• Title/Summary/Keyword: De-rating

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A Determining System for the Category of Need in Long-Term Care Insurance System using Decision Tree Model (의사결정나무기법을 이용한 노인장기요양보험 등급결정모형 개발)

  • Han, Eun-Jeong;Kwak, Min-Jeong;Kan, Im-Oak
    • The Korean Journal of Applied Statistics
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    • v.24 no.1
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    • pp.145-159
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    • 2011
  • National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.

Association among stress, salivary cortisol levels, and chronic periodontitis

  • Refulio, Zoila;Rocafuerte, Marco;de la Rosa, Manuel;Mendoza, Gerardo;Chambrone, Leandro
    • Journal of Periodontal and Implant Science
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    • v.43 no.2
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    • pp.96-100
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    • 2013
  • Purpose: Chronic periodontitis (CP) seems to be associated with stress and depression, but little information on this possible association is available in the literature. Thus, the objective of this study was to evaluate the association among stress, the salivary cortisol level (SCL), and CP. Methods: Seventy systemically healthy subjects were included in the study from January to September 2011. Full medical and dental histories were obtained, and the following measurements were recorded: 1) probing depth; 2) clinical attachment level; 3) bleeding on probing; and 4) tooth mobility. Saliva samples were collected for the evaluation of SCL (via a highly sensitive electrochemiluminescence immunoassay), and all subjects also answered a questionnaire (i.e., the Zung Self-rating Depression Scale). The odds ratio (OR) with a 95% confidence interval (CI) was calculated, and one way analysis of variance and the Tukey-Kramer method were performed. Results: A total of 36 subjects with CP (51.4%) and 34 without CP were evaluated. Of them, all of the subjects with CP and one periodontally healthy subject were diagnosed with depression. Subjects with moderate CP had statistically significantly higher levels of SCL than subjects with a diagnosis of slight CP (P=0.006). Also, subjects with severe CP showed the same outcome when compared to those with slight CP (P=0.012). In addition, 46 subjects presented high SCL whereas 24 had a normal level. CP was found to be correlated with the SCL, with an OR of 4.14 (95% CI, 1.43 to 12.01). Conclusions: Subjects with a high SCL and depression may show an increased risk for CP.

The correlations between acupuncture sensation and analgesic effects (침감과 침 진통 효과의 상관성 연구)

  • Chae, Youn-Byoung;Lee, Hwa-Jin;Kim, Hee-Young;Lee, Hye-Jung;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.24 no.1
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    • pp.43-58
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    • 2007
  • Objectives : The elicit of DeQi, a composite of sensation including numbness and fullness that develops at the site of acupuncture stimulation, is considered to be clinically essential to establish treatment efficacy. However, there was little studies investigating the relationship between the subjective feeling of acupuncture sensation and acupuncture analgesia, The current study was therefore performed to determine the correlation between the acupuncture sensation scale (ASS) and the degree of acupuncture analgesia. Methods : Ninety-two female subjects were stimulated at LI4 acupoint on non-dominant hand with real (RA) or sham acupuncture (SA). Finger withdrawal latency (FWL) of each group was also measured to evaluate analgesic effect of acupuncture on the noxious heat stimuli on the dominant hand. All subjects were asked to complete seven point-Likert scale ASS developed by Vincent et al. Results : The increase rate of FWL of the RA group was significantly higher than that of the SA group(36.03 ${\pm}$ 4.45% vs 24.50 ${\pm}$ 3.73%). RA stimulation produced significantly higher rating of all the ASS except for dull sensation, compared to SA stimulation. Significant correlations between analgesic effect of RA, but not of SA, and the degree of the ASS, including burning sensation(r=0.349), Intense sensation(r=0.299), pulsating sensation (r=0.335), and stinging sensation (r=0.306) were found. Conclusions : The results of our study indicate that the DeQi sensation are associated with acupuncture analgesia. Our findings suggest that the evocation of DeQi might be useful clinical indicator of acupuncture treatment.

