• Journal of Preventive Medicine and Public Health
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• 제51권2호
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• pp.83-91
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• 2018

Objectives: One of the main objectives of the Targeted Subsidies Law (TSL) in Iran was to improve equity in healthcare financing. This study aimed at measuring the effects of the TSL, which was implemented in Iran in 2010, on equity in healthcare financing. Methods: Segmented regression analysis was applied to assess the effects of TSL implementation on the Gini and Kakwani indices of outcome variables in Iranian households. Data for the years 1977-2014 were retrieved from formal databases. Changes in the levels and trends of the outcome variables before and after TSL implementation were assessed using Stata version 13. Results: In the 33 years before the implementation of the TSL, the Gini index decreased from 0.401 to 0.381. The Gini index and its intercept significantly decreased to 0.362 (p<0.001) 5 years after the implementation of the TSL. There was no statistically significant change in the gross domestic product or inflation rate after TSL implementation. The Kakwani index significantly increased from -0.020 to 0.007 (p<0.001) before the implementation of the TSL, while we observed no statistically significant change (p=0.81) in the Kakwani index after TSL implementation. Conclusions: The TSL reform, which was introduced as part of an economic development plan in Iran in 2010, led to a significant reduction in households' income inequality. However, the TSL did not significantly affect equity in healthcare financing. Hence, while measuring the long-term impact of TSL is paramount, healthcare decision-makers need to consider the efficacy of the TSL in order to develop plans for achieving the desired equity in healthcare financing.

• Steel and Composite Structures
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• 제48권2호
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• pp.163-177
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• 2023

Complex and intricate preparation techniques, the imperative for utmost precision and sensitivity in instrumentation, premature sample failure, and fragile specimens collectively contribute to the arduous task of measuring the fracture toughness of concrete in the laboratory. The objective of this research is to introduce and refine an equation based on the gene expression programming (GEP) method to calculate the fracture toughness of reinforced concrete, thereby minimizing the need for costly and time-consuming laboratory experiments. To accomplish this, various types of reinforced concrete, each incorporating distinct ratios of fibers and additives, were subjected to diverse loading angles relative to the initial crack (α) in order to ascertain the effective fracture toughness (Keff) of 660 samples utilizing the central straight notched Brazilian disc (CSNBD) test. Within the datasets, six pivotal input factors influencing the Keff of concrete, namely sample type (ST), diameter (D), thickness (t), length (L), force (F), and α, were taken into account. The ST and α parameters represent crucial inputs in the model presented in this study, marking the first instance that their influence has been examined via the CSNBD test. Of the 660 datasets, 460 were utilized for training purposes, while 100 each were allotted for testing and validation of the model. The GEP model was fine-tuned based on the training datasets, and its efficacy was evaluated using the separate test and validation datasets. In subsequent stages, the GEP model was optimized, yielding the most robust models. Ultimately, an equation was derived by averaging the most exemplary models, providing a means to predict the Keff parameter. This averaged equation exhibited exceptional proficiency in predicting the Keff of concrete. The significance of this work lies in the possibility of obtaining the Keff parameter without investing copious amounts of time and resources into the CSNBD test, simply by inputting the relevant parameters into the equation derived for diverse samples of reinforced concrete subject to varied loading angles.

• 한국치위생학회지
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• 제9권4호
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• pp.606-619
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• 2009

Objectives : This study was to examine the state of customized visiting oral health programs in a bid to help facilitate the unified operation of the programs and the development of required guidelines. Methods : The subjects in this study were 49 dental hygienists who were professionals responsible for customized visiting health care programs across the nation. Results : 1. Regarding the form of employment of the dental hygienists were investigated many contract and daily workers. 2. As to the possession of equipment necessary for visiting oral health programs, denture cleaners(12.2%) were most widely possessed in some regions, followed by mobile scalers(10.2%) and mobile suctions(8.2%). In terms of expendable devices and materials, dental mirrors, pincettes and explorers were the most widely possessed dental checkup devices, and the most widely possessed oral hygiene supplies were toothbrushes, interdental brushes and denture cleaners. Those devices and materials were in more possession than the other types of devices and materials. The most widely possessed equipment for educational purpose was laptop computers, followed by beam projectors and screens. The most widely possessed teaching materials were dentiform, followed by CD-ROMs. 3. Those whom they visited the most for oral health care service were elderly people, followed by the disabled and patients with chronic diseases. The dental hygienists who went out to visit those people outnumbered the others who stayed at public health centers. Concerning the types of visiting oral health care service, the most prevalent service provided to the elderly included denture cleaning/management, oral massage and preventive treatment against dental caries. The most dominant service provided to the disabled involved education of the oral health care act, preventive treatment against dental caries and toothbrushing by professionals. The most common service offered to patients with chronic diseases was education of the oral health care act and oral health education. The dental hygienists paid a visit to a mean of 5.8 households a day. The average weekly number of households cared by the dental hygienists was 27.3. It took a mean of 37.1 minutes for them to take care of each household. 4. As for satisfaction level with the implementation of the visiting oral health programs, they expressed the greatest satisfaction at teamwork with professionals($3.56{\pm}0.94$), followed by the professionalism of their work($3.21{\pm}0.94$) and workload($3.08{\pm}0.94$). Their satisfaction level with the work conditions required for creative job performance($2.75{\pm}0.98$) and partnership with other institutions($2.64{\pm}1.03$) was below 3.0. In regard to the impact of their characteristics, marital status made a statistically significant difference to satisfaction level with workload. The unmarried dental hygienists were more pleased with their workload than the married ones(p<0.05). 5. As to needs for education for professionalism improvement, they asked for education about visiting oral health care skills the most, followed by education about oral health care for patients with chronic diseases, education of planning/evaluation and education of oral health care for the disabled. Conclusions : The top priority for the vitalization of the programs was the procurement of budget, followed by the procurement of equipment and educational media and the procurement of human resources.

