According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.
This study was carried out from 2011 to 2012 in order to analyze the cultivation technology system by six organic rice cultivation types in the southern provinces for the purpose of utilizing organic rice farming guidelines. This surveys were conducted by site visit on 8 counties and 115 farms in southern area. Cultivation technology system by six organic rice cultivation types were cultivated by the principle of minimum input or non-input. cropping systems, a mixture of barley and rice, or rice green manure crops were grown. Cultivars were mixture of the local cultivars and Japanese varieties. Soil were managed by a self-manufactured compost, indigenous microorganisms and barley straw without any fertilization. Pest control was mainly practied by purchased eco-friendly organic materials or herbal medication residue and indigenous microbial self-manufactured. Weed was controled by snails and barley straw. In addition, considering the restore of a longtail pitching shrimp and grasshoppers, the fuction of environmental ecology of six organic rice cultivation type proved to be excellent all. Meanwhile, the productivity of the organic farming per 10a were the order of Life and environment > Natural circulation > Stevia > Ji jang > Art and nature > Taepyoung of Farming Methods, but the farmers received prices showed the opposite tendency. Simple profitablity did not show a big difference. But, the productivity of all type of the organic farming were lower then the conventional farming. Finally, If we want to conduct safety and easy farming, we can suggest stevia farming, Natural circulation farming and life and environmental farming out of 6 organic rice cultivation types.
Journal of the Korea Institute of Information Security & Cryptology
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v.26
no.6
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pp.1619-1637
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2016
With wide distribution of smart phones and development of mobile network, social network service (SNS) is displaying remarkable growth rates. Users build new social relations by sharing their interests, which brings surging growth to the SNS based on the combination between the strength of expanding the place for communication and distribution of smart phones featured with easy portability. This study is designed to understand impact factors of SNS on users in Korea and to conduct empirical research on casual relationship between the factors above and the factors affecting personal information behavior through the privacy protection and self-efficacy. In order to accomplish the objective above, the study presented a research model applied with key variables of the Health Belief Model (HBM) predicting behaviors capable of recognizing and preventing individual diseases in the field of health communication. To perform empirical verification on the research model of this study, a survey was conducted upon college students at N university located in Chungcheongnam-do and K university in rural area, who have experiences using the SNS. Through this survey, a total of 186 samples were collected, and path analysis was performed in order to analyze the relationship between the factors. Based on the findings from the survey, first, variables Perceived probability, Perceived severity, Perceived impairment of the HBM, key factors of personal information protection behavior on the SNS, were found to exhibit negative relationship with self-efficacy, and Perceived probability, Perceived benefit, Perceived impairment were found to exhibit negative relationship with privacy protection. But the above, Perceived severity showed positive relationship with privacy protection, and Perceived benefit and self-efficacy also displayed positive relationship. Second, although self-efficacy, a parameter, showed positive relationship with privacy protection, it demonstrated negative relationship with personal information protection behavior. Lastly, privacy protection exhibited positive relationship with personal information protection behavior. By presenting theoretical model reflected with characteristics of prevention based on these findings above unlike previous studies on personal information protection using technologies threatening personal information, this study is to provide theoretical and operational foundation capable of offering explanations how to predict personal information protection behavior on the SNS in the future.
