• Journal of Korean Neurosurgical Society
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• v.29 no.5
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• pp.668-674
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• 2000

Objective : The classic and accepted surgical method of compound comminuted depressed skull fractures (FCCD) involves total resection of all the contaminated bone and fragments at the fracture site. A second operation for cranioplasty is then performed at a later date. However, we have believed that primary repair of these bony defects can be achieved by the replacement of bone fragments at the time of the initial debridement, and this can be accomplished without danger to patient. The authors retrospectively reviewed the surgical results to assess the advantages and disadvantages, and also propose the selection criteria of replacement of fractured bone fragments as a primary procedure in FCCD. Materials and Methods : The authors analyzed the data extracted from medical records, and radiological findings in 22 of 71 patients with FCCD, who underwent immediate replacement of fractured bone fragments between April 1993 and October 1998. The mean follow-up period was 13.7 months. The selection criteria for the operation included the patients with mild to moderate severity, regardless of the degree of contamination or dural violation, which presented in hospital within 24 hours of injury. Results : The ages of the patients varied from 4 to 63 years, and there were 20 males and 2 females. Seventeen of 22 patients were fully conscious on admission and the others also had relatively good Glasgow coma scales. Sixteen fractures were located in the frontal area, 9 with involvement of the frontal sinuses, and 6 in the parietal and temporoparietal areas. Of the 22 patients, 8(36.3%) had dural lacerations with 3 of these requiring patching with pericranium, and 12(54.5%) had intracranial hematoma requiring wide craniotomy. The degree of wound contamination was also variable. Fifteen patients had relatively clean wounds, while seven(31.8%) had seriously contaminated wounds with soil, sand, hair, and wood. Only one patient(4.5%) developed infection, and the bone fragments were removed. All wounds healed primarily without pulsatile defect, the skull has remained solid, and no complications have occurred, except the infected case. Conclusion : It is proposed that bone fragments removal for FCCD, regardless of the degree of contamination or dural violation, is not necessary and that primary bone fragments replacement avoids a second operation for cranioplasty.

• Korean Journal of Clinical Pharmacy
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• v.26 no.3
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• pp.213-219
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• 2016

Objective: Although guideline recommends beta blockers (BBs) as first line antianginal agent and calcium channel blockers (CCBs) as alternatives after percutaneous coronary intervention (PCI), the prescription patterns in real practice are not in accordance with the guideline. We aimed to investigate the prescribing patterns of primary antianginal drug and relating factors in patients who underwent PCI. Methods: Patients who have undergone PCI without myocardial infarction (MI) from November 2012 to June 2014 and followed up at least one year in a tertiary teaching hospital were included. Prescribing patterns of primary antianginal drug before, at the time of, and one year after PCI were described. Factors affecting drug selection, and their relationship with incidence of clinical outcomes defined as MI and repeated PCI, unscheduled admission or visit related with heart problem were analyzed with multivariate logistic regression. Results: A total of 506 patients were included and as primary antianginal drugs, BB, CCB, and both were prescribed in 32.2%, 24.5%, and 17.8% of patients, respectively. Also, neither BB nor CCB was prescribed at the time of PCI in 25.5% of patients. Compared with BB, CCBs were more likely prescribed in patients who had hypertension (Odds Ratio, OR 2.18, 95% confidence interval, CI 1.16-4.07), use of same class before PCI (OR 7.18, 3.37-15.2) and concomitant angiotensin receptor blocker (ARB) use (OR, 1.92, 95% CI 1.10-3.33). Incidence of clinical outcomes were not significantly greater in patients who prescribed CCB compared with BB at the time of PCI (aOR 1.32, CI 0.65-2.68). Conclusion: This study demonstrated that half of the patients who underwent PCI were prescribed BB. CCB were favored in patients with hypertension, use of same class before PCI, and concomitant ARB use. Significant difference in clinical outcome was not observed between BB and CCB selection as primary antianginal drug.