• 대한간호
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• 제36권3호
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• pp.49-69
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• 1997

The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

• 한국치위생학회지
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• 제10권2호
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• pp.393-411
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• 2010

Objectives : The purpose of this study was to examine factors related to the satisfaction level of patients with dental services. Methods : The subjects in this study were 200 patients at three different dental clinics in South Gyeongsang Province, on whom a survey was conducted from June 1 to July 31, 2009. The collected data were analyzed, and the findings of the study were as follows. Results : In regard to the general characteristics of the patients investigated, the women(61.5%) out-numbered the men. By age, those who were at the age of 30 and down made up the largest age group(47.0%). By academic background, the greatest group received junior-college education(54.0%). By occupation, the company employees constituted the largest group (50.5%). By income, the greatest group earned an income of 2 to 2.99 million won(75.0%). Second, as to connections between the characteristics of dental treatment and the reason of choosing the dental clinics, the largest group(70.4%) chose the dental clinics by word of mouth or the recommendation of others. Concerning the reason of dissatisfaction, the biggest group(72.7%) was unsatisfied with medical costs. As for the degree of explicit complaint, the greatest group(49.7%) sort of complained about what made them dissatisfied. Regarding the type of treatment, the biggest group(49.0%) received prosthodontic treatment. In relation to fear for dental treatment, the largest group(34.0%) feared receiving the treatment, and the biggest group(42.6%) did that due to the sound of machines. Third, satisfaction with services(0.762) had the closest correlation to overall satisfaction level, followed by satisfaction with employees(0.735), satisfaction with dentists(0.644) and satisfaction with convenient facilities (0.579). Fourth, the factors that affected overall satisfaction level were gender, the reason of choosing the dental clinic, satisfaction with dentists, satisfaction with employees, satisfaction with services and satisfaction with convenient facilities. The patients who were better satisfied with services(p<0.001), who were more contented with dentists(p<0.001), who chose the dental clinics by the recommendation of others(p<0.01), who were male(p<0.05), who were more gratified with employees(p<0.05) and who were more contented with convenient facilities expressed better overall satisfaction. Conclusions : The above-mentioned findings suggested that dental institutions should keep track of the expectations of patients to prepare differentiated strategies for marketing and human-resources development in consideration of their own circumstances to boost the satisfaction level of patients. Specifically, it's required to heighten the satisfaction level of patients with dentists.

• Asian-Australasian Journal of Animal Sciences
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• 제19권8호
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• pp.1206-1211
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• 2006

