• Title/Summary/Keyword: Status of children

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Current Status of the Reimbursement for Pharmacist-provided Health Care Services in Japan, the United States, and the United Kingdom (국외 약사서비스 지불보상체계 현황 : 일본, 미국, 영국을 중심으로)

  • Park, Ji Hyun
    • The Journal of the Korea Contents Association
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    • v.22 no.6
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    • pp.712-728
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    • 2022
  • World-widely, there has never been a greater need for people to access high-quality expertise about the effective and safe use of medications. Therefore, the profession of pharmacy should meet these needs of the times, as the demographic shifts have led to a situation where older adults now outnumber children, and polypharmacy is also a commonplace. However, the reimbursement system covered by the National Health Insurance (NHI) in Korea is still limited to the traditional dispensing and compounding role of pharmacist. To provide a take-home message to Korean pharmacy reimbursement system, we aimed to review and analyze the international trends in pharmacy remuneration systems. This is a comparative study between Korea, Japan, the United Kingdom, and the United States. Comparison was conducted by reviewing each country's policy and enforcement programs, as well as the related literature. Japan, the UK and the US systems remunerate diverse patient-centered pharmaceutical care services. The Korean pharmacy service fee is, however, narrowly focused on the traditional product-oriented pharmacy services. This study discussed the future direction of improving pharmacist reimbursement systems in Korea, by expanding professional pharmacy service coverage and diversifying fee schedule.

Clinical significance of acanthosis nigricans in children and adolescents with obesity induced metabolic complications (비만으로 인한 대사적 합병증을 가진 소아 및 청소년에서 흑색가시세포증의 임상적 의의)

  • Chueh, Hee Won;Cho, Gyu Rang;Yoo, Jaeho
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.987-994
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    • 2007
  • Purpose : This study investigated the clinical significance of AN in children and adolescents with obesity induced metabolic complications. Methods : Forty-nine patients who had obesity induced metabolic complications were participated in this cross-sectional study. Obesity induced metabolic complications are as follows: hypertension, dyslipidemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), nonalcoholic steatohepatitis (NASH), homeostasis model assessment of insulin resistance (HOMA-IR)>3.16. Clinical characteristics, such as, age, percentage-weight-for-height (PWH), pubertal status, blood pressure (BP), fasting plasma insulin level, fasting and post-oral glucose tolerance test 2-hour glucose levels, liver function test, lipid profile, HOMA-IR were compared according to the presence of AN. Results : Sixty-five percent of patients had AN, 57.1% NASH, 57.1% dyslipidemia, 55.1% hypertension, 46.9% IFG, 24.5% HOMA-IR>3.16 and 16.2% IGT. The patients who were moderately to severely obese with AN had higher incidence of IGT and HOMA-IR>3.16. The patients with AN had significantly higher diastolic BP ($79.4{\pm}6.9$ vs $75.4{\pm}5.6mmHg$), fasting levels of plasma insulin ($10.6{\pm}6.0$ vs $6.2{\pm}5.4{\mu}IU/mL$), HOMA-IR index ($2.6{\pm}1.4$ vs $1.4{\pm}1.3$) and PWH ($42.4{\pm}13.0$ vs $34.3{\pm}1.8%$). The increasing tendency for the presence of AN was significantly related to the cumulative number of obesity induced metabolic complications. Binary logistic regression analysis revealed that the presence of AN was significantly associated with fasting plasma insulin level, PWH and IFG. Conclusion : AN could be useful as a clinical surrogate of obesity induced metabolic complications.

Change Process of the Zoo in the Seoul Children's Grand Park (서울 어린이대공원 내 동물원의 변화과정)

  • Kim, Dong-Hoon;Kim, Ah-Yeon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.6
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    • pp.13-25
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    • 2016
  • This study aims to analyze the change process in order to set the improvement strategies for the zoo in the Seoul Children's Grand Park. The zoo can be reviewed through three significant time periods with noticeable changes. As a framework to analyze the major changes that happened in the zoo, this study looks at the changes in terms of the planning aspect as well as the animal welfare and program operation aspect. The findings are as follows: first, the era of general theme park turned out to have focused on exhibiting animals to meet visitor demands by expanding the zoo area of the zoo without enlarging stockyards for the animals. Second, the environmental park era created a zoo having entertaining and educational functions by arranging animal houses with the concept of zoological taxonomy and introducing animal behavioral enrichment, animal welfare programs and visitor participatory programs. The era of the zoo as an Urban Cultural Park improved old animal houses and facilities for the welfare of the animals and increased educational programs to preserve species and provide environmental education. The current status of the zoo turns out not to meet the conditions for creating an ecological zoo, which is the overall goal for contemporary zoos. The improvement strategies based on the analysis through three different eras are three-fold. First, the zoo needs to improve the boundary conditions of the animals to showcase animal wildness through landscape immersion. Second, the zoo should provide a shared environment for animals from the same habitats by changing the classification methods from the existing polyphyletic taxon to a classification that considers ecological habitat. Third, the zoo needs to develop various ecological education programs by supplementing specialists in professional education.

