• Journal of agricultural medicine and community health
• /
• v.28 no.2
• /
• pp.1-14
• /
• 2003

Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

• Journal of agricultural medicine and community health
• /
• v.37 no.2
• /
• pp.84-95
• /
• 2012

Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

• Journal of agricultural medicine and community health
• /
• v.35 no.2
• /
• pp.151-164
• /
• 2010

Objective:Korea has 3,170 islands with about 188,000 inhabitants. These inhabitants' needs for health services might go unmet because of geographic isolation, slimmer availability of health services, and higher proportion of the elderly compared with the mainland population. Unmet health service needs might result in serious health problems for these island residents. Therefore, the purpose of this study was to investigate their unmet health service needs and related factors from population of Nowha island. Methods: The survey was conducted from July 30 to August 1 by trained interviewers. Target population were residents in Nohwa island and the sampling method was incomplete quota sampling. General characteristics, socioeconomic status, utilization of health service, and unmet medical service needs were investigated. First univariate and then multivariate logistic analyses were done for the statistical analysis. Results: 324 residents were surveyed and the proportion of unmet health services needs was 26.5%. People living alone and of female sex had increased health services needs based on univariable analysis. From the multivariate analysis, those living alone increased the health services needs. Self-determined low socioeconomic status and medical aid increased the proportion of unmet medical needs, but these were not statistically significant. Conclusion:In Nowha island, those who are elder, and of lower socioeconomic status had much higher unmet medical needs. The results suggest the need for more social support by qualified health services to solve this unmet medical needs problem.

• Journal of Arbitration Studies
• /
• v.24 no.2
• /
• pp.33-52
• /
• 2014

Although climate change is a global scale question, some concerns have been raised that principles of investment arbitration may not adequately address the domestic implementation of climate change measures. A recent ICSID investment arbitration of Vattenfall v. Germany with regard to the investor's alleged damages from the phase-out of nuclear plants is a salient climate change case. The 2005 Kyoto Protocol was made to reduce greenhouse gas emissions and it provides a number of flexible mechanisms such as Joint Implementation (JI) and Clean Development Mechanism (CDM). Implementation of the Kyoto Protocol allows dispute settlement through investor-state arbitration. Any initiation of stricter emission standards can violate the prohibition on expropriations in investment agreements, regardless of the measures created to reduce greenhouse gas emissions. The effect-based expropriation doctrine can charge changes to existing emission standards as interference with the use of property that goes against the legitimate expectation of a foreign investor. In regulatory chill, threat of investor claims against the host state may preclude the strengthening of climate change measures. Stabilization clauses also have a freezing effect on the hosting state's regulation and a new law applicable to the investment. In the fair and equitable standard, basic expectations of investors when entering into earlier carbon-intensive operations can be affected by a regulation seeking to change into a low-carbon approach. As seen in the Methanex tribunal, a non-discriminatory and public purpose of environmental protection measures should be considered as non-expropriation in the arbitral tribunal unless its decision would intentionally impede a foreign investor's investment.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.6 no.3
• /
• pp.414-433
• /
• 1999