The effects of taurine supplementation on growth performance, serum and liver concentrations of lipid, fatty acid composition and lipid peroxidation in the livers of broilers under chronic heat exposure conditions were investigated. The chicks with a similar body weight were equally assigned to one of three controlled-environment chambers. The brolier chicks, which were kept at $34^{\circ}C$ were fed either with a control diet or the control diet supplemented with 0.8% taurine, whereas broiler chicks kept at $22^{\circ}C$ were fed a control diet. Both of the BW and BW gains of broilers maintained at a temperature of $34^{\circ}C$ were significantly lower than those of the control group, which was maintained at a temperature of $22^{\circ}C$ (p<0.05). However, taurine addition in the diet of birds submitted to heat stress siginficantly improved BW gain (p<0.05). The feed intake of chicks declined with increases in temperature. The relative liver and gall bladder weights of chicks fed the control diet and maintained at $34^{\circ}C$ were significantly lower than those measured in the control birds (p<0.05). However, dietary taurine was found to compensate for these reductions in liver and gall bladder weights. Relative weights of abdominal fat did not differ significantly among the three groups. Serum triglyceride concentrations were significantly lower in the chicks fed the control diet and maintained at $34^{\circ}C$ compare to those measured in the chicks fed the control diet at $22^{\circ}C$ (p<0.05). Heat stress resulted in a significant reduction in total lipid and triglyceride levels, but also increased the levels of total cholesterol in the liver (p<0.05). However, dietary taurine supplementation under the heat stress condition resulted in the recovery, to control levels, of serum triglyceride concentrations, as well as the amounts of total lipids, triglycerides, and cholesterol in the liver. The livers of chicks fed on taurine diets at $34^{\circ}C$ showed significantly higher proportions of C14:0, C16:1, C18:1, C18:2, and 20:3, and lower C18:0 and C20:4 proportions than those of chicks fed on control diets at the same temperature (p<0.05). The total levels of saturated fatty acids decreased, but monounsaturated fatty acids and unsaturated fatty acid levels increased in chicks fed the taurine diet, as compared to chicks fed the control diet at $34^{\circ}C$ (p<0.05). Peroxidizability indices were significantly lower in the heat-exposed chicks fed the taurine diet than in the non-taurine heat-exposed groups (p<0.05). In conclusion, dietary taurine results in an increase in the growth performances of chicks under heat stress conditions via improvements in lipid absorption and metabolism, as well as an induced reduction in lipid peroxidation.

• 지역사회간호학회지
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• 제16권1호
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• pp.86-94
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• 2005

Purpose: This study investigated the Korean nurses' international migration to provide the basic data for establishing plans of supply and demand for nurses and the status of Korean nurses' application for foreign nurse licenses and overseas employment. Method: The subjects were 5.447 nurses who requested English written nurse license to the Ministry of Health and Welfare for the application of foreign nurse license examinations and overseas employment. Human Resources Development of Korea provided documents of nurses migrated to Saudi Arabia. Data were collected from December, 2002 to July, 2003 and analyzed by using descriptive statistics. Result: The total applicants for foreign nurse license were 3,149 for 2 years. In the year 2001, 1.129 nurses applied, 2,020 nurses in the year 2002. Out of 3,149 total subjects, 2,705(85.9%)nurses applied for U. S. A. nurse license. Eighty percent of the applicants of the U. S. A. nurse license examination applied for the New York states. The number of applicants for Canada was 215(6.8%), followed by Australia 88(2.8%), U. K. 86(2.7%), and New Zealand 45(1.4%). Average age of the applicants was 31, 49.0% of them were in their twenties. Three year college graduates accounted for 64.1% B.S.N. 33.9%. Applicants graduated from universities or colleges of Seoul area were 37.3%, followed by Daegu. The total number of nurses employed overseas were 1,291 during 2001 and 2002. Seven hundred thirty eight nurses(57.2%) were employed in the U. S. A.. Average age was 34, 60.9% were 3year college graduates, nurses graduated from Seoul area were 44.9%. No one applied for Saudi Arabian nurse license, 172 nurses were employed during 1999 and 2002, 39.5% of them were in their thirties. Conclusion: The results of this study shows relatively young and experienced nurses have intention to migrate internationally and they actually migrate to other countries. Comparing the number of nurses migrating to other country with the number of newly issued nurse licenses in Korea every year. the percentage of overseas employment was relatively high. To cope with Korean nurses international migration. new policy to monitor the status of nurse's international migration and an institution to deal with the affairs should be established. And the further study is needed to measure nurse's competence and influencing factors of Korean nurses employed in the U. S. A.

• 농촌계획
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• 제20권4호
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• pp.77-87
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• 2014

Ecotourism has the potential to boost the energy of a village as it pays keen attention to the ecosystem and the residents of the village. It is empowered by participation of and cooperation among stakeholders who are closely involved in ecotourism. However, many of them express difficulty in striking a right balance between development and conservation with regard to promoting ecotourism. Against this backdrop, this research paper investigates the structure of conflict that the stakeholders, especially those in Stork Village in Yesan County, South Chungcheong Province of Korea, experience during the process of establishment of government-led ecotourism. In addition, this study examines the problems of government-led ecotourism model and how they can be addressed. To analyze conflict structure, this paper used Q methods and found out that the budget-related stakeholders are largely divided into four groups as who; a) complain about how business profits are distributed; b) secure profits by expanding programs; c) consider human settlement, and; d) broaden people's participation. The biggest contributor to the conflicts is found that compensation was given discriminately to different jurisdictions. The second finding is that residents became less cooperative when the financial compensation did not live up to their expectation. For instance, they would demand the tourism facility physically expanded, repeatedly complain about the process of the work, and even accuse the government of degrading ecosystem. In other words, unless the compromise is reached with the residents regarding financial compensation, it could be difficult to encourage their participation and develop as a program-oriented tour. Lastly, the tour program needs to induce voluntary participation of the residents and deliver proper information on ecosystem and natural resources so as to last as sustainable ecotourism. The success of ecotourism will be subject to the cooperation of stakeholders in a region, conservation of our fragile ecosystem, and realization of sustainable growth through sharing economic benefits. This study looks into the cause of the conflicts of ecotourism sites and their structure. If this paper can bring about cooperation of stakeholders, the management and operation of ecotourism sites would be more sustainable.

