A social phenomenon that occurs in a physical space is said to be a complex system. However, space syntax, which is commonly employed by researchers to identify such social phenomena, has various limitations in interpreting their complexity. On the other hand, agent-based modeling considers a variety of factors including the personality of the agent, objective-oriented work flows, estimation according to time flows and better prediction of space use through diverse parameters depending the situation, as well as the characteristics of the space. The agent-based method thus has the potentials to be developed as an alternative to space syntax techniques. In particular, discrete event driven simulation(DEVS), which is part of the agent-based modeling method, embraces the concept of networks just like space syntax, which allows a possible theoretical linkage in the future. This study suggests a procedural model of agent-based DEVS reflecting two different connection methods, i.e. connections between adjacent areas and those of the entire space, and attempts to identify the relationship between the local and regional indices of space syntax. A number of spaces were selected as examples-one for a preliminary experiment and eight modified for the main experiment-and space syntax and DEVS were applied to each of them. The comparative analysis of the results led to the conclusions as follows: 1) Adjacent connections were closely related to local indices, while the whole-space approach to regional indices. Local integration shows both characteristics. 2) Observation of the time flow model indicated a faster convergence with the range of 1 to 3-fold of the total time of one lap, with the error of less than 10%. 3) The heat map analysis showed more obvious characteristics of using the space for the entire space rather than adjacent connections. 4) Space syntax shows higher eligibility than ABM.
Self-management training is one of the ways to empower patients to cope with disease. The aim of this before-and-after quasi-experimental study was to determine effects of a teach-back self-management training method on breast cancer patient happiness. Fifty breast cancer patients who visited the Park-e Neshat Limited Surgery Clinic in Kerman, Iran were randomly divided into intervention and control groups after convenience sampling and checking for inclusion eligibility. Data were collected using a demographic questionnaire and the Oxford Happiness Inventory before and after teach-back training and analyzed using SPSS 23. Findings showed no significant difference between mean happiness scores in the two groups before the intervention. However, after the intervention, the mean happiness score in the intervention group increased from 37.2 to 62.9, while it decreased from 41.4 to 29.8 in the control group. These changes were statistically significant (p<0.001). Even after controlling for the effect of confounding factors such as residence location and history of cancer education, the observed differences between the groups were statistically significant (p<0.001). A teach-back self-management training program can increase happiness levels in breast cancer patients. Therefore, the use of this method is recommended to improve self-management and increase happiness.
Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.
This paper is aimed to design for qualification structure and criteria for preparation of qualification test of computer operation engineer. In this study, a DACUM(Development A curriculum) method job analysis to extract contents such as task range, grades or ranks, eligibility, examination standards, selection criteria of examination questions, examination methods, etc was done by an job analysis committee composed of 7 specialists in the industry and academia. In the first place, this report presents job analysis models by procedures for developing selection criteria of examination questions of computer operation engineer. The first step is preparation for job analysis(data research, interviews and selection of experts), the second step the establishment of job models(first expert council and site study), the third step the drawn-out of knowledge, skills, and tools(the second expert council and site study), the fourth step the selection of courses and subjects(the third expert council), the fifth step the establishment of guidelines for making questions(the third site study).
Kim, Ki Young;Dong, Jae Yong;Han, Seung Yeon;Lee, Kwang-Soo
Health Policy and Management
/
v.27
no.1
/
pp.47-55
/
2017
Background: This study purposed to analyze the effects of metabolic syndrome on the total medical charge of patients. Methods: 2013 National Health Insurance Service sample research database (eligibility database, medical database, and health examination database) was used for this study. Gamma regression was applied to analyze the effects of metabolic syndrome on the total medical charge and logistic regression was used to determine the probability of medical charge which was higher than the third quartile. Sociodemographic characteristics (age and household income), health behavior factors (smoking, drinking, exercise, and body mass index), and disease related factors (family history and metabolic syndrome) were included as the independent variables. Results: people who had metabolic syndrome spent more medical expenses than those without metabolic syndrome both in man and woman group. The standard regression coefficient was 0.09 (p< 0.001) in man with metabolic syndrome and 0.16 (p< 0.001) in woman. In addition, woman with metabolic syndrome spent more than the third quartile of medical charge. The odds ratios was 1.04 (p= 0.16) for man with metabolic syndrome and 1.18 (p= 0.013) for woman. Conclusion: people with metabolic syndrome spent more medical charge, so it will need to consider policy interventions for preventing the incidence and management of metabolic syndrome in Korean people.
In Mongolia, the regulation related to the private security industry, the Law on Contracted Private Security Services, was legislated relatively recently. The Law on Contracted Private Security Services was enacted into law in Mongolia 16 years ago, in 2000. This regulation has undergone two amendments since its inception. However, new revisions still need to be made to ensure that this regulation is in line with internationally accepted standards and practices. This paper compares the existing private security regulations of South Korea and Mongolia. The purpose of this comparative study was to identify the weaknesses of and problems in the Mongolian regulation and propose amendments to the Mongolian regulation. The comparative study of the two countries' regulations showed and underscored an imperative need to make further amendments to the Law on Contracted Private Security Services. Specifically, the weaknesses of and problems in the Mongolian regulation at issue include the following: the level of accuracy in defining certain legal terms and providing the proper names for various regulations; stipulations which set forth the procedure for registering a private security company; provisions regarding operating a private security company; the details of eligibility and accountability requirements concerning chief executives and security service officers; and the scope of work provisions. This study proposes constructive amendments to strengthen the Law on Contracted Private Security Services.