The Impact of Declining Profits on Closures of Pediatric Clinics (소아청소년과 의원의 수익 감소가 폐업에 미치는 영향)

  • Jeong-Yoon Oh;Su-Jin Cho;Hyun-Jung Byun;Choon-Seon Park;Jin-Suk Cho
    • Health Policy and Management
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    • v.34 no.1
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    • pp.38-47
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    • 2024
  • Background: Korea's population of children and adolescents has decreased by 2.88 million over the past decade and is expected to decline further due to the unprecedented low birth rate. In the fee-for-service compensation system, the decline in the pediatric population relates directly to the profit decrease in the pediatric clinics. This study analyzed whether the worsening profits of pediatric clinics impacted their closure. Methods: We built annual data for pediatric and other department clinics (internal medicine, otolaryngology, and family medicine) using the status of medical institute and health insurance claims data from 2012 to 2022. Then, we analyzed whether institutional variables such as annual profit and regional variables (Herfindahl-Hirschman index, the number of clinics per 100,000, etc.) affected the closure of clinics. The methods used in this study are descriptive statistics and chi-square analysis. Odds ratios for each variable were estimated by generalized estimating equations (GEE). Results: The closure rate of pediatric clinics was 2.66%-7.04% in 2012-2022, which was consistently higher than those of internal medicine, otolaryngology, and family medicine clinics. The profit gap per institution between the pediatric and the other clinics grew from 126 million won in 2012 to 245 million won in 2019. In the GEE analysis, profit decrease compared to the previous year with lower profit was the main factor that increased the closure of pediatric and other department clinics. After adjusting profit-related variables, the decrease in the pediatric population itself did not relate to the closure of pediatric clinics. The number of pediatric clinics or monopolies also did not affect the closure of pediatric clinics. Conclusion: The worsening profit is the crucial factor for the closure of pediatric clinics, while the pediatric population is decreasing. For this reason, it is necessary to actively seek ways to maintain a stable treatment system for children and adolescents.

An analysis of correlation between EEG signal and HRV during attentional status with children under 15 years (15세 미만 아동을 대상으로 한 집중상태에서 EEG 신호와 HRV의 상관관계 분석)

  • Choi, Woo-Jin;Lee, Chug-Ki;Yoo, Sun-Kook
    • Science of Emotion and Sensibility
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    • v.14 no.2
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    • pp.269-278
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    • 2011
  • This paper illustrates the inter-relationship between the theta/alpha ratio of the EEG signal and multiple HRV related parameters associated with the cardiovascular system response during event-related stimuli. Both EEG and PPG signals were simultaneously recorded in 21 healthy subjects. All subjects had their attention focused on the CNT program for nine minutes. Time-frequency analysis was applied to the EEG and PPG signals. The theta/alpha ratio was extracted from the EEG results, and the HRV features, including beat interval(1), SDNN(2), RMSSD(3), NN50(4), LF(5), HF(6), and LFIHF(7), were extracted from the PPG. Through multiple linear regression, the relationship ($R^2$) between the multiple combined features and the theta/alpha rhythm was identified. As a result, the combinations of $R^2$($R^2=0.253$; seven dimensions) and the theta/alpha ratio indicated a higher inter-relationship value than those of other combinations. The combinations of features that were greater than three dimensions, based on {SDNN(2), HF(6)}, generally showed higher $R^2$ value. We demonstrate that the high dimensional combinations had a higher correlation than did the low dimensional combinations.

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Psychological, relational and financial resources: How do they influence happiness among Koreans (심리적, 관계적, 경제적 자원: 한국인의 행복에 어떠한 영향을 미치는가?)

