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Effects of Usual Source of Care by Patients with Diabetes on Use of Medical Service and Medical Expenses (당뇨병 환자의 상용치료원 보유가 의료이용 및 의료비에 미치는 영향)

  • Lee, So Dam;Shin, Euichul;Lim, Jae-Young;Lee, Sang Gyu;Kim, Ji Man
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.1-17
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    • 2017
  • Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

Prediction of commitment and persistence in heterosexual involvements according to the styles of loving using a datamining technique (데이터마이닝을 활용한 사랑의 형태에 따른 연인관계 몰입수준 및 관계 지속여부 예측)

  • Park, Yoon-Joo
    • Journal of Intelligence and Information Systems
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    • v.22 no.4
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    • pp.69-85
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    • 2016
  • Successful relationship with loving partners is one of the most important factors in life. In psychology, there have been some previous researches studying the factors influencing romantic relationships. However, most of these researches were performed based on statistical analysis; thus they have limitations in analyzing complex non-linear relationships or rules based reasoning. This research analyzes commitment and persistence in heterosexual involvement according to styles of loving using a datamining technique as well as statistical methods. In this research, we consider six different styles of loving - 'eros', 'ludus', 'stroge', 'pragma', 'mania' and 'agape' which influence romantic relationships between lovers, besides the factors suggested by the previous researches. These six types of love are defined by Lee (1977) as follows: 'eros' is romantic, passionate love; 'ludus' is a game-playing or uncommitted love; 'storge' is a slow developing, friendship-based love; 'pragma' is a pragmatic, practical, mutually beneficial relationship; 'mania' is an obsessive or possessive love and, lastly, 'agape' is a gentle, caring, giving type of love, brotherly love, not concerned with the self. In order to do this research, data from 105 heterosexual couples were collected. Using the data, a linear regression method was first performed to find out the important factors associated with a commitment to partners. The result shows that 'satisfaction', 'eros' and 'agape' are significant factors associated with the commitment level for both male and female. Interestingly, in male cases, 'agape' has a greater effect on commitment than 'eros'. On the other hand, in female cases, 'eros' is a more significant factor than 'agape' to commitment. In addition to that, 'investment' of the male is also crucial factor for male commitment. Next, decision tree analysis was performed to find out the characteristics of high commitment couples and low commitment couples. In order to build decision tree models in this experiment, 'decision tree' operator in the datamining tool, Rapid Miner was used. The experimental result shows that males having a high satisfaction level in relationship show a high commitment level. However, even though a male may not have a high satisfaction level, if he has made a lot of financial or mental investment in relationship, and his partner shows him a certain amount of 'agape', then he also shows a high commitment level to the female. In the case of female, a women having a high 'eros' and 'satisfaction' level shows a high commitment level. Otherwise, even though a female may not have a high satisfaction level, if her partner shows a certain amount of 'mania' then the female also shows a high commitment level. Finally, this research built a prediction model to establish whether the relationship will persist or break up using a decision tree. The result shows that the most important factor influencing to the break up is a 'narcissistic tendency' of the male. In addition to that, 'satisfaction', 'investment' and 'mania' of both male and female also affect a break up. Interestingly, while the 'mania' level of a male works positively to maintain the relationship, that of a female has a negative influence. The contribution of this research is adopting a new technique of analysis using a datamining method for psychology. In addition, the results of this research can provide useful advice to couples for building a harmonious relationship with each other. This research has several limitations. First, the experimental data was sampled based on oversampling technique to balance the size of each classes. Thus, it has a limitation of evaluating performances of the predictive models objectively. Second, the result data, whether the relationship persists of not, was collected relatively in short periods - 6 months after the initial data collection. Lastly, most of the respondents of the survey is in their 20's. In order to get more general results, we would like to extend this research to general populations.

