• Health Policy and Management
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• v.34 no.2
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• pp.163-177
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• 2024

Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

• The Korean Journal of Air & Space Law and Policy
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• v.32 no.1
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• pp.83-138
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• 2017

Korea-China FTA entered into force on the 20th of December 2015, and one year elapsed after its effectuation as the FTA with China, our country's largest trading partner. Therefore, this study looks at the trends of air transport trade between Korea and China, and examines the contents of concessions to the air transport services sector in Korea-China FTA, and analyzes the impact on the air transport sector by Korea-China FTA, and proposes our country's aviation policy direction in order to respond to such impact. In 2016 the trends of air transport trade between Korea and China are as follows : The export amount of air transport trade to China was 40.03 billion dollars, down by 9.3% from the last year, and occupied 32.2% of the total export amount to China. The import amount of air transport trade from China was 24.26 billion dollars, down by 9.1% from the last year, and occupied 27.7% of the total import amount from China. The contents of concessions to the air transport services sector in Korea-China FTA are as follows : China made concessions to the aircraft repair and maintenance services and the computer reservation system services with limitations on market access and national treatment in the air transport services sector of the China Schedule of Specific Commitments of Korea-China FTA Chapter 8 Annex. Korea made concessions to the computer reservation system services, selling and marketing of air transport services, and aircraft repair and maintenance without limitations on market access and national treatment in the air transport services sector of the Korea Schedule of Specific Commitments of Korea-China FTA Chapter 8 Annex. The impact on the air transport sector by Korea-China FTA are as follows : As for the impact on the air passenger market, in 2016 the arrival passengers of the international flight from China were 9.96 million, up by 20.6% from the last year, and the departure passengers to China were 9.90 million, up by 34.8% from the last year. As for the impact on the air cargo market, in 2016 the exported goods volumes of air cargo to China were 105,220.2 tons, up by 6.6% from the last year, and imported goods volumes from China were 133,750.9 tons, up by 12.3% from the last year. Among the major items of exported air cargo to China, the exported goods volumes of benefited items in the Tariff Schedule of China of Korea-China FTA were increased, and among the major items of imported air cargo from China, the imported goods volumes of benefited items in the Tariff Schedule of Korea of Korea-China FTA were increased. As for the impact on the logistics market, in 2016 the handling performance of exported air cargo to China by domestic forwarders were 119,618 tons, down by 2.1% from the last year, and the handling performance of imported air cargo from China were 79,430 tons, down by 4.4% from the last year. In 2016 the e-commerce export amount to China were 109.16 million dollars, up by 27.7% from the last year, and the e-commerce import amount from China were 89.43 million dollars, up by 72% from the last year. The author proposes the aviation policy direction of Korea according to Korea-China FTA as follows : First, the open skies between Korea and China shall be pushed ahead. In June 2006 Korea and China concluded the open skies agreement within the scope of the third freedom and fourth freedom of the air for passenger and cargo in Sandong Province and Hainan Province of China, and agreed the full open skies of flights between the two countries from the summer season in 2010. However, China protested against the interpretation of the draft of the memorandum of understanding to the air services agreement, therefore the further open skies did not take place. Through the separate aviation talks with China from Korea-China FTA, the gradual and selective open skies of air passenger market and air cargo market shall be pushed ahead. Second, the competitiveness of air transport industry and airport shall be secured. As for the strengthening methods of the competitiveness of Korea's air transport industry, the support system for the strengthening of national air carriers' competitiveness shall be prepared, and the new basis for competition of national air carriers shall be made, and the strategic network based on national interest shall be built. As for the strengthening methods of the competitiveness of Korea's airports, particularly Incheon Airport, the competitiveness of the network for aviation demand creation shall be strengthened, and the airport facilities and safety infrastructure shall be expanded, and the new added value through the airport shall be created, and the world's No.1 level of services shall be maintained. Third, the competitiveness of aviation logistics enterprises shall be strengthened. As for the strengthening methods of the competitiveness of Korea's aviation logistics enterprises, as the upbringing strategy of higher added value in response to the industry trends changes, the new logistics market shall be developed, and the logistics infrastructure shall be expanded, and the logistics professionals shall be trained. Additionally, as the expanding strategy of global logistics market, the support system for overseas investment of logistics enterprises shall be built, and according to expanding the global transport network, the international cooperation shall be strengthened, and the network infrastructure shall be secured. As for the strengthening methods of aviation logistics competitiveness of Incheon Airport, the enterprises' demand of moving in the logistics complex shall be responded, and the comparative advantage in the field of new growth cargo shall be preoccupied, and the logistics hub's capability shall be strengthened, and the competitiveness of cargo processing speed in the airport shall be advanced. Forth, in the subsequent negotiation of Korea-China FTA, the further opening of air transport services sector shall be secured. In the subsequent negotiation being initiated within two years after entry into force of Korea-China FTA, it is necessary to ask for the further opening of the concessions of computer reservation system services, and aircraft repair and maintenance services in which the concessions level of air transport services sector by China is insufficient compared to the concessions level in the existing FTA concluded by China. In conclusion, in order to respond to the impact on Korea's air passenger market, air cargo market and aviation logistics market by Korea-China FTA, the following policy tasks shall be pushed ahead : Taking into consideration of national air carriers' competitiveness and nation's benefits, the gradual and selective open skies shall be pushed ahead, and the support system to strengthen the competitiveness of air transport industry and airport shall be built, and entry into aviation logistics market by logistics enterprises shall be expanded, and the preparations to ask for the further opening of air transport services sector, low in the concessions level by China shall be made.