The purpose of this study is to identify the needs which are perceived by one of the familiy members who have head injury parients by traffic accidents in the intensive care units. Subjects were 70 families members of head injury patients admitted to 2 general hospitals NICU located Pusan city, 1 general hospital NICU located Ulsan city from December 1. 1998 to February 28. 1999. For this study, 70 family members were interviewed with aid of a Likert scale which was developed by researcher for this study. For development of the survey instrument, literature review and open questionnaire technique with family members and the nurses working in NICU. The 50needs-items were classified into 7 groups according to the homogeneity of the items with the support of literature review. For the content validity, the instrument was reviewed by 1 nursing professor and the internal reliability of this instrument was Cronbach alpha=0.94 which is highly accepted. Data was analyzed by a SPSS computer program. Data analysis included frequency. percentage, mean, standard variance and t-test or ANOVA. The results were as followings : 1. The general characteristics of head injury patients shows that the male was 74.3%, the female was 25.7% and age distribution shows that the fifty-fifty nine years was 30%, the highest. Of religion the buddhism was the most, The diagnosis distribution shows that epidural hematoma was 32.9% and subdural hematoma was 24.3%. The mentalility distribution shows that semicoma was 31.4% and stupor was 31.4%. Hemiplegia was 42.9% 2. The general charaterisrics of the family needs of head injury patients shows that thirty-thirty nine years was 31.4%, the highest. sex distribution shows that the male was 20%, the female was 80%. Of religion the buddism was the most. 3. The family needs of head injury patients was $3.03{\pm}0.42$, needs for the information of a patient's condition was $3.65{\pm}0.48$, the highest. And needs for the information of care and treatment was $3.48{\pm}0.48$, needs to be supplied with comfortable facilities for family was $3.04{\pm}0.66$, needs to be participate in a patient's care was $2.90{\pm}0.55$, needs to be informed about the available resources was $2.83{\pm}0.59$, needs to be supported emotionally for family was $2.79{\pm}0.55$, needs for religious assistance was $2.51{\pm}0.85$. 4. Examining the family needs of head injury patients according to patient's characteristics, mentality, plegia degree and operation were shown be variables to make an effect on the needs for the head injury patients family. At all, according to severity of head. injury, the family needs of head injury patients was high. 5. Examining the family needs of head injury patients according to their general characteristics, we could know that religion, job. income were shown to be variables to make an effect on the family needs. Through the examination it can be seen that the characteristics of head injury patients and the family needs of head injury patients. In conclusion, the family needs of head injury patients was almost same the family needs of ICU patients. Therefore we must involve the family's care of head injury patients and we must provide exact and repeated explanation, education and support the family of head injury patients. As this study was resulted in selecting the families admitted to NICU of some general hospital, we couldn't stretch the result in our favor. Therefore, continuous studies are suggested.

• KDI Journal of Economic Policy
• /
• v.32 no.4
• /
• pp.153-195
• /
• 2010

The recent global financial crisis has been the outcome of, among other things, the mismatch between institutions and the reality of the market in the current global financial system. The International financial institutions (IFIs) that were designed more than 60 years ago can no longer effectively meet the challenges posed by the current global economy. While the global financial market has become integrated like a single market, there is no international lender of last resort or global regulatory body. There also has been a rapid shift in the weight of economic power. The share of the Group of 7 (G7) countries in global gross domestic product (GDP) fell and the share of emerging market economies increased rapidly. Therefore, the tasks facing us today are: (i) to reform the IFIs -mandate, resources, management, and governance structure; (ii) to reform the system such as the international monetary system (IMS), and regulatory framework of the global financial system; and (iii) to reform global economic governance. The main focus of this paper will be the IMS reform and the role of the Group of Twenty (G20) summit meetings. The current IMS problems can be summarized as follows. First, the demand for foreign reserve accumulation has been increasing despite the movement from fixed exchange rate regimes to floating rate regimes some 40 years ago. Second, this increasing demand for foreign reserves has been concentrated in US dollar assets, especially public securities. Third, as the IMS relies too heavily on the supply of currency issued by a center country (the US), it gives an exorbitant privilege to this country, which can issue Treasury bills at the lowest possible interest rate in the international capital market. Fourth, as a related problem, the global financial system depends too heavily on the center country's ability to maintain the stability of the value of its currency and strength of its own financial system. Fifth, international capital flows have been distorted in the current IMS, from EMEs and developing countries where the productivity of capital investment is higher, to advanced economies, especially the US, where the return to capital investment is lower. Given these problems, there have been various proposals to reform the current IMS. They can be grouped into two: demand-side and supply-side reform. The key in the former is how to reduce the widespread strong demand for foreign reserve holdings among EMEs. There have been several proposals to reduce the self-insurance motivation. They include third-party insurance and the expansion of the opportunity to borrow from a global and regional reserve pool, or access to global lender of last resort (or something similar). However, the first option would be too costly. That leads us to the second option - building a stronger globalfinancial safety net. Discussions on supply-side reform of the IMS focus on how to diversify the supply of international reserve currency. The proposals include moving to a multiple currency system; increased allocation and wider use of special drawing rights (SDR); and creating a new global reserve currency. A key question is whether diversification should be encouraged among suitable existing currencies, or if it should be sought more with global reserve assets, acting as a complement or even substitute to existing ones. Each proposal has its pros and cons; they also face trade-offs between desirability and political feasibility. The transition would require close collaboration among the major players. This should include efforts at the least to strengthen policy coordination and collaboration among the major economies, and to reform the IMF to make it a more effective institution for bilateral and multilateral surveillance and as an international lender of last resort. The success on both fronts depends heavily on global economic governance reform and the role of the G20. The challenge is how to make the G20 effective. Without institutional innovations within the G20, there is a high risk that its summits will follow the path of previous summit meetings, such as G7/G8.

