The purpose of this study was to examine the effect of sustainability management (SM) at coffee houses on customers' store image and behavioral intention. In addition, customers' willingness to pay a premium for sustainable coffee houses was studied. During October 2011, a web survey was conducted via an on-line research company with customers aged 20 to 39 visiting one of the top five coffee houses in Korea at least once a month. A total of 300 targeted customers responded and all the data were analyzed. An exploratory factor analysis derived two dimensions of SM: SM in Social and Environmental Perspective and SM in Economic Perspective. The result of structural equation modeling indicated that SM in Economic Perspective at coffee houses had a significant positive effect on customers' behavioral intention with mediating effect by store image, but SM in Social and Environmental Perspective did not have such effect. Approximately one-third (31%) of the respondents were willing to pay a premium for a sustainable coffee house in a scenario. approximately 84% of the respondents unwilling to pay a premium for the sustainable coffee house chose the cost-related reasons including "Coffee price at the coffee house that they most often visit is already expensive (62.3%)" for such unwillingness. The results of this study showed that SM of coffee houses, especially that in Economic Perspective, could contribute to store image, and therefore increase customers' favorable behavioral intention, although the additional cost resulted from such SM practices might not be easily accommodated by customers.
Aged ; Coffee ; Surveys and Questionnaires ; Humans ; Intention ; Korea ; Negotiating

Background: Glyphosate and glufosinate use widely used as herbicide ingredients. There have been several reported cases of chemical burns caused by dermal exposure to glyphosatecontaining herbicide, and patients in these cases were discharged without fatal complications.There were no cases of severe symptoms due to non-oral exposure of glufosinate-containing herbicides. Here, we report a case of fatality accompanied with severe chemical burns in an 81-year-old man who did not wash his skin for more than 48 hours after dermal exposure to herbicide containing glyphosate and glufosinate with surfactant (HGlyGluS).Case presentation: An 81-year-old male with no underlying disease was admitted to the emergency department (ED). He had sprayed HGlyGluS with a manual knapsack sprayer 3 days ago and had not wash away the herbicide. On arrival, he was drowsy and had multiple severe corrosive skin lesions. Skin necrosis (10 × 15 cm) on the right shoulder and skin lesions with subcutaneous fat exposure (15 × 20 cm) on the right thigh were observed. Although he was treated including continuous renal replacement therapy, antibiotic apply, debridement operations, and so on, he was unable to recover and expired. Conclusions We suggest that prolonged dermal exposure to HGlyGluS induces fatality.Further studies including prolonged dermal exposure and ingredients of surfactants should be carried out. Also, it is necessary to educate farmers that it is very important to wash immediately after dermal exposure to pesticide.

BACKGROUND: The objective of the present study is to identify differences in the prevalence of acute occupational pesticide poisoning across Korean orchard farmers' farming characteristics and the risk factors that have an effect on acute occupational pesticide poisoning. METHODS: For 3 years (2014, 2015, and 2017), a questionnaire survey was conducted on 394 orchard farmers in some parts of south Chungcheong Province in relation to pesticide poisoning. 323 orchard farmers who responded to acute occupational pesticide poisoning were included for final analysis. With acute occupational pesticide poisoning as the dependent variable, a χ² test and a multiple logistic regression analysis were conducted. RESULTS: The results of the prevalence of acute occupational pesticide poisoning across farming characteristics showed that the group wearing 4 or more pesticide personal protective equipment (PPE) had a lower prevalence of acute occupational pesticide poisoning than the group wearing 3 or less pesticide PPE (p < 0.05). Furthermore, an analysis by area of fruit farming revealed that the group with more than 12,000m² in the area of fruit farming had a higher prevalence of acute occupational pesticide poisoning (p < 0.05). Orchard farmers mainly use a speed sprayer to spray pesticides, and the speed sprayer can be categorized by presence of cabin. The analysis of the prevalence of acute occupational pesticide poisoning by speed sprayer's cabin existence found that existence of speed sprayer's cabin did not show a statistically significant difference in the prevalence of acute occupational pesticide poisoning. CONCLUSIONS The present study analyzed the prevalence of acute occupational pesticide poisoning depending on the speed sprayer's cabin existence and found no significant difference. The fact that famers using the cabinless style speed sprayer shows a higher percentage in wearing PPE than those using the cabin style speed sprayer is suggested to elucidate the result. As the first study in Korea which examined the prevalence of acute occupational pesticide poisoning by speed sprayer's cabin existence, the present study proposes the expected effect that increase of wearing pesticide PPE along with employ of speed sprayer's cabin can reduce the prevalence of acute occupational pesticide poisoning among orchard farmers.