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Selection of Energy Conservation Measures for Building Energy Retrofit: a Comparison between Quasi-steady State and Dynamic Simulations in the Hands of Users

  • Kim, Sean Hay
    • KIEAE Journal
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    • v.16 no.6
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    • pp.5-12
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    • 2016
  • Purpose: Quasi-steady state simulations have played a pivoting role to expand the user group of simulation to design engineers and architects in Korea. Initially they are introduced in the market as a building energy performance rating tool. In domestic practice, however, quasi-steady state simulations seem to be regarded as a de facto simulation only available for energy retrofit. Selection of ECMs and economic feasibility analysis are being decided through these tools, which implies that running these tools has become a norm step of the Investment-grade Audit. Method: This study aims at identifying issues and problems with the current practice via test cases, analyzing the reasons and opportunities, and then eventually suggesting proper uses of quasi-steady state and dynamic simulations. Result: The functionality of quasi-steady state simulations is more optimized to the rating. If they are to used for energy retrofits, their off-the-shelf functions also need to be expanded for customization and detailed reports. Yet their roles may be limited only to the go/no go decision; because their algorithms are still weak at precisely estimating energy and load savings that are required for making investment decisions compared to detailed simulations.

The Potential of Building Information Modeling in Application Process of G-SEED

  • Chen, De Jian;Yoon, Heakyung
    • Architectural research
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    • v.20 no.4
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    • pp.121-128
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    • 2018
  • Given the barriers to implement green building rating systems, Building Information Modeling (BIM) was suggested as an effective solution integrating information into one model and saving substantial time to facilitate certification process. Synergies between BIM and Leadership in Energy and Environment Design (LEED), the most widely used rating system, have been researched for a few decades. This paper demonstrates literature review about the development of integration between BIM and LEED. The research focuses on synergies between BIM and Green Standard for Energy & Environmental Design (G-SEED) in Korea, as one of important strategies to mitigate greenhouse gas emission. The research compares LEED and G-SEED related items based on evaluation contents. The result manifests G-SEED and LEED share many common items in different degrees. Therefore, it is entirely possible for G-SEED and BIM to adapt same developing mode of LEED and BIM. Moreover, the study measures the potential of BIM in application process of G-SEED certification by investigation of credits in LEED and G-SEED can be earned by BIM. The results of paper indicate the documentation support LEED and G-SEED may be prepared directly, semi-directly and indirectly via sustainability analyses software in BIM.

Total Delay for Treatment among Cancer Patients: a Theory-guided Survey in China

  • Feng, Rui;Wang, De-Bin;Chai, Jing;Cheng, Jing;Li, Hui-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4339-4347
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    • 2014
  • Purpose: This study aimed at exploring treatment delay (TD) among cancer patients in China with an attempt to develop a practical methodology facilitating frontline Chinese clinicians in promoting earlier cancer diagnosis and treatment. Materials and Methods: The study comprised framework development, qualitative interviews and paired factor rating. Framework development utilized systematic literature review, soft systems thinking and consensus groups. Qualitative interviews employed a checklist of open questions soliciting information about all the domains included the framework from cancer patients drawn via stratified randomized sampling of inpatients at 10 hospitals in Hefei, China. Paired factor rating used a self-developed computer aid and the interviewed patients as referring cases to weigh the relative importance of the factors listed in the framework in terms of their contributions to specific components of total delay (TD). Results: a) A conceptual framework was proposed consisting of a 6-step path to TD and 36 category determinants. b) A total of 227 patients were interviewed; their TD was 267.3 mean or 108 median days ranging from 0 to 2475 days; average appraisal, illness, behavioral, preparation and treatment delay accounted for 52.1%, 9.4%, 0.30%, 8.8% and 29.4% of the TD respectively. Individual side factors were rated substantially more important than environmental side factors (60% vs. 40%); most influential TD factors included cancer symptoms, overall health, family relations and knowledge about cancer and health. Conclusions: The framework proposed together with the interviewing and rating approaches used provide a potential new methodology for understanding cancer patients' TD and promoting earlier cancer treatment.