Evaluation of the quality of Italian Ryegrass Silages by Near Infrared Spectroscopy (근적외선 분광법을 이용한 이탈리안 라이그라스 사일리지의 품질 평가)

  • Park, Hyung-Soo;Lee, Sang-Hoon;Choi, Ki-Choon;Lim, Young-Chul;Kim, Jong-Gun;Jo, Kyu-Chea;Choi, Gi-Jun
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.32 no.3
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    • pp.301-308
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    • 2012
  • Near infrared reflectance spectroscopy (NIRS) has become increasingly used as a rapid and accurate method of evaluating some chemical compositions in forages. This study was carried out to explore the accuracy of near infrared spectroscopy (NIRS) for the prediction of chemical parameters of Italian ryegrass silages. A population of 267 Italian ryegrass silages representing a wide range in chemical parameters and fermentative characteristics was used in this investigation. Samples of silage were scanned at 2 nm intervals over the wavelength range 680~2,500 nm and the optical data recorded as log 1/Reflectance (log 1/R) and scanned in intact fresh condition. The spectral data were regressed against a range of chemical parameters using partial least squares (PLS) multivariate analysis in conjunction with spectral math treatments to reduced the effect of extraneous noise. The optimum calibrations were selected on the basis of the highest coefficients of determination in cross validation ($R^2$) and the lowest standard error of cross validation (SECV). The results of this study showed that NIRS predicted the chemical parameters with very high degree of accuracy. The $R^2$ and SECV were 0.98 (SECV 1.27%) for moisture, 0.88 (SECV 1.26%) for ADF, 0.84 (SECV 2.0%), 0.93 (SECV 0.96%) for CP and 0.78 (SECV 0.56), 0.81 (SECV 0.31%), 0.88 (SECV 1.26%) and 0.82 (SECV 4.46) for pH, lactic acid, TDN and RFV on a dry matter (%), respectively. Results of this experiment showed the possibility of NIRS method to predict the chemical composition and fermentation quality of Italian ryegrass silages as routine analysis method in feeding value evaluation and for farmer advice.

A Study on the Effect of Students' Problem Solving Ability and Satisfactions in Woodworking Product Making Program Using Design Thinking (목공 제품 제작 활동에서 디자인 씽킹의 활용이 학생들의 만족도와 문제해결력에 미치는 영향)

  • Kim, SeongIl
    • 대한공업교육학회지
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    • v.44 no.2
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    • pp.142-163
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    • 2019
  • The purpose of this study is to analyze the effect of problem solving ability and satisfaction of university students who are pre-technology teachers in woodworking products(birdhouse) making program using design thinking. Survey responses are analyzed by statistical programs(SPSS ver.20) such as satisfaction, confidence in problem solving, difficulties and causes of difficulties according to gender and grade of 33 students who conducted experience programs in extra-curricular programs to improve creativity and problem solving ability. The main conclusions of this study are as follows: First, the average of total satisfaction about experience programs is 4.39, which is somewhat high. The highest average response is 'feelings of accomplishment' and 'advice in the surroundings'(M = 4.46). There is no significant difference between male and female, and grade. The students interest in group-based different birdhouse woodworking together with the help of the surrounding people by the process of design thinking rather than practice to follow. Therefore, I'd like to recommend to other students due to this program shows a high self-confidence, sense of accomplishment, and satisfaction. Second, the total average response of students 'self-confidence for problem solving at the group based making experience program using design thinking is 3.80. In result of group activities, the students have self-confidence of 'problem-solving ability and deal with difficult situations'. Later, in making programs, complementing difficulties of making can enhance the satisfaction of the students. Third, in the survey questionnaire related with problem solving ability confidence, between 'I have the ability to solve many problems' and 'I always have the ability to cope with new and difficult business situations' show the highest correlation. Therefore, in order to improve self-confidence of problem solving ability, it is necessary to prepare teaching learning programs that can strengthen problem solving ability. Fourth, in the new design and making process not a given product design, the most difficult step is 'the process of rework and modifying idea product'. The main reason that students have difficulty in the production process is 'lack of knowledge and ability to produce'. To make various woodworking products using design thinking process, it can be helpful to make works if you have enough training on woodworking and design thinking before product making. The students' satisfaction about team-based learning using design thinking that helps improving creativity and problem solving ability is high. Therefore, the result of the research in other making activity program that design thinking is applied and analyzed can improve students' problem solving ability.