• Journal of the Korean Geographical Society
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• v.30 no.3
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• pp.242-254
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• 1995

The Hadano Basin is located at a distance of about 70kms and 60kms from Tokyo and Yokohama and lies in the south-west part of the Kanto region in Japan. The basin area, which correspoends to the catchment of the Kaname River, is about areal size of 60.7$\textrm{km}^2$ and extends about length of 8kms in E-W direction and about width of 5kms in N-S direction (Fig.1). The Hadano basin is filled with thick pile of the alluvum from deposits composed of volcanic materials, mostly came from the Hakone Volcano and overlain by Fuji Volcanic ashes. Fluvial deposits form the good aquifer, therefore water resources of Handano City has been largely depending upon the eroundwater. Urbanization and industrialization of the basin has been rapid in the last thirty years, after activation of "Factory Attraction Policy of Hadano City" in 1956. Growth in population and number of factory due to urbanization changed the land-use pattern of the basin rapidly and increased the water demands. Therefore, Hadano City exploited a new source of water supply, and have introduced the prefectureal waterworks since 1976. On the other hand, the rapid urbanization has brought about the pollution of streams in the basin by domestic sewage and industrial waste water. Diffusion rate of sewerage systems in Hadano City is 38% in 1993. In ordcr to examine the impact of anthropogenic factors on river environments, the author took up the change of land-use and diffusion area of sewerage as parameters, and performed field surveys on water discharge and quality. The survey has been made at upstream and downstream of the main stream regularly per month, to get informati ons about the variation of discharge and water quality aiong the stream and its diurnal fluctuation. Annual variation has been analyzed based the data from Hadano City Office. The results are summarized as follows. 1. Stream discharge has been increasing by urbanization (Fig.3). Water quality (C $l^{-10}$ , N $H^{+}$$_{ 4}$-N, BOD) has been improving gradually after the application of sewerage service, yet water pollution load at the lower station has increased than that at the upper one because of the larger anthropogenic discharge volumes (Fig.4). 2. Corrclation coefficient of discharges between upper and lower was 0.81-0.92. Pollutant loads of the R. Kamame after the confluence with R. Kuzuha grew up by 2.4-3.7 times as compared with its upper reaches, and it increased to 3.7-6.9 times after the confluence with the R. Muro (Fig.5). 3. The changes of water quality along the stream can be divided into two groups (Fig.6a). First: water quality of the R. Kaname and R. Shijuhachisse is becoming worse towards the lower reaches because the water from branches are polluted. Second: water quality are improved in the lower where spring and small branch streams supply clear water, for example R. Mizunashi, R. Muro and R. Kuzuha. 4. Measured discharge at the upper station in the R. Shijuhachisse is 0.153㎥/sec, and about 55% of this is recharged until it reaches to the lower point. The R. Mizunashi has a discharge of 1.155㎥/sec at the upper point, is recharged 0.24㎥/sec until the midstream and groundwater spring 0.2㎥/sec at the lower reaches. R. Kuzuha recharged all the mountain runoff (0.2㎥/sec) at the upper reaches. The R. Muro is supplied by many springs and the estimated discharge of spring was 0.47㎥/sec (Fig.6b). 5. Diurmal variations in discharge and water quality are influenced clearly by domestic and industrial waste waters (Fig.7, 8).ed clearly by domestic and industrial waste waters (Fig.7, 8).