• 지구물리
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• 제9권1호
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• pp.47-62
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• 2006

국내 지형의 약 70%는 산악지역이며, 도로, 철도 및 터널 등에는 무수한 암반 불연속면이 존재한다. 이러한 암반 불연속면의 조사, 안정성 분석 및 합리적인 안정화 대책공법 등의 시스템 구축이 시급한 실정이다. 기존의 암반 불연속면 조사방법은 인력, 시간 및 현장 접근성 등의 여러 한계점을 가지고 있다. 본 논문에서는 이러한 단점을 보안하기 위한 방법으로현재 정밀한 3차원 공간정보군(群)을 얻을 수 있는 지상 레이저 스캐닝 시스템을 활용한 방법을 제안하였다. 지상 레이저스캐닝 시스템을 이용한 방법은 측정시간이 짧고, 대절토사면 및 접근이 불가능한 지역에서도 측량이 가능한 장점을 가지고 있다. 본 연구에서는 암반사면의 안정성 분석, 댐체 및 터널내부의 변위특성을 지상 레이저 스캐닝 시스템을 이용하여 3차원 공간정보(좌표)를 갖는 측점운(測點雲: point-cloud)을 측정함으로써 만족할 만한 결과를 얻을 수 있었다. 암반사면의 경우, 실제 암반사면의 3D 모델링 결과로부터 불연속면의 방향성 추출, 파괴형태 분석, 절리면의 거칠기 정량화 및 붕괴체적 등을 구할 수 있었다. 댐체 및 터널과 같은 구조물의 경우에는 역설계를 수행하여, 설계도면과의 오차 확인 및 구조물의 변위측정 등 안전진단에 활용할 수 있었다.

• 한국간호교육학회지
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• 제8권1호
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• pp.51-60
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• 2002

The purpose of this study was to identify the relationship between self-esteem, self- efficacy and clinical practice performance, academic achievement, decision making of major field in clinical practice . The study subjects consisted with 244 students from G. junior nursing college that will adapt a new majoring program of clinical nursing practice funded by Ministry of human and resources development. Data were analyzed using descriptive statistics, and t-test, Pearson correlation, and multiple regression. The results of this study were summarized as follows: 1. The students were relatively performed well in clinical practice setting (total M :3.78). The item of student's personal relationship between patients, patient's family, and professional staff showed high score (M=3.96). However students did not feel comfortable to communicate with patients, patient's family and professional staffs in clinical setting(mean=3.56). 2. Students who had experiences of temporal absence from school showed significant difference in the variable of academic achievement and decision making of major field in clinical practice Students who entered to nursing school with self-motive revealed statistically significant difference in the variable of clinical practice performance, academic achievement, self-esteem, self-efficacy, and decision making of major field in clinical practice. 3. There was a significant correlation between self-esteem and clinical practice performance, (r=.512, p<.000). And the relation between self-esteem and decision making of major field in clinical practice was significantly correlated(r=.377, p<.000). Self-efficacy and clinical practice performance(r=.567, p<.000), and decision making of major field in clinical practice (r=.441, p<.000) showed significant correlations. Also relation between academic achievement and self-esteem reveled a significant correlation(r=.129, p<.05) but correlation between self-efficacy and academic achievement was not significant. 4. Correlation between clinical practice performance and decision making of major field in clinical practice also identified a significant relation(r=.498, p<.000). 5. Self-esteem and self-efficacy variables predicted clinical practice performance and explained 37.7% of clinical practice performance. 6. Aptitude and personal interests(m=4.07) reveled important factor affecting to select majoring area in clinical practice, and advice from parents reflected low percentage on selecting places(m=2.42). In conclusion, the variables of self-esteem and self-efficacy showed significant correlations with the variables of student's clinical practice performance, academic achievement, and decision making of major field in clinical practice. Thus it is recommended that student's affective domain of self-esteem and self-efficacy should be developed by nursing intervention before clinical nursing education.