• The Journal of the Korea Contents Association
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• v.16 no.7
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• pp.50-62
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• 2016

The aim of this study was to develop scale of test taker to affect on process of selection of college. The study procedures were performed as follow : establish of study model, item generation, verification of content validity, 1st and 2nd pilot test and verification of construct validity and reliability. In order to verification of validity and reliability, 230 freshman were surveyed and the data were analyzed by mean, standard deviation, skewness. kurtosis, Pearson correlation, Verimax factor analysis and Cronbach's ${\alpha}$. As result of factor analysis, the 15 factors(61 items) that explain 68.37% of the total variance were extracted and each factors were classified by attribution as follow : Information collection-mass media(4items), college activity (3items), support and environment(4items), education(5items), Influential person on decision making(3items), education quality(4items), education service(5items), reputation(3items), accessibility(2items), personal circumstances(2items), college's mass media(5items), promotion (4items), on-line(4items), person's PR (3items), College image(10items). Cronbach's ${\alpha}$ of total items was 0.916 and Cronbach's ${\alpha}$ of each factors were showed range between 0.694~0.878. Measurement scale of this study may be utilized to collect basic data be required to establish policy strategy of local college be faced with difficulty of admission recruitment.

• 모자간호학회지
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• v.4 no.1
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• pp.3-11
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• 1994

Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

• Journal of the Institute of Electronics Engineers of Korea TC
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• v.42 no.12
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• pp.9-16
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• 2005

A new online routing algerian is proposed in this paper, which use the interference-prediction to solve the network congestion originated from extension of Internet scope and increasing amount of traffic. The end-to-end QoS has to be guaranteed in order to satisfy service level agreements (SLAs) in the integrated networks of next generation. For this purpose, bandwidth is allocated dynamically and effectively, moreover the path selection algorithm is required while considering the network performance. The proposed algorithm predicts the level of how much the amount of current demand interferes the future potential traffic, and then minimizes it. The proposed algorithm considers the bandwidth on demand, link state, and the information about ingress-egress pairs to maximize the network performance and to prevent the waste of the limited resources. In addition, the interference-prediction supports the bandwidth guarantee in dynamic network to accept more requests. In the result, the proposed algorithm performs the effective admission control and QoS routing. In this paper, we analyze the required conditions of routing algorithms, the aspect of recent research, and the representative algorithms to propose the optimized path selection algorithm adequate to Internet franc engineering. Based on these results, we analyze the problems of existing algorithms and propose our algorithm. The simulation shows improved performance by comparing with other algorithms and analyzing them.

• Health Policy and Management
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• v.17 no.3
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• pp.87-105
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• 2007

The purpose of this study was to analyze whether nonemergency, isolated coronary artery bypass graft (CABG) surgery for high- or low-risk patients biases the assessment of the risk-adjusted mortality rates of hospitals. This study used 2002 National Health Insurance claims data for tertiary hospitals in Korea. The study sample consisted of 1,959 patients from 23 tertiary hospitals. The risk-adjustment model used the patients' biological, admission, and comorbidity data identified in the claims. The subjects were classified into high- and low-risk groups based on predicted surgical risk. The crude mortality rates and risk-adjusted mortality rates for low-risk, high-risk, and all patients in a hospital were compared based on the rank and the four intervals defined by quartile. Also, the crude mortality rates of the three groups were compared with their 95% confidence intervals of predicted mortality rates. The C-statistic (0.83) and Hosmer-Lemeshow test ($X^2$=11.47, p=0.18) indicated that the risk-adjustment model performed well. Presenting crude mortality rates with their 95% confidence intervals of predicted rates showed higher agreements among the three groups than using the rank or intervals of mortality rates defined by quartile in the hospital performance assessment. The crude mortality rates for the low-risk patients in 21 of the 23 hospitals were located on the same side of their 95% confidence intervals compared to that for all patients. High-risk patients and all patients differed at only one hospital. In conclusion, the impact of risk selection by hospital on the assessment results was the smallest when comparing the crude inpatient mortality rates of CABG patients with the 95% confidence intervals of predicted mortality rates. Given the increasing importance of quality improvements in Korean health policy, it will be necessary to use the appropriate method of releasing the hospital performance data to the public to minimize any unwanted impact such as risk-based hospital selection.