• KDI Journal of Economic Policy
• /
• v.32 no.4
• /
• pp.1-34
• /
• 2010

We conduct a comprehensive risk analysis of household debt in Korea for the first time using the whole sample credit bureau (CB) data of 2.2 million individual debtors. After analysing debt service capacity profiles of debtor groups classified by the borrower characteristics such as income, age, occupation, credit scoring, and the type of creditor business companies, we investigate the impact of interest rate and income changes on debt service-to-income ratios (DTIs) and default rates of respective debtor groups. Empirical results indicate that debt service burdens are relatively high for low income wage earners, high income self-employed, low income capital and card loan holders, and high income mutual savings loan holders. We also find that debtors from multiple financial companies are particularly weak in their debt service capacity. The scenario analysis indicates that financial companies, with the current level of capital buffers, may be able to absorb negative consequences arising from the increase in DTIs and loan default rates if the interest rate and income changes remain modest. However, the negative consequences may fall disproportionately on non-bank financial companies such as capital, credit card, and mutual savings banks, whose debtors' DTIs are already high. We also find that the refinancing risk of household debt is relatively high in Korea as more than half of household mortgage debts are bullet loans. As the DTIs of mortgage loan holders are already high, under the current DTI regulation, mortgage loans may not be readily refinanced especially when the interest rate rises. Disruptions in mortgage loan refinancing may put downward pressure on housing prices, which may in turn magnify refinancing risk under the current loan-to-value (LTV) regulation. Overall our analysis suggests that, for more effective monitoring of household debt risk, it is necessary to combine existing surveillance schemes based on macro aggregate indicators with more comprehensive and detailed risk analyses based on micro individual data.

• Journal of Technologic Dentistry
• /
• v.29 no.2
• /
• pp.151-161
• /
• 2007

To obtain the information of dental arch size and the distance from one tooth center to adjacent tooth center of occlusal surface of each tooth which is perforated by Pindex system on working cast for removable die system, 600 dental casts in Busan were examined. The distance of center of occlusal surface of each tooth and dental arch size were digitized. The results were as follows; 1. Mean values of the distance from center of maxillary central incisor to maxillary lateral incisor(tooth number 11$\sim$12, 21$\sim$22) is 5,7 mm, 12$\sim$13(22$\sim$23) is 5.9 mm, 13$\sim$14(23$\sim$24) is 6.9 mm, 14$\sim$15(24$\sim$25) is 7.1 mm, 15$\sim$16(25$\sim$26) is 8.4 mm, 16$\sim$17(26$\sim$27) is 10.2 mm, 11$\sim$21 is 7.30 mm. Mean values of the distance from center of mandibular central incisor to mandibular lateral incisor(tooth number 31$\sim$32, 41$\sim$42) is 4.5 mm, 32$\sim$33(42$\sim$43) is 4.8 mm, 33$\sim$34(43$\sim$44) is 6.3 mm, 34$\sim$35(44$\sim$45) is 7.2 mm, 35$\sim$36(45$\sim$46) is 9.2 mm, 36$\sim$37(46$\sim$47) is 10.7 mm, 31$\sim$41 is 4.7 mm. 2. Mean values of the distance from the center of maxillary right central incisor to the center of maxillary left central incisor(11$\sim$21) is 7.3 mm, 12$\sim$22 is 18.2 mm, 13$\sim$23 is 26.9 mm, 14$\sim$24 is 37.2 mm, 15$\sim$25 is 43.2 mm, 16$\sim$26 is 48.5 mm, 17$\sim$27 is 53.5 mm. Mean values of the distance from the center of mandibular right central incisor to the center of mandibular left central incisor(31$\sim$41) is 4.7 mm, 32$\sim$42 is 13.3 mm, 33$\sim$43 is 21.7 mm, 34$\sim$44 is 31.9 mm, 35$\sim$45 is 38.2 mm, 36$\sim$46 is 44.8 mm, 37$\sim$47 is 50.7 mm. 3. Mean values of the distance from the line of between 11$\sim$21 to 12$\sim$22 is 10.9 mm, 12$\sim$22 to 13$\sim$23 is 8.7 mm, 13$\sim$23 to 14$\sim$24 is 10.3 mm, 14$\sim$24 to 15$\sim$25 is 6.0 mm, 15$\sim$25 to 16$\sim$26 is 5.3 mm, 16$\sim$26 to 17$\sim$27 is 5.0 mm. 31$\sim$41 to 32$\sim$42 is 8.6 mm, 32$\sim$42 to 33$\sim$43 is 8.4 mm, 33$\sim$43 to 34$\sim$44 is 10.2 mm, 34$\sim$44 to 35$\sim$45 is 6.3 mm, 35$\sim$45 to 36$\sim$46 is 6.6 mm, 36$\sim$46 to 37$\sim$47 is 5.9 mm. 4. We checked the bottom side of cast to verify the position of dowel pin. There is no difference upper side and lower side.