Background: Glyphosate and glufosinate use widely used as herbicide ingredients. There have been several reported cases of chemical burns caused by dermal exposure to glyphosatecontaining herbicide, and patients in these cases were discharged without fatal complications.There were no cases of severe symptoms due to non-oral exposure of glufosinate-containing herbicides. Here, we report a case of fatality accompanied with severe chemical burns in an 81-year-old man who did not wash his skin for more than 48 hours after dermal exposure to herbicide containing glyphosate and glufosinate with surfactant (HGlyGluS).Case presentation: An 81-year-old male with no underlying disease was admitted to the emergency department (ED). He had sprayed HGlyGluS with a manual knapsack sprayer 3 days ago and had not wash away the herbicide. On arrival, he was drowsy and had multiple severe corrosive skin lesions. Skin necrosis (10 × 15 cm) on the right shoulder and skin lesions with subcutaneous fat exposure (15 × 20 cm) on the right thigh were observed. Although he was treated including continuous renal replacement therapy, antibiotic apply, debridement operations, and so on, he was unable to recover and expired. Conclusions We suggest that prolonged dermal exposure to HGlyGluS induces fatality.Further studies including prolonged dermal exposure and ingredients of surfactants should be carried out. Also, it is necessary to educate farmers that it is very important to wash immediately after dermal exposure to pesticide.

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The occurrence of severe hypotension and bradycardia, following placing to the beach chair position from supine during general anesthesia for repair of tendon injury of the rotator cuff of shoulder in a healthy 50 year-old man was described. The Bezold-Jarisch reflex, which is known to inhibit cardiovascular reflex and composed of three kinds of symptoms such as vasodilation, bradycardia and hypotension, has been reported mainly in peripheral nerve block, and may occur during orthostasis, hypovolemia, hemorrhage, supine inferior vena cava compression in pregnancy, interscalene block for shoulder surgery in the sitting position and so on. The bradycardia and hypotension can be more aggravated when causative elements overlaps each other. Anticholinergics and vasopressor were injected intravenously, and position of the patient was changed to the supine position immediately resulting in a normal vital signs dramatically.
Anesthesia, General ; Arthroscopy ; Bradycardia ; Cholinergic Antagonists ; Dizziness ; Hemorrhage ; Humans ; Hypotension ; Hypovolemia ; Peripheral Nerves ; Pregnancy ; Reflex ; Rotator Cuff ; Shoulder ; Supine Position ; Tendon Injuries ; Vasodilation ; Vena Cava, Inferior ; Vital Signs

OBJECTIVES: The Korean government has enacted two laws, namely, the Personal Information Protection Act and the Bioethics and Safety Act to prevent the unauthorized use of medical information. To protect patients' privacy by complying with governmental regulations and improve the convenience of research, Asan Medical Center has been developing a de-identification system for biomedical research. METHODS: We reviewed Korean regulations to define the scope of the de-identification methods and well-known previous biomedical research platforms to extract the functionalities of the systems. Based on these review results, we implemented necessary programs based on the Asan Medical Center Information System framework which was built using the Microsoft. NET Framework and C#. RESULTS: The developed de-identification system comprises three main components: a de-identification tool, a search tool, and a chart review tool. The de-identification tool can substitute a randomly assigned research ID for a hospital patient ID, remove the identifiers in the structured format, and mask them in the unstructured format, i.e., texts. This tool achieved 98.14% precision and 97.39% recall for 6,520 clinical notes. The search tool can find the number of patients which satisfies given search criteria. The chart review tool can provide de-identified patient's clinical data for review purposes. CONCLUSIONS: We found that a clinical data warehouse was essential for successful implementation of the de-identification system, and this system should be tightly linked to an electronic Institutional Review Board system for easy operation of honest brokers. Additionally, we found that a secure cloud environment could be adopted to protect patients' privacy more thoroughly.
Access to Information ; Bioethics ; Computer Security ; Electronics ; Electrons ; Ethics Committees, Research ; Ethics, Research ; Humans ; Information Systems ; Jurisprudence ; Masks ; Privacy ; Research Design ; Social Control, Formal ; Tertiary Care Centers