Background: Lung cancer has become one of the most common cancers in Korea. It is important to determine the accurate histologic types and stages because of different therapeutic modlaity, especially in small cell carcinoma. This study was designed to evaluate diagnostic yields according to variable diagnostic methods in lung cancer. Methods: The records of 683 patients with a confirmed diagnosis of primary lung cancer during the period of 7 years, from January, 1986 until December, 1992 at Presbyterian Medical Center were analyzed retrospectively. Results: 1) Age and sex distributions Male: female sex ratio was 5.57:1 and age distributions were 7th decade 41.4%, 6th decade 30.2%, 8th decade 17.0%, 5th decade 7.9%, 4th decade 2.5%, 9th decade 1.3%, and 3rd decade 0.2% in decreasing order. 2) The frequencies according to histologic cell types were squamous cell carcinoma 44.7%, small cell carcinoma 23.9%, adenocarcinoma 22.8%, alveolar cell carcinoma 2.5%, large cell carcinoma 1.2%. mixed forms 1.2%, undifferenciated cell carcinoma 0.6% and malignant fibrous histiocytoma 0.2%(1 case) in decreasing order. 3) The most common locations of lung cancer were in left upper lobe and right lower lobe, and no differences of diagnostic methods according to locations were noted. 4) In central lesions, bronchoscopic examination was very accurate and frequently used diagnostic method, and in peripheral lesions, transthoracic lung biopsy(TTLB) was apparent1y accurate method. 5) The diagnostic yields of bronchoscopic biopsy, bronchial brushing, sputum cytology, transthoracic lung biopsy and transbronchial lung biopsy(TBLB) were 81.3%, 57.5%, 31.1%, 69.6% and 61.6%, respectively. 6) The concordance rates between the histologic diagnosis with bronchial brushing and sputum-cytology were 91.3% and 98.4%, respectively. 7) It was appropriate in lung cancer to repeat sputum cytology 3 to 5 times. Conclusion: Bronchoscopic examination is important to determine the histologic cell types in lung cancer. In addition, we should be interrested in improving diagnostic yields of sputum cytology as an easy method.
Journal of Korean Home Economics Education Association
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v.20
no.1
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pp.45-62
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2008
The purpose of this study was to investigate middle school home economics(HE) teachers' perception and needs on self supervision related to HE subject matter, Using the methods of survey and interview, 177 samples were collected. For collected surveys, mean value, standard deviation, frequency, percentage analysis were performed by using an SPSS/Win (ver10.1) program. The results of this study were as follows. First, the middle school HE teachers recognized that self supervision related to HE subject matter was absolutely needed to expand the improvement of techniques for teaching instructions and the width of knowledge on the studies on textbook. Second, the middle school HE teachers recognized the necessary parts of self supervision related to HE subject matter as HE teaching-learning methods, the studies on textbook contents, and HE education philosophy in order. Third, the middle school HE teachers recognized that it would be helpful in improving their HE class and expertise in order of field survey, participation in various training programs, utilization of mass media, participation in societies for researches and meetings and information sharing with co-teachers among the types of self supervision. Fourth, the middle school HE teachers needed the reduction in miscellaneous duties, less pressure for time, restoration of teachers' desire, support of physical resources (improvement of various environments such as classrooms and special rooms), economic support and various support programs (expanding the opportunities to participate in training and society and establishment of a database for relevant materials, etc.) to facilitate self supervision. As such, the middle school HE teachers' overall recognition on HE-related self supervision became significantly higher. To enhance the HE-related expertise, however, it would be necessary to conduct concrete and active support for HE education, philosophical area and the studies on textbook contents as well as the teaching-learning methods for HE in which teachers' demand was high. In addition, the HE teachers wanted to have an easy and quick access to various HE-related data; therefore, it would be urgent to summarize scattered relevant data and support the HE teachers more systematically.
An Internet shopping mall for clothing operates a warehouse for packing and shipping products to fulfill its orders. All the products in the warehouse are put into the boxes of same brands and the boxes are stored in a row on shelves equiped in the warehouse. To make picking and managing easy, boxes of the same brands are located side by side on the shelves. When new products arrive to the warehouse for storage, the products of a brand are put into boxes and those boxes are located adjacent to the boxes of the same brand. If there is not enough space for the new coming boxes, however, some boxes of other brands should be moved away and then the new coming boxes are located adjacent in the resultant vacant spaces. We want to minimize the movement of the existing boxes of other brands to another places on the shelves during the warehousing of new coming boxes, while all the boxes of the same brand are kept side by side on the shelves. Firstly, we define the adjacency of boxes by looking the shelves as an one dimensional series of spaces to store boxes, i.e. cells, tagging the series of cells by a series of numbers starting from one, and considering any two boxes stored in the cells to be adjacent to each other if their cell numbers are continuous from one number to the other number. After that, we tried to formulate the problem into an integer programming model to obtain an optimal solution. An integer programming formulation and Branch-and-Bound technique for this problem may not be tractable because it would take too long time to solve the problem considering the number of the cells or boxes in the warehouse and the computing power of the Internet shopping mall. As an alternative approach, we designed a fast heuristic method for this reallocation problem by focusing on just the unused spaces-empty cells-on the shelves, which results in an assignment problem model. In this approach, the new coming boxes are assigned to each empty cells and then those boxes are reorganized so that the boxes of a brand are adjacent to each other. The objective of this new approach is to minimize the movement of the boxes during the reorganization process while keeping the boxes of a brand adjacent to each other. The approach, however, does not ensure the optimality of the solution in terms of the original problem, that is, the problem to minimize the movement of existing boxes while keeping boxes of the same brands adjacent to each other. Even though this heuristic method may produce a suboptimal solution, we could obtain a satisfactory solution within a satisfactory time, which are acceptable by real world experts. In order to justify the quality of the solution by the heuristic approach, we generate 100 problems randomly, in which the number of cells spans from 2,000 to 4,000, solve the problems by both of our heuristic approach and the original integer programming approach using a commercial optimization software package, and then compare the heuristic solutions with their corresponding optimal solutions in terms of solution time and the number of movement of boxes. We also implement our heuristic approach into a storage location assignment system for the Internet shopping mall.