  • Youngshin Park ;Uichol Kim
    • Korean Journal of Culture and Social Issue
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    • v.15 no.1
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    • pp.95-132
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    • 2009
  • Can money buy happiness? If not, what are the factors that influence happiness? What makes people happy? What are the factors that influence happiness among Korean adults? How can we better explain factors that influence happiness? These are the research questions that led to the analyses of psychological, relational, financial resources that influence happiness. To examine differences in socio-economic status, adults and elderly from three different districts that vary wealth and income were interviewed in their own home. A total of 313 respondents (male=133, female=180) between the ages of 20 through 80 completed a questionnaire that contained background information, emotional support scale and happiness scale developed by the present researcher and resiliency of efficacy developed by Bandura(1995). The results are as follows. First, monthly income influence happiness to some extent, but when the variable was excluded from the path analysis, the goodness-of-fit did not change significantly. Although those who have more money can be happier, those without much money can also be happy. These results indicate that financial resource has limited influence on happiness. In addition, monthly income did influence self-efficacy of respondents indicating that those with more money were not necessarily more confident about themselves. Second, an important factor influencing happiness is the relational resource. Emotional support was the most powerful predictor of happiness, four to five times more important than monthly income. Third, self-efficacy influenced happiness. Those respondents with higher resiliency of efficacy had higher happiness scores and the influence was two times greater than monthly income. Moreover, self-efficacy played a mediating role between emotional support and happiness. Fourth, those respondents with higher occupational achievement reported higher happiness score and the influence was two times greater than monthly income. Fifth, success of children influenced happiness score and the influence was 1.5 times greater than monthly income. Sixth, education did not directly influence happiness, but had an indirect influence through self-efficacy and occupational achievement. Seventh, age was not related to self-efficacy and happiness.

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The Relationship between Social Relations and Physical Activity in the Young-old and Old-old Elderly (전·후기 노인들의 사회적 관계와 신체활동 실천과의 관련성)

  • So Youn Jeon;Sok Goo Lee
    • Journal of agricultural medicine and community health
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    • v.48 no.2
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    • pp.103-117
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    • 2023
  • Objectives: This study aims to reveal the relationship between social relations and physical activity in the young-old and old-old elderly. Methods: Data from 2020 National survey of Older Koreans were used, and a total of 10,097 subjects over the age of 65 were included in analysis. The dependent variable was physical activity, and the independent variables were social relations barrier and motivational factors. x2-test and binary logistic regression were performed for data analysis. Results: The physical activity rate in the elderly were 40.8% in the young-old and 29.2% in the old-old. The socio-demographic characteristics affecting physical activity were the young-old elderly were sex, residential area, employment status and household income, and the old-old elderly were sex, age, residential area, education level and household income. The social relations barrier factors affecting physical activity were the young-old elderly were number of close friends, family care, exercise information search and video viewing, and the old-old elderly were household type, number of close friends, participation in exercise education, exercise information search and video viewing. The social relations motivational factors affecting physical activity were the young-old elderly were call with children/relative/friend, participation in sports activity, access time from home to parks, and the old-old elderly were call with children/relative/friend, participation in sports activity, satisfaction with green spaces. Conclusions: It was found that social relations barrier and motivational factors of the elderly are important factors to consider when developing physical activity promotion strategy, and there are also difference between the age of the elderly.

A Meta-Analysis of Parental Involvement and Gifted Development (영재아의 부모 특성이 영재성에 미치는 영향에 대한 연구)

  • Kim, Sung-Won;Choi, Sung-Youn
    • Journal of The Korean Association For Science Education
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    • v.22 no.3
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    • pp.671-681
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    • 2002
  • The idea that parental involvement has a positive influence on gifted children is so intuitively appearing that society in general. and educators in particular, have considered parental involvement as the remedy for many problems in education. However the vast proportion of the literatures in this area give results qualitatively. Among the empirical studies that have investigated this issue quantitatively, there appear to be considerable inconsistencies. A meta-analysis was conducted to synthesize the quantitative literatures about the relationship between parental involvement and gifted development. The findings reveal a moderate relationship between parental involvement and gifted development. We focused on the effect between parental involvement and gifted development, and conducted meta-analysis involving correlation coefficients between the two constructs. Using correlation coefficients, We can get the effect size, and explain the influence. We initially identified 539 articles over twelve-year period. Based on abstracts of these 539 articles, 463 studies were used for analyzing the current stream of the study. Finally, 15 studies met our inclusion criteria, and were subsequently used in this meta-analysis. From the 15 studies, 37 variables influenced on gifted development were collected. Using meta-analysis, it is revealed that internal effects for gifted development have stronger relationship than parents' socioeconomic status. In addition, the differences between female and male student have been reducing.