The purpose of the study was to develop an integrated prevention program to strengthen elders self-care capability and to examine its effectiveness on their psychological condition. This study used one group pre- and post-test design. Subjects were 85 elderly residents (over 65 years of age) who lived alone, and received free basic medical care and social welfare services in a rural community in Korea. Subject eligibility criteria for this study were to an elders who 1) is not currently taking any anti-depressant medication 2) is able to communicate, and 3) agrees to participate in this study. The integrated program was composed of horticulture, reminiscence, and friendship activities. Twelve sessions were provided for 12 weeks in community-based partnerships to achieve better outcomes. The intervention was case-managed by a public health nurse and aided by six volunteers. The main outcome variable was depression, which was assessed by using 15 items selected from the Geriatric Depression Scale-short form Korean version. Socio-demographic characteristics, functional status, and satisfaction with social support were used as covariates. Results showed that there was a significant intervention effect at post-intervention time point compared to pre-intervention time point(E.S. 0.94). Multiple linear regression analysis showed significant interaction effects between intervention and satisfaction with social support. These findings must be interpreted within the context that an effects of an integrated program could be more synergistically increased when social support factor is considered in the program. A community-based integrated prevention program of depression is effective for vulnerable rural elderly. It is suggested that randomized controlled trials within community setting for better methodological strength as well as multi-level outcomes on community need to be conducted in future.
Over the past few decades, the proportion of elderly people in Korea has been rapidly increasing. In particular, rural areas are experiencing aging of communities more rapidly compared to urban areas. However, public policy for the elderly does not respond to the needs of rural elderly. To distribute health care resources equitably, it is necessary to gather reliable information on the health status of the elderly. The purpose of this study is to explore factors affecting Korean elderly people's ADL functional status. The data sources are from 2004 Elderly Living Condition Survey. The Analysis sample consists of 3,278 cases. Analysis results show that there is a significant residential variability in education, monthly stipend, living arrangement, subjective health status, regular food in-take, and regular exercise. Logistic regression analysis results also show that 'cognitive ability'(exp(B)=6.603), 'subjective health status'(exp(B)=4.576), 'age'(exp(B)=2.610), and 'living arrangement'(exp(B)=.589) are factors affecting ADLs. Namely, when a respondent's cognitive ability is limited, subjective health status is poor, or if their age is over 75, the probability of having a limited ADL has been 6.6 times, 4.6 times, and 2.6 times higher than otherwise. Among these variables, cognitive ability was the best explanation. In contrast, respondents who live with a spouse or adult children have a lower probability of having limited ADL compared with those who live alone. Considering that the most critical criteria in determining eligibility for social welfare services is ADLs, the development of appropriate ADL assessment tools is in an urgent need. Without the accurate assessment on ADLs, particularly on rural as well as the urban elderly, it seems to be hard to achieve effectiveness in the health care policy for the elderly.
Purpose: To determine the long-term efficacy of the anti-tumor necrosis factor (TNF) agents, infliximab (IFX) and adalimumab (ADA), in pediatric luminal Crohn's disease (CD) by performing a systematic literature review. Methods: An electronic search was performed in Medline, Embase, and the Cochrane Library from inception to September 26, 2019. Eligible studies were cohort studies with observation periods that exceeded 1 year. Studies that reported time-to-event analyses were included. Events were defined as discontinuation of anti-TNF therapy for secondary loss of response. We extracted the probabilities of continuing anti-TNF therapy 1, 2, and 3 years after initiation. Results: In total, 2,464 papers were screened, 94 were selected for full text review, and 13 studies (11 on IFX, 2 on ADA) met our eligibility criteria for inclusion. After 1 year, 83-97% of patients were still receiving IFX therapy. After 2 and 3 years the probability of continuing IFX therapy decreased to 67-91% and 61-85%, respectively. In total, 5 of the 11 studies subgrouped by concomitant medication consistently showed that the probabilities of continuing IFX therapy in patients with prolonged immunomodulator use were higher than those in patients on IFX monotherapy. Conclusion: This review of real-world evidence studies confirms the long-term therapeutic benefit of IFX therapy in diverse cohorts of children with luminal CD. Moreover, it supports the view that combination therapy with an immunomodulator prolongs the durability of IFX therapy in patients who previously failed to recover following first-line therapy. The limited number of time-to-event studies in patients on ADA prevented us from drawing definite conclusions about its long-term efficacy.
Vitamin D is a cofactor responsible for autoimmune disorders. There is no agreement in the studies investigating the association between vitamin D and fibromyalgia. This study aims to combine the conflicting results of the primary studies which compared these patients with control groups regarding the serum concentration of vitamin D. This meta-analysis has been designed based on PRISMA guidelines. Relevant keywords were searched in PubMed, Science direct, Scopus, Cochrane, and Google scholar and primary studies were selected. After screening the eligible studies according to inclusion/exclusion criteria, we investigated the risk of bias in the selected studies and also the heterogeneity between the primary results using Cochrane (Q) and I-squared ($I^2$) indices. The primary results were combined using inverse variance method and Cohen statistics as well as a random effects model. Publication bias was assessed using Egger test. Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Suspected factors in the heterogeneity were assessed using meta-regression models. We entered 12 eligible studies in the meta-analysis including 851 cases compared with 862 controls. The standardized mean difference of Vitamin D between the two groups was -0.56 (95% confidence interval: -1.05, -0.08). Our meta-analysis showed that vitamin D serum levels of patients with fibromyalgia was significantly lower than that of control group.
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