Journal of the Korea Institute of Information Security & Cryptology
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v.30
no.5
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pp.909-928
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2020
From the early 1970s, the US government began to recognize that penetration testing could not assure the security quality of products. Results of penetration testing such as identified vulnerabilities and faults can be varied depending on the capabilities of the team. In other words none of penetration team can assure that "vulnerabilities are not found" is not equal to "product does not have any vulnerabilities". So the U.S. government realized that in order to improve the security quality of products, the development process itself should be managed systematically and strictly. Therefore, the US government began to publish various standards related to the development methodology and evaluation procurement system embedding "security-by-design" concept from the 1980s. Security-by-design means reducing product's complexity by considering security from the initial phase of development lifecycle such as the product requirements analysis and design phase to achieve trustworthiness of product ultimately. Since then, the security-by-design concept has been spread to the private sector since 2002 in the name of Secure SDLC by Microsoft and IBM, and is currently being used in various fields such as automotive and advanced weapon systems. However, the problem is that it is not easy to implement in the actual field because the standard or guidelines related to Secure SDLC contain only abstract and declarative contents. Therefore, in this paper, we present the new framework in order to specify the level of Secure SDLC desired by enterprises. Our proposed CIA (functional Correctness, safety Integrity, security Assurance)-level-based security-by-design framework combines the evidence-based security approach with the existing Secure SDLC. Using our methodology, first we can quantitatively show gap of Secure SDLC process level between competitor and the company. Second, it is very useful when you want to build Secure SDLC in the actual field because you can easily derive detailed activities and documents to build the desired level of Secure SDLC.
Journal of the Korean Institute of Landscape Architecture
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v.40
no.3
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pp.69-80
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2012
The purpose of this paper was to study the issues related to converting the graveyards within forests into spaces intended for tree burials by means of planting, given the situation that the graveyards have encroached on land and damaged the environment. For the reason, a field survey was performed to determine the width, length, and distance to the nearest tree of 205 graveyards in the capital area. Through this, it was determined that the domestic lands damaged by graveyards amounted to $862km^2$, including the areas that were deforested to manage the graves. This only confirms that land encroachment by graveyards is a serious issue. The methods for making tree burial sites were examined from the perspective of how to meet public demands given the graveyard's spatial distinctiveness. As a result, this study suggested different methods to establish tree burial sites according to the degree of transformation and the term of its formation. This study also classified the graveyards into three types, and identified the planting methods that harmonized the safe growth of trees and the scenic beauty of memorial places based on the standard. This is in order to plant trees that are shade-tolerant and suitable to the forest line, along with which other tree line was and also, to plant aesthetic trees around the empty space. Through applying the developed methods, this study established and monitored two exemplary sites in Yongin and Boryeng. Aesthetic trees were planted in Yongin site which was located in an open area, aod the shade-tolerant trees were planted in Boryeong, which was located in a forest area. As a result, the image of a garden appeared at Yongin site and the image of a tree colony harmonized with the near forest emerged at Boryeong site. Therefore, it is confirmed that the method of planting according to the distribution status of neighboring trees was effective. As a result of monitoring, mulching wood chips were suitable for sites that were small or easy to approach. This is because the weeds were controlled in Yongin site by mulching. Furthermore, by monitoring the growth of 11 species of vegetation, this study confirmed that low and cover-type vegetations were suitable for tree burial sites. In Boryeong site, the wild cherry trees, which were planted as adult trees, all died, and the tilling of snake's beard, which were planted as cover vegetation, was slow. Therefore, this study found that seedlings were more suitable to plant in forest graveyards than adult trees, which were large and difficult to approach, and it was effective to use the remaining lawn and form a low vegetation after the crown of trees had expanded to such places.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.2