PURPOSE: This study examined and compared the associations of the iron status and food intake with the blood lead, mercury, and cadmium concentrations among Korean adolescent girls, premenopausal women, and postmenopausal women. METHODS: The data from the 2010~2011 Korea National Health and Nutrition Examination Survey (KNHANES) was used. The subjects were classified into three groups: adolescent girls (n = 268), premenopausal women (n = 1,157), and postmenopausal women (n = 446). The iron status was assessed by hemoglobin, hematocrit, serum ferritin, and iron concentrations, as well as the total iron binding capacity (TIBC). The food intake was estimated by a food frequency questionnaire. RESULTS: The blood heavy metal concentrations and poisoning rate in postmenopausal women were higher than in the other groups. The iron status in the adolescent girls and postmenopausal women was higher than that in the premenopausal women. In the adolescent girls, the iron status was inversely associated with the blood cadmium concentration. The dairy food intake was inversely related to the blood lead and cadmium concentrations. In premenopausal women, the iron status was inversely associated with the cadmium concentrations. The fish and shellfish food intakes were positively associated with the mercury concentrations. In postmenopausal women, the iron status was positively associated with the mercury and cadmium concentrations. Fast foods and fried foods were inversely associated with the lead concentration. CONCLUSION: The premenopausal women showed a lower iron status than the adolescent girls and postmenopausal women. The associations of the iron status with the blood heavy metal concentrations were different among the adolescent girls, premenopausal women, and postmenopausal women. In addition, the relationships of the food intakes with the blood heavy metal concentrations differed among adolescent girls, premenopausal women, and postmenopausal women. Further studies will be needed to confirm these findings.
Adolescent* ; Cadmium ; Eating* ; Fast Foods ; Female* ; Ferritins ; Hematocrit ; Humans ; Iron* ; Korea* ; Nutrition Surveys* ; Poisoning ; Shellfish

OBJECTIVES: This study was to examine the effectiveness of computerized cognitive ability enhancement program (CCAEP) using Smart-toy. The CCAEP using Smart-toy which can interact with children via bluetooth is a kids-friendly and convenient method for improving children's cognitive abilities by increasing their motivation for performing the program. We developed the CCAEP which designed to train auditory-verbal memory, visual-spatial memory, auditory-verbal working memory, and visual-spatial working memory. METHODS: Eighteen children aged 8 to 10 participated in CCAEP individual training composed of 8 sessions of 40 minutes each for 4 weeks. The effect of the training was measured with Smart Toyweb's cognitive assessment tasks (smart device based assessment) as well as traditional neuropsychological tests before and after the training. RESULTS: Children showed significant improvement in auditory-verbal memory, visual-spatial memory, auditory-verbal working memory and visual-spatial working memory abilities after the training. CONCLUSION: This study demonstrated promising results suggesting the effectiveness of CCAEP using Smart-Toy in clinical settings as well as school and home situations. Further controlled study with larger sample size including various clinical groups is needed to confirm the present results.
Child* ; Humans ; Memory ; Memory, Short-Term ; Methods ; Motivation ; Neuropsychological Tests ; Sample Size

PURPOSE: The purpose of this study was to identify non-psychiatric nurses' difficulties in caring for patients with mental illness. METHODS: Data were collected from eighteen general medical-surgical nurses working at a university hospital in Seoul, Korea. This study involved two focus group discussions and three in-depth individual interviews. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. RESULTS: General medical-surgical nurses experienced difficulties in 3 categories, 9 subcategories, 27 codes. The three categories were ‘nurse’ related factors, ‘patient’ related factors, ‘resource’ related factors. The nine categories were ‘unpreparedness’, ‘nursing barriers due to stigma’, ‘undervaluing and avoidance of psychiatric nursing’, ‘eroding into the trap of a vicious cycle’, ‘facing unapproachable patients’, ‘dealing with unhelpful family members’, ‘burdening already overburdened staff’, ‘obstructive environment’, and ‘isolation of staff with heavy responsibilities’. CONCLUSION: The results of this study indicate the need to develop psychiatric mental health education programs for non-psychiatric nurses. Education about psychiatric mental health and support from institutions for non-psychiatric nurses can reduce their negative attitude toward psychiatric patients and difficulties in caring for psychiatric patients.
Education ; Focus Groups ; Humans ; Korea ; Medical-Surgical Nursing ; Mental Disorders ; Mental Health ; Psychiatric Nursing ; Qualitative Research ; Seoul