• 보건행정학회지
• /
• 제21권1호
• /
• pp.132-157
• /
• 2011

The purpose of this article is to examine the cause of policy non-compliance in the case of pharmaceutical rebates from the perspective of rational choice institutionalism. In Korea, there have been rebates practices between pharmaceutical companies and hospitals since the introduction of the Actual Remuneration System for insured medicine in 1999. The government has chosen the policy means of punishment to eliminate pharmaceutical rebates but the illegal practices are still widespread. Institution in rational choice institutionalism usually reflects the incentives and preferences of actors, and the Actual Remuneration System has resulted in a the lack of procedures to ensure savings on drug expenditures. Pharmaceutical rebates are the product of the institutions which reflect their incentives: the Actual Remuneration System, the current pricing policy for generic drugs, the drug distribution system, and so on. In the end, the problem of the rebates is the consequence of policy non-compliance as actors' rational choice because their incentives lead to opportunistic behaviors. We should therefore understand the incentive structure of policy stakeholders, which is derived from the view of new institutionalism; also, the newly designed Korean drug pricing policy reform must be compatible with the incentive structure.

• Safety and Health at Work
• /
• 제5권3호
• /
• pp.147-151
• /
• 2014

Background: Agriculture ranks among the most dangerous trades worldwide. There is, however, still a lack of knowledge on nonfatal injuries in agriculture. The aim of this study was to describe the nature and occurrence of nonfatal injuries in farmers in two counties in central Norway. Methods: A questionnaire was sent to 7,004 farmers in Norway. We asked for information about the respondents and the farm, whether the farmer had had work-related injuries on the farm during the past 12 months, and details about the incidence and seriousness of the injury. Results: A total of 2,699 respondents gave a response rate of 42%. Of the respondents, 249 (9.2%) reported one or more work-related injuries. The most usual cause of injury involved an animal, and >75% of these happened inside the outbuilding. Among these, 17.5% had a consequence of sick leave or a more serious result. When all the accidents were analyzed by stepwise logistic regression, only the variables: works alone, has >3,500 stipulated working hours at the farm, and the type of production were statistical significant explanatory variables for having an injury. Conclusion: Incorporating safety aspects to a greater extend in the design and construction of outbuildings would make a substantial contribution to injury prevention in agriculture.

• 한국환경보건학회지
• /
• 제46권5호
• /
• pp.576-587
• /
• 2020

Objectives: This study calculated local residents exposures to VOCs (Volatile Organic Compounds) released into the atmosphere using the CalTOX model and carried out uncertainty analysis and sensitivity analysis. The model validity was analyzed by comparing the predicted and the actual atmospheric concentrations. Methods: Uncertainty was parsed by conducting a Monte Carlo simulation. Sensitivity was dissected with the regression (coefficients) method. The model validity was analyzed by applying r² (coefficient of determination), RMSE (root mean square error), and the Nash-Sutcliffe EI (efficiency index) formula. Results: Among the concentrations in the atmosphere in this study, benzene was the highest and the lifetime average daily dose of benzene and the average daily dose of xylene were high. In terms of the sensitivity analysis outcome, the source term to air, exposure time, indoors resting (ETri), exposure time, outdoors at home (ETao), yearly average wind speed (v_w), contaminated area in ㎡ (Area), active breathing rate (BRa), resting breathing rate (BRr), exposure time, and active indoors (ETai) were elicited as input variables having great influence upon this model. In consequence of inspecting the validity of the model, r² appeared to be a value close to 1 and RMSE appeared to be a value close to 0, but EI indicated unacceptable model efficiency. To supplement this value, the regression formula was derived for benzene with y=0.002+15.48x, ethylbenzene with y ≡ 0.001+57.240x, styrene with y=0.000+42.249x, toluene with y=0.004+91.588x, and xylene with y=0.000+0.007x. Conclusions: In consequence of inspecting the validity of the model, r² appeared to be a value close to 1 and RMSE appeared to be a value close to 0, but EI indicated unacceptable model efficiency. This will be able to be used as base data for securing the accuracy and reliability of the model.

• 한국가스학회지
• /
• 제24권5호
• /
• pp.20-28
• /
• 2020

불산 누출사고 발생 시 피해영향범위 예측을 수계산, 영향평가 시뮬레이션, CFD 시뮬레이션을 활용하여서 예측하고 실제 환경영향보고서와 비교·분석하였다. 수계산은 누출원모델과 확산모델을 활용하여서 계산하였으며 영향평가 시뮬레이션은 우리나라 환경부에서 제공하는 KORA, 미국 환경부의 ALOHA, 상용화 프로그램 중 비교적 널리 사용 중인 PHAST를 사용하였고, CFD 시뮬레이션은 STAR-CMM+ 프로그램을 활용하였다. 사용자 입장에서 편리성, 신속성, 수용성, 경제성 등을 고려할 때 불산 누출사고 영향예측에 가장 적절하게 사용할 수 있는 프로그램은 ALOHA와 KORA 이었다. 아울러, 본 연구결과는 정부의 정책개발과 기업의 안전부서에서 피해영향범위 프레임워크를 선정하고 불필요한 규제, 불필요한 안전투자를 최적화하여 정부 또는 기업의 제한된 자원을 효율적으로 활용하는 데 도움이 될 것으로 기대된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권10호
• /
• pp.6055-6059
• /
• 2013

The current study determines the knowledge of female course attendees of the "Municipality Cultural Center for Women", located in the city center of Sivas, Turkey, and their attitudes regarding gynecological cancer prevention. The participants of the study include 497 women attending one of the two Municipality Cultural Centers situated in the city center of Sivas. In this study, the sample was not selected; all participants were encompassed within the scope of our research. A total of 418 female course attendees who volunteered to participate in the research were identified as the sample. The data were collected during the months March-June 2011, by a questionnaire developed by the researchers. To compare the distribution of the collected data "Anova", "two independent t test examples" and "chi square test" were used. The research indicates that 45.1% of the women had had gynecological examination as a consequence of a physical disorder. The reason for 54.9% of the women to have gynecological examination is to have been scanned to check for gynecological cancer, 51.2% had a pap smear test. Some 34.9% of them had obtained information about cervical cancer, 39.7% via radio, television or internet and 36.3% from a doctor. Age, education level and marital status of the women participating in this study demonstrated statistically significant correlations (p<0.05) with gynecological examination and undergoing a pap smear test.