• KDI Journal of Economic Policy
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• v.13 no.1
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• pp.115-134
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• 1991

The role of pension plans in the macroeconomy has been a subject of much interest for some years. It has come to be recognized that pension plans may alter basic macroeconomic behavior patterns. The net effects on both savings and labor supply are thus matters for speculation. The aim of the present paper is to provide quantitative results which may be helpful in attaching orders of magnitude to some of the possible effects. We are not concerned with the providing empirical evidence relating to actual behavior, but rather with deriving the macroeconomic implications for a alternative possibilities. The pension plan interacts with the economy and the population in a number of ways. Demographic variables may thus affect both the economic burden of a national pension plan and the ability of the economy to sustain the burden. The tax transfer process associated with the pension plan may have implications for national patterns of saving and consumption. The existence of a pension plan may have implications also for the size of the labor force, inasmuch as labor force participation rates may be affected. Changes in technology and the associated changes in average productivity levels bear directly on the size of the national income, and hence on the pension contribution base. The vehicle for the analysis is a hypothetical but broadly realistic simulation model of an economic- demographic system into which is inserted a national pension plan. All income, expenditure, and related aggregates are in real terms. The economy is basically neoclassical; full employment is assumed, output is generated by a Cobb-Douglas production process, and factors receive their marginal products. The model was designed for use in computer simulation experiments. The simulation results suggest a number of general conclusions. These may be summarized as follows; - The introduction of a national pension plan (funded system) tends to increase the rate of economic growth until cost exceeds revenue. - A scheme with full wage indexing is more expensive than one in which pensions are merely price indexed. - The rate of technical progress is not a critical element in determining the economic burden of the pension scheme. - Raising the rate of benefits affects its economic burden, and raising the age of eligibility may decrease the burden substantially. - The level of fertility is an element in determining the long-run burden. A sustained low fertility rate increases the proportion of the aged in total population and increases the burden of the pension plan. High fertility has inverse effects.

• The Journal of Art Theory & Practice
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• no.1
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• pp.109-144
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• 2003

Orientalness is a concept that expresses the collective identity of the Orient in relation to the West. The concept itself is mutable and defined by the relationship between the two regions at different points in time. Changes in the concept depend on a number of factors, such as cultural influence, the political balance of power between the two regions, and on the interpretative scheme that defines the relationship. In addition, the geographical notion of the concept evolves culturally, socially and politically. During this process, Oriental-ness becomes Oriental-ism at times. I will attempt to survey and measure the progression of Orientalness from its emergence in early 17th century to its subsequent transformation in modern Korea as reflected in art theory and art works. The recognition of the comparative characteristics of Oriental art began when the Orient was exposed to the art of the West in the late Ming dynasty during the early 17th century. The changes in the artistic climate in China affected the late Chosun. I will start with a brief introduction of this time and the birth of Orientalness. The concept gradually changed during the period of Enlightenment(開化期) towards the end of the 19th century, and during the colonial period( 1910-1945) it took on a new form. Establishment of the concept of "Orient"as a single, unifying concept spanning across cultures and national boundaries has been attributed to late Meiji period Japan, whose intention at that time is believed to have been to build a pan-Asia(亞細亞) empire with Japan at its commanding center. It has been stressed that the real motive behind the formation of one single cultural unit, where the shared common written language was Chinese and Confucianism and Taoism were the common metaphysical traditions, was to build one political unit. When the notion of a geographical unit of Asia was replaced by the concept of Asia as a cultural and political unit, a massive growth of interest and discourse were provoked around the concept of Orientalism. When Orientalism was being formulated, Korea automatically became member of "one Asia" when the country became colonized. For Koreans, the identity of the Orient had to be defined in cultural terms, as the political notion of a nation was non-existent at that time. The definition of identity was pursued at two levels, pan-Asian and local. If Orientalism was an elite discourse centered in pan-Asian philosophical and religious tradition, localized Orientalism was a popular discourse emphasizing locality as the byproduct of natural geographic condition. After the liberation in 1945 from colonial rule, a thrust of movement arose towards political nationalism. Two types of discourses on Orientalism, elite and popular, continued as central themes in art. Despite the effort to redefine the national identity by eradicating the cultural language of the colonial past, the past was enduring well into the present time. As discussed above, even when the painting themes were selected from Korean history, the tradition of using history painting as a manifestation of political policy to glorify the local identity had its founding during the Meiji period. The elevation of folk art to the level of high art also goes back to the colonial promotion of local color and local sentiment. Again, the succession of the past (colonial) ideal was defended as the tradition assumed a distinct modern shape that was abstract in style. The concept of the "Orient" is of relative and changing nature. It was formulated in relation to Western culture or civilization. Whatever the real motive of the adoption of them had been, the superiority of the Orient was emphasized at all times. The essence of the Orient was always perceived as the metaphysical tradition as a way to downgrade Western culture as materialistic. This view still prevails and the principle of Orient was always sought in Confucianism, Taoism, and Buddhism. Even when Orientalism was employed by imperialist Japan in an effort to establish her position as the center of the Orient, the spiritual source was still in Chinese philosophy and religion. In art also, the Chinese literati tradition became the major platform for elite discourse. Orientalism was also defined locally, and the so-called local color was pursued in terms of theme and style. Thus trend continued despite the effort to eradicate the remnants of colonial culture long after liberation. These efforts are now being supported politically and also institutionalized to become the aesthetic ideal of the modern Korean art.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.36 no.1
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• pp.49-63
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• 2016

