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A Study on Type Classification of Erosion Control Dam using Ecosystem Connectivity (생태연결성을 고려한 사방댐 유형분류에 관한 연구)

  • Koo, Gil-Bon;Kim, Min-Sik;Kim, Chul;Yu, Seung-mun
    • Journal of Korean Society of Forest Science
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    • v.100 no.3
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    • pp.483-493
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    • 2011
  • Erosion control dams play a primary role in preventing or controlling natural disasters (landslide and debris flow etc.) and also conserve ecosystem in forested watersheds. This study examines structural characteristics of the dams such as the height of ecosystem control and the ecosystem permeability of the erosion control dams under standard drawings and the existing construction works. The objective of this study was to characterize the type classification of erosion control dams as ecosystem. Average permeability was highest on eco-piller dam (63.0%), followed in increasing order by wire rope (13.9%), silt dam (10.9%), multifunctional dam (7.2%), and gravity dam (0.4%). The height of ecosystem control was highest on gravity dam (3.2 m), followed in increasing order by multifunctional dam (1.7 m), wire rope dam (1.2 m), silt dam (0.6 m), and eco-piller dam (0.0 m). Criteria for defining the height of ecosystem control was indefinite. We grouped erosion control dams into three functional types (eco-connection, eco-semi connection, and eco-disconnection) by considering physical and structural characteristics such as the ecosystem permeability and the height of ecosystem control. The type of eco-connection (permeability > 20%) had connection areas from streambed to adjacent riparian areas, and these connection areas serve as ecosystem corridors for fauna and flora. Typical wildlife species includes mammals, reptiles, amphibians, and fishes. The type of eco-semi connection (5% < permeability < 20%) had < 2 m in the eco-barrier height from streambed, however, this type of dams partially serve as wildlife corridors and often provide fish ways. The type of eco-disconnection (permeability < 5%) had > 2 m in the eco-barrier height from streambed, thereby preventing wildlife movement.

Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.4 no.2
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    • pp.249-263
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    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

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A Study on the Breeding Density and Diet of Magpie Pica pica in Jeju Island1a (제주도에 서식하는 까치 Pica pica의 번식 밀도 및 식이물에 관한 연구)

  • Park, Joo-Yeon;Kim, Byoung-Soo;Oh, Hong-Shik
    • Korean Journal of Environment and Ecology
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    • v.22 no.6
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    • pp.648-657
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    • 2008
  • This research was conducted to investigate the breeding density and seasonal food items of the magpies in Jeju Island and the near-manned islets. The examination of nest distribution to determine breeding density was performed during breeding season from February 2006 to April 2008, and that of food items from May 2006 to February 2008. A total of 2,113 nests were found across Jeju Island, the average density was $1.33\;nest/km^2$, and the magpies were distributed up to 600 meters above the sea level. The nest density was the highest in the central areas of Jeju Island, with 688 nests at $3.61\;nest/km^2$, while that in the eastern areas was the lowest, with 214 nests at $0.66\;nest/km^2$. In terms of the number of nests depending on the height above the sea level, 1,172 nests, which was equivalent to the density of $1.85\;nest/km^2$, was observed below 100m and highest among the intervals of height, but 16 nests found at 500-600m were the lowest, corresponding to $0.20\;nest/km^2$. The number of nests found in the manned islets near Jeju Island was eight in Biyang-do with the density of $15.38\;nest/km^2$, nine in U-do with $1.49\;nest/km^2$, and one in Gapa-do with $1.15\;nest/km^2$, whereas none of nests were observed in Mara-do. The contents of stomach consisted of 17 types of prey sources including countless bones, eggshells, plants, and seed, most of which were the individuals of the order Coleoptera. In spring and summer, the foraging frequency for invertebrate animals such as insects was high, but less than 30% in winter. In contrast, the magpies preyed upon plants and seeds at the frequency of 10% and 30%, respectively, in spring, while the foraging frequencies for both of them were 100% in winter and higher than any of other seasons. Eggshells and bones of birds were also detected infrequently. If the density of the magpies, which may play role as the upper predator within the ecosystem, increases, it would be expected to affect directly the reduction of the number of the species and population of endemic animals such as small birds and reptiles, etc. Therefore, it is considered that long-term monitoring for the density of the magpies and precaution is prerequisite to minimize adverse effects on ecosystem.