A Study of the Conservation Policy and Management Status of Historic Gardens in England - Focused on the National Trust - (영국 역사정원 보전정책과 관리현황에 대한 연구 - 내셔널 트러스트를 중심으로 -)

  • Yoon, Sang-Jun;Kwon, Jin-Wook
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.3
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    • pp.131-143
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    • 2010
  • This paper investigates the history, policy and status of the conservation of historic gardens in the National Trust in England and its implications for Korea. It was conducted in three phases as follows: First, related literature data was collected to understand the National Trust and its role in the conservation of historic gardens. Second, The National Trust Policy Papers: Gardens and Landscape Parks in 1996 was reviewed and analyzed into eight categories with a review of 216 gardens and interviews with gardener-in-charge via e-mail. Finally an understanding of the policy for the conservation of historic gardens was formed from the results of the previous phases, and implications were drawn from the integrated analysis guidelines of the policy and status. The key feature of the conservation of the National Trust's historic gardens is that the conservation process has been conducted systematically through acquisition, management, upkeep, advice and so on. Furthermore, the conservation principles are defined in a concise and accessible form. According to their practical conservation process and principles, the results of the National Trust activities are to appreciate the significance of the gardens and act with accountability; integration; managing change; access and participation; and training gardener and partnership. According to the results of its activities under the premise that the purpose of the conservation and the meaning of a garden do not differ significantly among nations, implications for Korea can be primarily suggested by three points as follows: First of all, a flexible approach to change in historic gardens should be managed. In response to inevitable and desirable change, anything that is added or transferred should be recorded for the future as much as possible. Therefore, everything must be recorded and any change should be managed. Second, is to provide sustainable access for the benefit for the people and visitors. The aim of conserving the gardens is for human's to eventually understand that the present generation just borrows the historic gardens before they are passed down. The ensuing implication is that people may enjoy the gardens educationally, aesthetically, and physically, and children can be continuously interested in historic gardens as apart of educating the future generation. Finally, the National Trust educates apprentice gardeners who will maintain the historic gardens and continuously keep the current garden staff up to date with workshops. This is in contrast to the day laborers who work for historic gardens in Korea. In practice, the maintenance of historic gardens is not a simple process. The gardener must understand the past, reflect the present, and prepare for the future. Therefore, gardeners deliver culture from generation to generation.

A Study on Growth Condition and Management of Protected Trees in Kimpo (김포시 보호수의 생육실태와 관리방안 연구)

  • Doo, Chul-Eon;Lee, Jong-Bum;Lee, Jae-Keun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.30 no.1
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    • pp.125-134
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    • 2012
  • This study is determined by tree vigor of analyzing of each object's growth condition in Locational Characteristics and compare the result with impediment extent rate in crown area to provide the management Study about the influence of man-made structures in numbers of protected trees. 68 places where are in the list of Kimpo protected trees were researched in Natural environments, vital degree of trees, number of trees. Crown area was calculated surveying it around the directions of North, East, South and West branching out. Impediment in the area was analyzed after classified into artificial impediment like paved surface(ascon, concrete, block, etc.), a building and a breast wall and natural impediment like soil, stonework and gravel and conclusions are as follow. In analyzing of natural environments, he ground where protected trees have located is consist of 72.05 of manmade structure and artificial in all. There are many protected trees which have less space than crown area for growth suggested by Woo-kyung Sim and Se-kyun Shin in 1992. And it was analyzed that making growth space for protected trees and management of impediment are urgently needed because of that the proportion of impediment covering the crown area has increased as cities are becoming more urbanized results in transforming of trees and weakness of tree vigor. This research shows that under 20% of in crown area is tree vigor determination 1-2 grade 21-50% under is 2-3 grade, higher than 50% is 3-5 grade. More impediment have more difficulty for growing, with the management of root system of protected trees need to be under 20% of rate of land is necessary was improved. As follows are suggested about the standard of management in artificial impediment which influence the number of trees. Firstly, impediment in crown area must be restricted under 20%, but in case outside of the area is not artificial the rate could be higher considerable. Secondly, protected trees growth space secured as much as crown area and impediment must be installed outside the crown area. Thirdly, to move the protected trees, condition of growth space secure must be considered. Fourthly, to develope land, the area around protected trees should be utilized in a park, the area of impediment installation in crown area should be limited as well. Fifthly, As many shown in previous research, for the improvement of old big trees and protected trees, need the tax favor of landowner and purchase of around land, to manage, it needs the budget of local government and advice of expert. Also the study on how various kind of impediment nearby protected trees influence on them has to be continued.