A comparative study of ADL and IADL of residential home and home for the aged dwelling elderly (노인의 거주 형태에 따른 일상생활동작(ADL) 및 도구적 일상 생활 동작(IADL)의 수행능력 비교)

  • Park, Chan-Eui;Chang, Chung-Hoon;Lee, Jae-Hyoung
    • The Journal of Korean Physical Therapy
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    • v.18 no.4
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    • pp.61-70
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    • 2006
  • Purpose: The purpose of this study was to investigate the activities of daily living (ADL) and instrumental activities of daily living (IADL) of residential home dwelling elderly and home for the aged dwelling elderly. In attempt to address medical professional caring the elderly, this comparative study examines the factors associated with dependence in the ADL and IADL in two samples of elderly people living in two different environments. Methods: The instrument of ADL and IADL widely used Katz ADL and IADL. Katz ADL and IADL was not a perfect fit for Korean. In concern with cultural factors Won developed K(Korean)-ADL and K-IADL scale reflecting Korean's own language expression and cultural factors in year of 2002. The assessment tool of this study was K-ADL and K-IADL. Differences of ADL and IADL were tested for statistical significance using group t-test and x2 test for comparisons between the residential home dwelling elderly and the home for the aged dwelling elderly. Results: Comparison of assessment for K-ADL and K-IADL in two different dwelling types was significant. Performance of ADL and IADL depend upon their living environment such as social status, number of children, income, present illness as well as age group. This study also showed significant differences of performance in some activities of ADL and IADL between the elderly who live in their own home and live in home for the aged. Comparison of performance of ADL and IADL in different dwelling types revealed that only one item of ADL was significant but only one item of IADL was not significant. It means that IADL is more difficult activities in the home for the aged dwelling elderly than the residential home dwelling elderly. The coupled elderly has more independent in some ADL and IADL activities compared with the single elderly. Conclusion: Using K-ADL and K-IADL is more convenient for Korean elderly. Medical professional consider some factors like dwelling style, social status, existing diseases and disabilities in order to care the elderly and train him/her activities of daily living as well as instrumental activities of daily living. Medical professional, especially physical and occupational therapist emphasize the training items which are bathing of ADL and grooming, housework, preparing meals, laundry, traveling, public transportation, shopping, using telephone and taking medicine of IADL based on the result of this study.

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The Political Background of the Installation of the Crown Prince During the Period of King Munjong in the Goryeo Dynasty (고려 문종대 왕태자(王太子) 책봉(冊封)과 태자(太子) 관련 제도(制度) 정비의 의미)

  • Kim, Seon-mi
    • Journal of Korean Historical Folklife
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    • no.45
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    • pp.263-289
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    • 2014
  • King Munjong(文宗), the eleventh King of the Goryeo Dynasty, was the son of King Hyeonjong(顯宗), the eighth king, and the younger stepbrother(異母弟) of King Jeongjong(靖宗), the 10th king. Although King Jeongjong had four sons, he abdicated the throne to King Munjong. King Taejo(太祖) had opened the possibility for sons other than the eldest son to succeed to the throne. When King Jeongjong died, his sons were children under the age of 10 years. In the early period of the Goryeo Dynasty, when kings had young sons, there were precedents of abdicating the throne to their grown-up younger brothers. In addition, King Jeongjong and Munjong had an identical blood background. During the period, Goryeo people also naturally accepted the fact that a former king's younger brother succeeded to the throne. In this background, King Munjong ascended the throne. However, King Munjong did not ascend the throne after identifying state affairs with politic power. Therefore, he needed to increase his authority as the king. Moreover, as the sons of King Jeongjong had grown up, they could stir up trouble in future succession to the throne. Therefore, King Munjong intended to concentrate power on himself and remove trouble in future succession to the throne by selecting his son as successor to the throne. After the installation of Wangtaeja(王太子, the Crown Prince), King Munjong expanded and organized Donggunggwan(東宮官, the establishment of Secretariat of Wangtaeja) and carried out various rituals related to Wangtaeja. The control system for Donggunggwan was completed institutionally in 1068. At this time, the newly organized Donggunggwan was operated as a miniature version of the central government office. In addition, the ritual for the installation of Taeja, which was held in 1054, complied with regulated procedures. After the ritual of the installation, a ceremony to congratulate on Jangheungjeol(長興節, the birthday of Wangtaeja) was held in 1056. In 1064, the wedding ritual of Taeja took place, and the ritual for Taeja regulated in Yeji(禮志) of "Goryeosa(高麗史)" was carried out. In addition, the installation of Wangtaeja was made known overseas, and the Taeja of Goryeo was proclaimed by the Kitan three times. Such various measures played an important role in strengthening the status of Taeja as the man of authority next to the king. Later, Taeja demonstrated his status as the man of authority following the king by participating in state affairs on behalf of King Munjong who was not able to move about freely in his later years.