Comparision of Family Environment, Health Behavior and Health State of Elementary Students in Urban and Rural Areas (도시.농촌 지역 초등학생의 가족환경, 건강행위 및 건강상태에 관한 비교)

  • Bae, Yeon-Suk;Park, Kyung-Min
    • Research in Community and Public Health Nursing
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    • v.9 no.2
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    • pp.502-517
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    • 1998
  • This research intends to survey family environment, health behavior and health status of the students in urban-rural elementary schools and analyze those factors comparatively, and use the result as basic material for school health teacher to teach health education in connection with family and regional areas. It also intends to improve a pupil's self-abilitiy in health care. The subjects involve 2,774 students of urban elementary schools and 583 student in rural ones, who were selected by means of a multi -stage probability sampling. Using the questionnaire and school documents, we collected data on family environment, health behavior and health status for 19 days. Feb. 2nd 1998 through Feb. 20th 1998. The R -form of Family Environment Scale (Moos, 1974) was used in the analysis of family environment(Cronbach's Alpha =0.80). Questionnaires of Health Behavior in School-aged children used by the WHO in Europe(Aaro et al., 1986) and the ones developed by the Health Promotion Committee of the Western Pacific(WHO, 1995)(adapted by long Young-suk and Moon Young-hee(1996)) were used in the analysis of health behavior, as well documents on absences due to sickness, school health room-visits, levels of physical strength, height, weight and degree of obesity were used to determine health status. In next step, We used them with an $X^2$-test, t-test, Odds Ratio, and a 95% Confidence Interval. 1. In two dimensions of three, family-relationship (t=3.41, p=0.001) and system -maintenances(t= 2.41, p=0.0l6) the mean score of urban children were significantly higher than those of rural ones. In the personal development dimension however, there was little significant difference. Assorting family environment into 10 sub-fields and analyzing them, we recognized that urban children were superior to rural children in the sub-fields of expressiveness (t =3.47, p=0.001), conflict (t=0.48, p=0.001), active-recreational orientation (t = 1.97, p=0.049) and organization (t=4.33, p=0.000). 2. Referring to the Odds Ratios of urban-rural children's health behaviors, urban children set up more desirable behavior than rural children wear ing safety belts (Odds Ratio =0.32, p=0.000), washing hands after meals(Odds Ratio = 0.43, p= 0.000), washing hands after excreting (Odds Ratio = 0.39, p=O.OOO), washing hands after coming - home ( Odds Ratio = 0.75, p = 0.003), brushing teeth before sleeping(Odds Ratio =0.45, p=0.000), brushing teeth more than once a day (Odds Ratio =0.73, p=0.0l2), drinking boiled water (Odds Ratio = 0.49, p=0.000), collecting garbage at home(Odds Ratio=0.31, p=0.000) and in the school(Odds Ratio =0. 67, p=0.000). All these led to significant differences. As to taking milk(Odds Ratio = 1.50, p=0.000), taking care of eyesight(Odds Ratio=1.41, p=0.001) and getting physical exercise in(Odds Ratio = 1.33, p=0.0l9) and outside the school(Odds Ratio = 1.32, p=0.005), rural children had more desirable behavior which also revealed a significant difference. There was little significant difference in smoking, but the smoking rate of rural children(5.5%) was larger than that of urban children(3.9%). 3. Health status was analyzed in terms of absences, school health room-visits, levels of physical strength, and the degree of obesity, height and weight. Considering Odds Ratios of the health status of urban-rural children, the health status of rural children was significantly better than that of the urban ones in the level of physical strength(t=1.51, p=0.000) and the degree of obesity(t=1.84, p=0.000). The mean height of urban children ($150.4{\pm}7.5cm$) is taller than that of their counterparts($149.5{\pm}7.9$), which revealed a significant difference (t =2.47, p=0.0l4). The mean weight of urban children($42.9{\pm}8.6kg$) is larger than that of their counterparts($41.8{\pm}9.0kg$), which was also a significant difference(t=2.81, p=0.005). Considering the results above, we can recognize that there are significant differences in family environment, health behavior, and health status in urban-rural children. These results also suggestion ideas for health education. What we would suggest for the health program of elementary schools is that school health teachers should play an active role in promoting the need and importance of health education, develop the appropriate programs which correspond to the regional characteristics, and incorporate them into schools to improve children's ability to manage their own health management.

