COD}\;L^{-1}$ and nutrients of $0.7\;mg\;N\;L^{-1}$ and $0.3\;mg\;P\;L^{-1}$ in the influent sewage. The economical benefit from this process application was estimated to be about $67 per $1,000m^3$ of sewage except for energy requirements and also, better benefits can be expected during the dry season. Also, the results revealed that the process has various additional advantages such as pathogen-free stabilized solids production, excellent solids control and economical benefits.

• Economic and Environmental Geology
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• v.38 no.6 s.175
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• pp.717-729
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• 2005

Peak cooling load of large buildings is generally greater than their peak heating load. Internal and solar heat gains are used fur selection of adquate equipment in large building in cold winter climate like Canada and even Korea. The cost of geothermal heat exchanger to meet the cooling loads can increase the initial cost of ground source heat pump system to the extend less costly conventional system often chosen. Thermal ice storage system has been used for many years in Korea to reduce chiller capacity and shift Peak electrical time and demand. A distribution system designed to take advantage of heat extracted from the ice, and use of geothermal loop (geothermal heat exchanger) to heat as an alternate heat source and sink is well known to provide many benifits. The use of thermal energy storage (TES) reduces the heat pump capacity and peak cooling load needed in large building by as much as 40 to $60\%$ with less mechanical equipment and less space for mechanical room. Additionally TES can reduce the size and cost of the geothermal loop by 1/3 to 1/4 compared to ground coupled heat pump system that is designed to meet the peak heating and cooling load and also can eliminate difficuties of geothermal loop installation such as space requirements and thermal conditions of soil and rock at the urban area.

• Journal of Korean Academy of Nursing
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• v.3 no.3
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• pp.97-110
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• 1973

The goal of modern nursing is to provide comprehensive nursing care to patients. If comprehensive nursing care to children (within the hospital setting) is to be provided, consideration of the stage of growth and development of the child is especially important. From clinical observation, it appeared that nurses often disregarded individual requirements of children in giving nursing care. Therefore, the purpose of this study is to show that comprehensive nursing care which is based on an understanding of the growth and development of the child contributes to both the child and the mother's adaptability to the child's hospitalization. Method: Sixty children, three to three year of age, hospitalized at the Yonsei University Pediatric Ward ware studied. From April 1, 1973 to May 5, 1973, children admitted to the hospital were assigned to either an experimental or a compare groups. There were 30 children in each group. The sex and age of the children in each group was similar. In both groups were more male than female children. In the experimental group, each mother stayed with hot child continuously during his hospitalization. In the compare groups, the mother or some other member of the family stayed with the child. Each day on the child's admission the investigator visited the ward from 1-2 P.M. to 9-10 P.M., in order to provide comprehensive care for the experimental -group. The assistance given the nurses by the investigator was in the form of conferences regarding care and in giving direct care to the child and his mother. The compare group of children received nursing care as usually provided by the hospital. The instruments used to obtain the data for analysis were as follows: 1. The fear and anxiety reaction of the child was recorded by observation of the investigator for four areas: 1) separation from parent and relatives 2) reaction to Doctor and Nurse with white gowns 3) reaction to nursing care 4) reaction to injection and tests, etc. 2. Regression in area of eating, sleeping, and elimination were recorded by the investigator by questioning the mother and by observation. 3. Adaptability to the hospitalization was recorded by direct questioning of the children for areas of emotional and social adjustment. For children older than 3 years of age or children not seriously ill, using the simple I. Q. test this was possible for only 35 of the total 60 children. Result: 1. 55 percents of the total 60 children had been prepared by their parents for hospitalization. The children who had received prior preparation accepted hospitalization more readily than those who had received no preparation. (χ²=4.6 Ρ<0.05) 2. On admission 31.7 percent of the children expressed verbal fear of their discase or treatment. 25 percent felt that the disease was due to their mistake. 3. There was a significant difference in the reaction of the child to separation from the parent or relatives between the two groups. The experimental groups showed less anxiety due to separation than the compare group. (χ²=4.34 Ρ<0.05) In both groups there was less anxiety due to separation among school age (6-12 years) children than among preschool age (3-5 years) children. (χ²=9.22 Ρ<0.05) 4. More than half of the children in both groups reacted with fear and avoidance to doctor and/or nurses wearing white gowns. (χ²=0.06 Ρ<0.05) 5. The experimental group reacted more favorably to nursing in general than the compare group. (χ²=4.8 Ρ<0.05) 6. There was no difference in the fear and refused reaction to special tests and/or such as X-rays and injections, etc. between the groups. (χ²=3.77 Ρ<0.05) 7. More children in the compare group showed regressive tendencies in eating, sleeping, and elimination habits than in experimental groups. (χ²=2.3 Ρ<0.05 χ²=3.88 Ρ<0.05 χ²=4.9 Ρ<0.05) 8. There was a significant difference in the adaptability to hospitalization between the two groups. The experimental groups adapted more readily. (χ²=2.02 Ρ<0.05) 9. For children who had higher I.Q. s the adaptability to hospitalization was better regardless of the group. (χ²=5.03 Ρ<0.05) However, because of the small number of cases (60), this finding cannot be extrapolated without further verification. The date demonstrates that there was a greater adaptability to hospitalization by the child when comprehensive nursing care was given. By planning care and applying knowledge of growth and development to meet, nurses are in a position to prevent some of the psychological trauma associated with hospitalization.

• 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.