HOW TO DEFINE CLEAN VEHICLES\ulcorner ENVIRONMENTAL IMPACT RATING OF VEHICLES

  • Mierlo, J.-Van;Vereecken, L.;Maggetto, G.;Favrel, V.;Meyer, S.;Hecq, W.
    • International Journal of Automotive Technology
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    • v.4 no.2
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    • pp.77-86
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    • 2003
  • How to compare the environmental damage caused by vehicles with different foe]s and drive trains\ulcorner This paper describes a methodology to assess the environmental impact of vehicles, using different approaches, and evaluating their benefits and limitations. Rating systems are analysed as tools to compare the environmental impact of vehicles, allowing decision makers to dedicate their financial and non-financial policies and support measures in function of the ecological damage. The paper is based on the "Clean Vehicles" research project, commissioned by the Brussels Capital Region via the BIM-IBGE (Brussels Institute for the Conservation of the Environment) (Van Mierlo et at., 2001). The VriJe Universiteit Brussel (ETEC) and the universite Libre do Bruxelles (CEESE) have jointly carried out the workprogramme. The most important results of this project are illustrated in this paper. First an overview of environmental, economical and technical characteristics of the different alternative fuels and drive trains is given. Afterward the basic principles to identify the environmental impact of cars are described. An outline of the considered emissions and their environmental impact leads to the definition of the calculation method, named Ecoscore. A rather simple and pragmatic approach would be stating that all alternative fuelled vehicles (LPG, CNG, EV, HEV, etc.) can be considered as ′clean′. Another basic approach is considering as ′clean′ all vehicles satisfying a stringent omission regulation like EURO IV or EEV. Such approaches however don′t tell anything about the real environmental damage of the vehicles. In the paper we describe "how should the environmental impact of vehicles be defined\ulcorner", including parameters affecting the emissions of vehicles and their influence on human beings and on the environment and "how could it be defined \ulcorner", taking into account the availability of accurate and reliable data. We take into account different damages (acid rain, photochemical air pollution, global warming. noise, etc.) and their impacts on several receptors like human beings (e.g., cancer, respiratory diseases, etc), ecosystems, or buildings. The presented methodology is based on a kind of Life Cycle Assessment (LCA) in which the contribution of all emissions to a certain damage are considered (e.g. using Exposure-Response damage function). The emissions will include oil extraction, transportation refinery, electricity production, distribution, (Well-to-Wheel approach), as well as the emission due to the production, use and dismantling of the vehicle (Cradle-to-Grave approach). The different damages will be normalized to be able to make a comparison. Hence a reference value (determined by the reference vehicle chosen) will be defined as a target value (the normalized value will thus measure a kind of Distance to Target). The contribution of the different normalized damages to a single value "Ecoscore" will be based on a panel weighting method. Some examples of the calculation of the Ecoscore for different alternative fuels and drive trains will be calculated as an illustration of the methodology.

Relationship Between Psychological Factors and Pain Intensity in Temporomandibular Disorders with or without Central Sensitization: A Cross-Sectional Observational Study Using Multiple Regression Analysis