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Suggestions for Invention Gifted Education Based on the Awareness of Teachers and Professionals Related to the Invention Gifted Education (발명영재 교원 및 전문직 인식에 기반한 발명영재교육의 방향 탐색)

  • Park, Ki-Moon;Lee, Kyu-Nyo;Lee, Byung-Wook;Na, Young-Min;Lee, Kyung-Pyo;Son, Da-Mi;Lee, Sang-Hyun
    • Journal of Gifted/Talented Education
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    • v.22 no.1
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    • pp.1-21
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    • 2012
  • The objective of this study is to suggest improvement plan for invention gifted education based on the awareness of teachers and professionals who related to the invention gifted education for the expansion and development of invention gifted education through improvement of relevant problems. To this end, invention gifted education system and its operational status were analyzed, and questionnaire survey on the awareness of the development plan and satisfaction level was conducted, targeting professionals related to the invention gifted education and teachers in charge of invention gifted education classes or gifted education center. The research results are as follows. First, the level of satisfaction on the invention gifted education was greater than normal (M=3.0) in general, but in the field of 'educational materials', 'teacher training programs' and 'human and material support system of support agencies', the level of satisfaction was relatively low, which requires expansion of the support. Second, it is necessary for Korean Intellectual Property Office and Korea Invention Promotion Association to designate and establish specialized research institution to play a key role in enhancing development and efficiency of invention gifted education. As a result of the questionnaire survey, it turned out that expectation and necessity of the specialized research agency was highly recognized. In particular, demand for 'research and development of gifted education method and materials' and 'research and development of teacher training materials and implementation of teacher training' was high among the key areas of the specialized research institution. Third, teachers and professionals related to the invention gifted education responded that 'invention knowledge' in the areas of invention knowledge and thinking and 'entrepreneurship' in the area of invention attitude was somewhat low toward the question on the level of the 9 characteristics of gifted students with invention talents which current beneficiaries of invention gifted education have, which leads to conclusion that review on the model for the selection of gifted children with invention talents as well as research and development of invention gifted education program to enhance characteristics with low levels is required. If long-term development plans and initiatives are deduced based on this, an effective framework for the invention gifted education will be established in the near future. In addition, it is expected that the differentiated political visions and goals will be established in connection with master plan for the promotion of gifted education.

Depositional Environments and Characteristics of Surface Sediments in the Nearshore and Offshore off the Mid-Western Coast of the Korean Peninsula (한반도 중서부 근 ${\cdot}$ 외해의 표층 퇴적물 특성과 퇴적환경)

  • Oh, Jae-Kyung;Kum, Byung-Chul
    • Journal of the Korean earth science society
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    • v.22 no.5
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    • pp.377-387
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    • 2001
  • In order to elucidate sedimentation processes and depositional environments in transitional area between continental shelf and coastal zone, sedimentologic study has been done with 84 surface sediments sampled in nearshore/offshore off the mid-western coast of the Korean Peninsula for 3 years (1996${\sim}$1999). The surface sediment can be classified into 4 facies (gravelly sand, sand, silty sand and sandy silt). Mean grain size, sorting, skewenss and kurtosis varies -0.39${\sim}7.82{\Phi}$, 0.36${\sim}4.68{\Phi}$, -0.38${\sim}$0.86, -1.56${\sim}$3.43, respectively. The textural parameters show a finer-grained and poorly-sorted trend shoreward, northward and southward from the central part of the study area. The positively-skewed distribution and relationship of each textural parameters indicate a tide-dominated depositional environment. According to C/M diagram, there are 3 different domains (mode A, B, C) of sediment transport mode. The northern part is characterized by bedload transport (mode A) and represents co-influence of wave and tide, whereas domain C in the southern part is controlled by uniform suspension transport (mode C), correlating with sandy-silt area. In the broad middle area, transport processes are complex (the mixture of bedload, graded suspension and uniform suspension; mode B). Hence, the subdivision depositional environments of this study area may be classified by 3 depositional environments dependent on the interplay of sediment supplies from river, relict sediments and hydrologic conditions. In results, the nearshore and offshore areas are thus characterized as a mixing zone between coastal terrigenous sediments and relict sediments in the continental shelf by complex processes (tide, wave and river flow). These sedimentation processes play an important role in producing distinct sedimentologic features in the transitional zone linking coastal and shelfal areas.