In this study, we analyzed the effects of regional hydrologic variability during warm season (June-September) in South Korea due to ENSO (El $Ni{\tilde{n}}o$-Southern Oscillation) pattern changes over the Tropical Pacific Ocean (TPO). We performed composite analysis (CA) and statistical significance test by Student's t-test using observed hydrologic data (such as, precipitation and streamflow) in the 113 sub-watershed areas over the 5-Major River basin, in South Korea. As a result of this study, during the warm-pool (WP) El $Ni{\tilde{n}}o$ year shows a significant increasing tendency than normal years. Particularly, during the cold-tongue (CT) El $Ni{\tilde{n}}o$ decaying years clearly decreasing tendency compared to the normal years was appeared. In addition, the La $Ni{\tilde{n}}a$ years tended to show a slightly increasing tendency and maintain the average year state. In addition, from the result of scatter plot of the percentage anomaly of hydrologic variables during warm season, it is possible to identify the linear increasing tendency. Also the center of the scatter plot shows during the WP El $Ni{\tilde{n}}o$ year (+17.93%, +26.99%), the CT El $Ni{\tilde{n}}a$ year (-8.20%, -15.73%), and the La $Ni{\tilde{n}}a$ year (+8.89%, +15.85%), respectively. This result shows a methodology of the tele-connection based long-range water resources prediction for reducing climate forecasting uncertainty, when occurs the abnormal SSTA (such as, El $Ni{\tilde{n}}o$ and La $Ni{\tilde{n}}a$) phenomenon in the TPO region. Furthermore, it can be a useful data for water managers and end-users to support long-range water-related policy making.

• The Journal of Art Theory & Practice
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• no.4
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• pp.77-104
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• 2006

The propaganda paintings in oil colors or in forms of posters made from 1949 to 1966 have gone through some changes experiencing the influence of the Soviet Union Art and discussion of nationalization, while putting political messages of the time in the picture planes. The propaganda paintings which have been through this process became an effective means of encouraging the illiterate people in political ideologies, production, and learning. Alike other propaganda paintings in different mediums, the ones which were painted in oil colors and in the form of posters have been produced fundamentally based on Mao Zedong's intensification of the literary art on the talks on literature at Yenan. Yet, the oil paintings and posters were greatly influenced by the socialist realism and propaganda paintings of the Soviet Union, compared to other propaganda paintings in different mediums. Accordingly, they were preponderantly dealt in the discussions of nationalization of the late '50s. To devide in periods, the establishment of People's Republic of China in 1949 as a diverging point, the propaganda paintings made before and after 1949 have differences in subject matters and styles. In the former period, propaganda paintings focused on the political lines of the Communists and enlightenment of the people, but in the latter period, the period of Cultural Revolution, the most important theme was worshiping Mao Zedong. This was caused by reflection of the social atmosphere, and it is shown that the propaganda painters had reacted sensitively to the alteration of politics and the society. On the side of formalities, the oil paintings and posters made before the Cultural Revolution were under a state of unfolding several discussions including nationalization while accepting the Soviet Union styles and contents, and the paintings made afterwards show more of unique characteristics of China. In 1956, the discussion about nationalization which had effected the whole world of art, had strongly influenced the propaganda paintings in oil colors more than anything. There were two major changes in the process of making propaganda paintings in oil colors. One was to portray lives of the Chinese people truthfully, and the other was to absorb the Chinese traditional styles of expression. After this period, the oil painters usually kept these rules in creating their works, and as a result, the subject matters, characters, and backgrounds have been greatly Sinicized. For techniques came the flat colored surface of the new year prints and the traditional Chinese technique of outlining were used for expressing human figures. While the propaganda paintings in oil colors achieved high quality and depth, the posters had a very direct representation of subject matters and the techniques were unskilled compared to the oil paintings. However, after the establishment of People's Republic of China, the posters were used more than any other mediums for propagation of national policy and participation of the political movements, because it was highly effective in delivering the policies and political lines clearly to the Chinese people who were mostly illiterate. The poster painters borrowed techniques and styles from the Soviet Union through books and exhibitions on Soviet Union posters, and this relation of influences constantly appears in the posters made at the time. In this way, like the oil paintings, the posters which have been made with a direct influence of the Soviet Union had developed a new, sinicised process during the course of nationalization. The propaganda paintings in oil colors or in forms of posters, which had undergone the discussion of nationalization, had put roots deep down in the lives of the Chinese people, and this had become another foundation for the amplification of influences of political propaganda paintings in the following period of Cultural Revolution.

• Clinical and Experimental Pediatrics
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• v.46 no.11
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• pp.1073-1079
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• 2003

Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

• Journal of Hospice and Palliative Care
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• v.18 no.2
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• pp.128-135
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• 2015

Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.