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pp.1092-1100
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2015
This thesis is a part of a case study conducted in order to understand the trends of the 16th~17th century Cheongju region bigwigs, and has examined the life and academic stream of Seogye Deuk-Yoon LEE (1553-1630) focused on the previous study, "The Great Family Genealogy of Ikjaegong of the Gyeongju LEE Family". Seogye Deuk-Yoon LEE learned from his father Seomgye Jam LEE, and GiSEO, Ji-Hwa PARK from an early age, and based the basic orientation of his studies on one's moral and religious self one's moral and religious self'. This is how he became to emphasize "Sohak" (an introductory book of Confucianism for children), and he made an effort to realize the world of Neo-Confucianism by distributing the 'YEO's Hyangyak(Lue-shih-hsiang-yueeh : autonomic regulations of the district areas)' published on "Sohak". Furthermore, he made great effort in education of the Cheongju by regarding it as his own mission to teach young scholars, continuing on the footsteps of his father. Considering this, Seogye was not only a Confucian scholar that devoted himself to 'Sugi(moral training of himself', but was also a practical scholar that committed his sense of social responsibility in ' teaching' and 'governing the people, who greatly affected the academic world of the regional bigwigs of the Cheongju during the 17th century. Furthermore, Deuk-Yoon LEE was a member of the 'Nangseongpalhyeon(eight wise men of the Cheongju region) together with his disciple Deok-soo LEE, who performed a core role in establishing the 'Gihohakpa(Capital and Chungcheong province School)' and 'Hoseosarim(forest of scholars in Chungcheong province)' of the Cheongju region. As a main figure in establishing the Sinhang Confucian academy, he prepared the socio-economic basis for the 'Gihohakpa' to take place in the Cheongju, and by academically associating with Sagye Jang-Seng Kim without regarding their conflicting parties, he became the bridge in allowing his disciple, Deok-Soo LEE to associate with the academic stream and the 'Gihohakpa'. Through such roles, he allowed the relatively easy establishment of the 'Gihohakpa' and 'Hoseosarim', which continued to Jang-Seng KIM and Si-Yeol SONG, in order to prepare the basis and establish the strength of its basis in the Cheongju region from the late 17th century.
The Korean Criminal Code ${\S}10$ (1) provides that "The act of a person who, because of mental disorder, is unable to make discriminations or to control one's will, shall not be punished". Therefore, it'll not be able to be given criminal punishment if a mentally defective person is determined to lack the criminal liability. The problem about judging the criminal liability for the mentally defective person exists in areas where the criminal law intersects with psychiatry. Although the supreme court ultimately judges whether the criminal liability by mental defectiveness exists or not, the judgment of mental defectiveness, which is biological element, needs psychiatric knowledge and it is no wonder to rely on this. In particular, a change is required in the procedure and contents of mental examination for a mentally defective person as implementation of the Civil Participation in Criminal Jury Trial. It is needed the improvement of procedure to submit more accurate mental examination and the result of it in order that jurors are able to understand the result of mental examination and make an decision. This is because jurors consisting of ordinary citizens take part in trial. For guaranteeing the precise result of mental examination in the criminal justice procedure, it is necessary to establish the pool of manpower consisting of psychiatrists or psychologists who have completed the specific educational programs about the criminal justice and legal psychiatry, and it is desired to carry out the psychiatric test with selecting appraisers who belong to a pool of manpower. Furthermore, it is required to draw up and submit the written appraisal of mental examination which is easy to be known because of considering the nonprofessional of jurors consisting of ordinary citizens in the Civil Participation in Criminal Jury Trial. In order to gain a fair verdict of the jury about whether mental defectiveness exists or not, it is recommended the prompt submission of the written appraisal of mental examination, the presentation of the written appraisal of mental examination summarizing the important contents, and making out the written appraisal of mental examination for jurors to understand it easily.
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