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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

A Comparative Study on Implicit Creativity of Korea and America Recognized by Korean University Students (한국 대학생이 생각하는 한국과 미국의 암묵적 창의성에 대한 비교 연구)

  • Sung, En-Hyun;Ryu, Hyung-Seon;Ha, Joo-Hyun;Lee, Jeong-Kyu;Han, Soon-Mi;Han, Yun-Yung
    • Journal of Gifted/Talented Education
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    • v.17 no.2
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    • pp.365-391
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    • 2007
  • As a previous study to investigate recognition gap of creativity between Korea and America, this study has examined Korean university students' implicit creativity toward Korea and America. The research method using in this study was as follows: The subject were university students in Korea, and they were asked to answer multiply for open-ended questions. For the analysis of the answers, a frequency analysis was used. The results were as follows: 1) It showed that Korean university students considered creativity trait as cognitive trait, personality, cultural trait, research and development areas and arts areas. This result means that Korean university students tend to recognize creativity similarly to the ways of established theories of creativity. 2) For the case of Korea, environmental trait like sociocultural background had great importance for all cases of creativity trait and non-creativity trait. 3) American creativity was recognized focused on individual tendency, on the while, community spirit was considered as creativity trait in Korean creativity. 4) It is considered that American culture had better condition for displaying creativity than Korean culture. 5) Traditional culture of Korea was recognized as creativity trait in terms of originality and superiority, and the possibility of modernistic use of Korean culture. 6) Creative people were ranked by artists, executives, rulers and scientists who were well-known to Korean university students. 7) In the comparison of creativity trait between the two countries revealed the traits of creative people, American creativity was reflected more than Korean creativity, This result seems that those people were favored by Korean university students who were familiar with American culture. In conclusion, this study has found another possibility of creativity of the East among cross-cultural creativity studies. Moreover, this study has suggested that traditional culture and tradition renewal, and values of the East are superior cultural resources which are not exist in the West, and those are expected to play a role in developing creativity.

An International Comparative Study of the Graduate Degree Programs for the Professionals of the Gifted/Talented Education - An Analysis of Korean Graduate Program in Comparison with the Standards of America and Europe - (영재교육 전문가 양성을 위한 대학원 교육과정 국제 비교 연구 - 미국과 유럽 표준에 비추어본 한국 대학원 교육과정의 교과목 분석 -)

  • Kang, Choong-Youl
    • Journal of Gifted/Talented Education
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    • v.18 no.3
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    • pp.569-589
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    • 2008
  • One of the main factors that affect the improvement of G/T education is the number and the level of quality of the professionals who are working for the gifted. The professionals vary depending on the role they play for the gifted from the classroom teacher, coordinator, to consultant. Since the legislation of the law for the enhancement of the gifted education in Korea, the in-service training for the classroom teacher has been expanded in number throughout the country. Nowadays, the gifted education is about to be expanded into the general school population, and it becomes more necessary that the training at the level of university graduate program be expanded beyond the short-term in-service training so far. In this vein, the number of universities in Korea that offer the staff development for the gifted education at the graduate level has been increased. However, the problem is whether those programs meet the need to produce the quality professionals. Based on this problem awareness, the study analyzed the graduate programs of 8 universities in Korea by comparing their course descriptions with the graduate-level training program standards of the United States and Europe. It was found that most of the universities fulfilled the areas that both standards commonly consider import, such as "concept and development of giftedness", "curriculum development for the gifted", "teaching methods for the gifted." However, the number of the offered subjects was different among the universities, which indicates that it is suspicious that the universities equally satisfy the areas both standards require. Furthermore, it was also found that the universities differ in satisfying the other standards, From these findings, several suggestions were made for the improvement of the university graduate programs in Korea.

The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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