• Journal of The Korean Association For Science Education
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• v.42 no.1
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• pp.51-60
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• 2022

This study aims to explore the direction of improvement that considers the talent image of science high schools in the admissions process. To this end, first, the talent image and competencies of science high schools were divided into 'publicity' and 'efficiency,' 'execution' and 'achievement' types, and 'publicity & execution' was predominant in most cases. Next, a total of 28 science high school teachers, education experts, and middle school teachers were surveyed on the degree of reflection of talent image and the direction of improvement in the admissions process of three science high schools. The results of the survey are as follows: first, the evaluation of 'publicity' was very limited in the first stage of admissions process, and selection based on 'achievement' was high. Second, there was a strong tendency to select based on 'efficiency & achievement' in the second stage of interview evaluation. Third, we need to improve the selection of students who fit the 'publicity & execution' type of talent image by introducing 'publicity & execution' type of talent image by introducing 'write a competency-oriented self-introduction letter, reflect other subjects' grades and comparative studies in the school life record, and experts' interviews' to the first-stage of admissions process. Fourth, convergence and open-ended questions that enable divergent thinking should be jointly submitted to reflect the 'publicity & execution' type of talent image in the second stage of interview evaluation. In conclusion, the direction of improvement that considers the talent image of science high schools in the admissions process should be changed to competency-oriented in the first-stage of admissions process and in the second stage of interview evaluation consisting of open-ended questions.

• Journal of Korean Dental Hygiene Science
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• v.5 no.2
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• pp.97-104
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• 2022

Background: Due to the declining number of students preparing for university entrance exams , the quota of universities has been decreasing continuously. This situation became increasingly diverse as new media used online, mobile, and PR tools to continuously invite students. This study is aimed at offering the helpful data to plan an effective PR strategy by analyzing the correlation between the major selection and satisfaction of the department's social media usage among freshmen majoring in dental hygiene. Methods: The collected data from the self-reported survey with freshmen were analyzed using the SPSS 22.0 program. The survey items were motive to select the major, social media platform that subjects used, reasons to use the media, time to visit the department's social media platform, and satisfaction level on the department's social media platform, using a 5-point Likert Scale. Results: The reasons for choosing a major were given by 32.2% and 15.9% respondents, respectively, as the vision after graduation and practice facilities. 39.9% and 31.4% used Instagram and YouTube for social media platforms, respectively, for using social media platform; 26.9% and 26.3% visited the department's social media before and after entering the university, respectively; 46.4% and 24.9% used Instagram and YouTube for department social media; and they generally satisfied with the contents of the department's social media. 40.9% of them said that information from the department's social media was useful. 33.8% of them said the information from the department's social media exceeded their expectations. 46.8% of them answered that the department's social media made the department's image positive. 33.4% got interested in the major more due to the department's social media. According to 32.1% of respondents, the department's social media was helpful in deciding on a major. With 35.4%, a positive correlation was discovered between the department's practice facilities and satisfaction on the department's social media. Conclusion: It is thought that the department's social media should try continuously by uploading the contents to meet the users' needs on a regular basis and seeking the plans to be able to collect various opinions using surveys through the related social media so that students can select the major and, moreover, lead the positive direction to adapt the university life under the unfamiliar environment after admission.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.116-121
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• 2009

Background: Tsutsugamushi, leptospirosis and hemorrhagic fever with renal syndrome (HFRS) are the prevalent diseases among the acute febrile illnesses in Korea. Pulmonary involvement in the patients with these diseases remains poorly recognized in endemic regions, and this is despite reports of recent outbreaks and epidemic episodes. Pulmonary involvement and a higher CRP level as clinical manifestations show a more severe form of infection. The aim of this study is to analyze the correlation of pulmonary involvement and the CRP level in patients with acute febrile illnesses. Methods: We retrospectively reviewed the clinical records of 105 patients who were diagnosed with tsutsugamushi, HFRS and leptospirosis from January 2002 to May 2008 in Chuncheon Sacred Heart Hospital. The radiographic images were retrospectively analyzed by two radiologists. We analyzed the pulmonary complications of the patients with these febrile diseases and we checked the CRP level at admission. Results: The study included 105 patients who were diagnosed with febrile diseases. Of these patients, 32 patients had hantaan, 10 patients had leptospirosis and 63 patients had tsutsugamushi disease. 42 (40%) patients had pulmonary complications, 20 patients had pulmonary edema, 20 patients had pleural effusion and 2 patients had interstitial pneumonitis. The patients with pulmonary involvement showed a more severe form of infection and a higher CRP level than that of those patients without pulmonary involvement (p=0.0073). Conclusion: Pulmonary involvement in patients with acute febrile diseases might be correlated with a higher CRP level. Identification of this factor on admission might provide useful selection criteria for the patients who need early intensive care.