Factors for Delayed Diagnosis of Acute Appendicitis in Children (소아 급성 충수돌기염 진단에 지연을 일으키는 요인에 관한 연구)

  • Han, Myung-Ki;Kim, Kyoung-Soo;Park, Yu-In;Kim, Jeong-Ho;Lee, Jung-Joo;Kim, Bong-Seong;Kang, Hye-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.2
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    • pp.158-165
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    • 2002
  • Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

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Mathematical Transformation Influencing Accuracy of Near Infrared Spectroscopy (NIRS) Calibrations for the Prediction of Chemical Composition and Fermentation Parameters in Corn Silage (수 처리 방법이 근적외선분광법을 이용한 옥수수 사일리지의 화학적 조성분 및 발효품질의 예측 정확성에 미치는 영향)

  • Park, Hyung-Soo;Kim, Ji-Hye;Choi, Ki-Choon;Kim, Hyeon-Seop
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.36 no.1
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    • pp.50-57
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    • 2016
  • This study was conducted to determine the effect of mathematical transformation on near infrared spectroscopy (NIRS) calibrations for the prediction of chemical composition and fermentation parameters in corn silage. Corn silage samples (n=407) were collected from cattle farms and feed companies in Korea between 2014 and 2015. Samples of silage were scanned at 1 nm intervals over the wavelength range of 680~2,500 nm. The optical data were recorded as log 1/Reflectance (log 1/R) and scanned in intact fresh condition. The spectral data were regressed against a range of chemical parameters using partial least squares (PLS) multivariate analysis in conjunction with several spectral math treatments to reduce the effect of extraneous noise. The optimum calibrations were selected based on the highest coefficients of determination in cross validation ($R^2{_{cv}}$) and the lowest standard error of cross validation (SECV). Results of this study revealed that the NIRS method could be used to predict chemical constituents accurately (correlation coefficient of cross validation, $R^2{_{cv}}$, ranging from 0.77 to 0.91). The best mathematical treatment for moisture and crude protein (CP) was first-order derivatives (1, 16, 16, and 1, 4, 4), whereas the best mathematical treatment for neutral detergent fiber (NDF) and acid detergent fiber (ADF) was 2, 16, 16. The calibration models for fermentation parameters had lower predictive accuracy than chemical constituents. However, pH and lactic acids were predicted with considerable accuracy ($R^2{_{cv}}$ 0.74 to 0.77). The best mathematical treatment for them was 1, 8, 8 and 2, 16, 16, respectively. Results of this experiment demonstrate that it is possible to use NIRS method to predict the chemical composition and fermentation quality of fresh corn silages as a routine analysis method for feeding value evaluation to give advice to farmers.

A Study of Dietary Intake and Vitamin/Mineral Supplement Usage among Adolescents (청소년의 식이섭취와 비타민.무기질 보충제 복용에 관한 연구)

  • 박은숙
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.1
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    • pp.30-40
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    • 1995
  • The relationship between dietary intake and vitamin/mineral supplement usage was examined in 706 adolescent girls who were high school students. 43.8% of subjects used vitamin/mineral supplements during one year. The higher the family income and parents education level, the higher percentage of vitamin/mineral supplement usage was. But there was no significant difference between grades and scores. And vitamin/mineral supplement usage was higher int he thin and obese groups than the average weight groups. Nutrition knowledge and food habit did not affect vitamin/mineral supplement usage. Calorie intakes of vitamin/mineral supplement users and nonusers were similar. However, independent of the supplements, the diets of supplement nonusers contained significantly more dietary protein, vitamin A, vitamin $B_2$, niacin, vitamin C, and calcium than the diets of the users. A considerable portion of both the users and nonusers had dietary intakes of less than 2/3 of the Recommended Dietary Allowances for vitamin $B_1$, vitamin $B_2$, niacin, calcium, and iron. Vitamin/mineral supplement nonusers generally consumed a more vitamin, mineral from diet. Reasons for taking supplements were to take energy, advice and illness.

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Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.