• Journal of the Institute of Electronics and Information Engineers
• /
• v.52 no.9
• /
• pp.117-124
• /
• 2015

In this paper, we introduce how to control TR, TE physical MR parameters for managing $H_1$ spin's SI(Signal Intensity) which is combined with gadolinium following administration MR agent in T1 effect for diagnostic usefulness. we used MRI phantom made with 0.5 mol Gadoteridol. This phantom was scanned by FSE sequence with different TR, TE parameters. In this study, to make T1 effect, TR was 200, 250, 300, 350, 400, 450, 500, 550, 600 msec. In addition to, TE was 6.2, 12.4, 18.6, 21.6 msec. The results were as follows ; Each RSP(Reaction Starting Point) was 100, 50, 40, 30 mmol in TE 6.2, 12.4, 18.6, 21.6 msec being irrelevant to TR. In MPSI(Max Peak Signal Intensity), 4 mmol was showed in TR 200 msec while peak signal was decreased to low concentration mol in TR 250-600 msec. In terms of RA(Reaction Area), the highest SI was TE 6.2 msec in TR 200-600msec. According to the study, we are able to recognize it is possible to control enhance rates by managing TR and TE of MR parameters; moreover, we expect that enhanced T1 image in MR clinical field can be performed in a practical way with this quantitative data.

• Journal of the Institute of Electronics and Information Engineers
• /
• v.52 no.12
• /
• pp.134-141
• /
• 2015

The purpose on this research is quantitatively comparing and analyzing signal intensity of 1.0mol and 0.5mol contrast agent. For this study, two MR phantoms were produced. One of them is used with 1.0mol Gadobutrol. The other is used with 0.5mol Gadoteridol. These two phantoms respectively have been scanned by SE T1 sequence which is used to get a general contrast-enhanced image in 1.5T MRI and 3D FLASH sequence which is used as enhanced angio MRI. Signal intensity was measured by scanned images as per contrast agent dilution ratio. The results were as follow: RSP(Reaction Starting Point) of the two sequences(2D SE, 3D FLASH) was respectively 6.0%, 60.0% in 0.5mol contrast and 2.0%, 20.0% in 1.0mol contrast, which means in 0.5mol contrast, RSP was formed faster than the one in 1.0mol contrast. MPSI was respectively 1358.8[a.u], 1573[a.u] in 0.5mol contrast and 1374[a.u], 1642.4[a.u] in 1.0mol contrast, which means 0.5mol contrast's MPP (0.4%, 10.0%) was formed faster than 1.0mol contrast's MPP (0.16%, 1.8%). Lastly, RA as per contrast agent dilution ratio was 27.4%, 11.8% wider in 0.5mol contrast(20747.4[a.u], 23204.6[a.u]) than in 1.0mol contrast(12691.9[a.u], 20747.4[a.u]). According to the study, we are able to assure that signal reaction time of 1.0mol contrast is slower than the one of 0.5mol contrast in contrast-enhanced MRI at two different sequences(2D SE, 3D FLASH). Furthermore, owing to the fact that there are not any signal intensity differences between 1.0mol and 0.5mol contrast, it is not true that high concentration gadolinium MR contrast agent does not always mean high signal intensity in MRI.