  • Sebastian Eustaquio Martin Perez;Isidro Miguel Martin Perez;Jose Andres Diaz Cordova;Leidy Milena Posada Cortes
    • Journal of Oral Medicine and Pain
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    • v.48 no.3
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    • pp.87-95
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    • 2023
  • Purpose: To quantify the relationship between perceived pain intensity and psychological variables in a sample of participants with temporomandibular disorder, with or without central sensitization (CS). Methods: A cross-sectional study with nonprobability convenience sampling was conducted from January 1, 2022, to June 30, 2023. Pain intensity (Numeric Pain Rating Scale), anxiety (State-Trait Anxiety Questionnaire, STAI), catastrophizing (Pain Catastrophizing Scale, PCS), perceived stress (Perceived Stress Scale, PSS), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were assessed. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Co.), which included descriptive and normality analyses and the calculation of strength of multiple correlational regression. Results: A total of 52 (n=34 female 65.4%; n=18 male 34.6%) subjects with diagnosis of temporomandibular disorders (TMD) were finally included. A total of 26 participants (n=26, 50.0%) were cases suffered from CS (TMD-CS mean=46.62±11.24) while the remaining participants (n=26, 50.0%) were the controls (TMD-nCS mean=26.77, standard deviation [SD]=8.42). The pain intensity was moderate in both groups TMDCS (mean=7.62, SD=0.83) and TMD-nCS (mean=7.05, SD=0.86), anxiety (TMD-CS STAI mean=53.27, SD=11.54; TMD-nCS STAI mean=49, SD=11.55), catastrophizing (TMD-CS PCS mean=46.27, SD=9.75; TMD-nCS PCS mean=26.69, SD=4.97), perceived stress (TMDCS PSS mean=30.35, SD=4.91; TMD-nCS PSS mean=26.12, SD=6.60) and sleep quality (TMD-CS PSQI mean=15.81, SD=3.65; TMD-nCS PSQI mean=12.77, SD=2.76) levels were measured in both groups. In TMD-CS and TMD-nCS, higher anxiety levels were moderately and significantly associated with greater pain intensity β=0.4467 (t=2.477, p=0.021) and β=0.5087 (t=2.672, p=0.014). Nevertheless, catastrophizing, perceived stress and sleep quality were not associated to pain intensity in neither of group. Conclusions: In both TMD-CS and TMD-nCS patients, elevated anxiety levels were moderately and significantly associated with increased pain intensity. However, heightened levels of pain catastrophizing, perceived stress, and poor sleep quality were not significantly associated with increased pain intensity in either of the two analyzed groups.

Prognostic Factors of Neurocognitive and Functional Outcomes in Junior and Senior Elderly Patients with Traumatic Brain Injury Undergoing Disability Evaluation or Appointed Disability Evaluation

  • Jung, Young-Jin;Kim, Oh-Lyong;Kim, Min-Su;Cheon, Eun-Jin;Bai, Dai-Seg
    • Journal of Korean Neurosurgical Society
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    • v.55 no.1
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    • pp.18-25
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    • 2014
  • Objective : This study explored the relationships among demographic (DVs) and clinical variables (CVs), neurocognitive (NOs) and functional outcome (FO) that could be used as prognostic factors for old aged patients with traumatic brain injury (TBI) undergoing or appointed disability evaluation (DE) after treatment. Methods : A total of 162 subjects with TBI above the age of 55 years undergoing DE or appointed to do so after treatments were selected. The patients were divided into two subgroups according to age : a junior elderly group 55 to 64 years old and a senior elderly group over the age of 65. NOs and FO were evaluated using the Seoul Neuropsychological Screening Battery and Clinical Dementia Rating scale. Results : Gender, age, and education level were shown to significantly impact the recovery of NOs after TBI. Other DVs and CVs such as area of residency, occupation, type of injury, or loss of consciousness were not found to significantly affect the recovery of NOs after TBI. Analysis of the relationships among DVs, CVs and NOs demonstrated that gender, age, and education level contributed to the variance of NOs. In FO, loss of consciousness (LOC) was included to prognostic factor. Conclusion : Gender, age and education level significantly influence the NOs of elderly patients with TBI. LOC may also serve as a meaningful prognostic factor in FO. Unlike younger adult patients with TBI, old aged patients with TBI did not show global faking-bad or malingering attitudes to DE for compensation, but assume that they could faking their performance in a test set available visual feedback.

Field Measurement and Analysis of Voltage Unbalance Factor (전압불평형율의 현장측정 및 분석)

  • Jeong, Jong-Ho;Park, Young-Jeen;Lee, Eun-Woong;Kim, Jong-Gyeum
    • The Transactions of the Korean Institute of Electrical Engineers P
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    • v.54 no.1
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    • pp.41-46
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    • 2005
  • Most of LV customer have applied the 3-phase four wire system distribution system because it has advantage of supplying both of 1-phase & 3-phase loads simultaneously. Due to its structural simplicity, it is more convenient for use rather than the conventional separated scheme. But voltage unbalance more commonly emerges in individual customer loads due to phase load unbalance, especially where, single-phase power loads are used. Voltage unbalance factor(VUF) represents the loss of symmetry in the supply(magnitude and angle). It leads some problems such as de-rating or power losses. In this paper, voltage and current waveform in the actual fields have been measured and analyzed in relation with internationally allowable voltage unbalance limits.