• 의료법학
• /
• 제15권2호
• /
• pp.345-366
• /
• 2014

Because the health care or medical sector has such characteristics as publicity, professionality, and exclusivity, it cannot be left to the free market system. As a consequence, the state has restricted the establishment of medical institutions in order to protect the life and health of people. Also, the medical law has regulated to permit the establishment of medical institutions by only medical personnel and a few corporate bodies and to ban the establishment of medical institutions under disguised ownership as well as double opening of medical institutions by medical personnel. Nevertheless, there are still many cases that non-medical personnel have dominantly established medical institutions under disguised ownership of other medical personnel or nonprofit corporation. Because they are willing to recover their investment costs as soon as possible, these illegally established medical institutions are likely to make patients undergo unnecessary tests or to perform the excessive treatments and, as a result, are likely to cause infringement on the health and lives of the people. In addition, even if the misconduct is uncovered, the rate at which the costs already paid is very low and, as a result, the damages are straightly connected to the people's loss. On the other hand, there are also increasing number of cases that medical personnel or nonprofit corporations are establishing medical institutions against the medical law regulations. The examples of this illegality are also the double opening of medical institutions and the establishment of medical institutions under disguised ownership by medical personnel or nonprofit corporations. And the damages in these cases may not differ from those in the above cases. In this study, regarding medical law regulations restricting opening a medical institution, I will review the intent of those regulations, the type of violations and criminal punishments, and the possibility of recovery from unlawful profit by the National Health Insurance Act. And then, I would like to find a way for rational improvement of each.

• 환경생물
• /
• 제35권4호
• /
• pp.533-544
• /
• 2017

본 연구는 서해로 유입되는 전남과 전북의 24개 독립하천들을 대상으로 2016년 3월부터 10월까지 어류상을 조사하고, 생물 및 비생물 평가지수(BAc index)를 선정하여 수생태계 건강성 평가를 실시하였다. 출현 어류는 총 18과 44속 59종 4,127개체가 확인되었다. 우점종은 피라미 (Zacco platypus)로 확인되었다. 한국고유종은 각시붕어 (Rhodeus uyekii) 등 12종이었다. BAc index는 통계적으로 유의한(p<0.01 또는 0.05) 상관관계가 확인되었다. 수생태계 건강성 평가의 단계별 분포는 보통 단계(Fair)가 41.7%로 가장 높은 비율을 나타냈다. 양호 단계(Good)와 불량 단계(Poor)는 20.8%, 최적 단계(Excellent)는 16.7%로 각각 나타났다. 독립하천의 수생태계 건강성은 생물학적 평가지수보다 지형적 특성, 인위적 자연적 제한 요소에 따른 비생물학적 평가지수의 영향을 더 받는 것으로 확인되었다.

• 대한치과교정학회지
• /
• 제52권1호
• /
• pp.29-41
• /
• 2022

Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..

• 한국가스학회지
• /
• 제23권1호
• /
• pp.54-61
• /
• 2019

휴대용 전자기기의 시장이 성장함에 따라서 Lithium Ion Battery(LIB)의 수요 또한 증가하고 있다. LIB는 다른 2차 전지에 비해 높은 효율성을 보이지만 열 폭주(Thermal runaway)로 인한 폭발/화재의 위험성이 있다. 특히나 대용량 LIB cell을 탑재한 Electric Vehicle(EV)의 경우 화재로 발생하는 대량의 독성 가스로 인한 위험성 또한 존재한다. 따라서 사고 피해를 최소화하기 위한 EV 화재로 발생하는 독성 가스의 위험성 분석이 필요하다. 이 연구에서는 EV의 화재로 발생하는 독성 가스의 유동을 전산유체역학(Computational Fluid Dynamic; CFD)을 이용하여 해석하였다. 문헌 조사 결과와 국내 EV 자료를 기반으로 시나리오를 설정하여 시나리오 발생 경과시간에 따른 독성 가스의 확산을 수치 해석하여 위험성에 대하여 분석 하였다. 이 연구는 EV 화재로 인한 독성 가스의 위험성을 분석하여 사고 발생에 의한 인명, 재산피해를 최소화하는데 의의를 가진다.

• Biomolecules & Therapeutics
• /
• 제21권2호
• /
• pp.126-131
• /
• 2013

Neuropathic pain is a chronic pain disorder caused by nervous system lesions as a direct consequence of a lesion or by disease of the portions of the nervous system that normally signal pain. The spinal nerve ligation (SNL) model in rats that reflect some components of clinical pain have played a crucial role in the understanding of neuropathic pain. To investigate the direct effects of gabapentin on differential gene expression in cultured dorsal root ganglion (DRG) cells of SNL model rats, we performed a differential display reverse transcription-polymerase chain reaction analysis with random priming approach using annealing control primer. Genes encoding metallothionein 1a, transforming growth factor-${\beta}1$ and palmitoyl-protein thioesterase-2 were up-regulated in gabapentin-treated DRG cells of SNL model rats. The functional roles of these differentially expressed genes were previously suggested as neuroprotective genes. Further study of these genes is expected to reveal potential targets of gabapentin.