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Lessons From Healthcare Providers' Attitudes Toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program?

  • Lee, Jin-Yong;Lee, Sang-Il;Jo, Min-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.3
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    • pp.137-147
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    • 2012
  • We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

A Design and Implementation of a P2P Streaming System with Considering Network Efficiency (망 효율성을 고려한 P2P 스트리밍 시스템 설계 및 구현)

  • Hong, Seung-Gil;Park, Seung-Chul
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.17 no.3
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    • pp.567-574
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    • 2013
  • Recently, many researches on P2P overlay network-based multimedia streaming services have been actively performed because of their high scalability and cost-efficiency advantages. However, P2P overlay networks also have the shortcoming of generating higher traffic owing to their unicast-based one-to-many multimedia deliveries. In order to reduce the traffic generated by the P2P streaming overlay network, we propose an ISP and locality-based parent node discovery method and check its feasibility through an implementation of a prototype streaming system. The measurement of RTTs and hop counts for random nodes having different ISPs and localities shows the proposed method to be able to shorten about 32% RTTs and about 17% Hop counts.

Adaptive Link Recovery Period Determination Algorithm for Structured Peer-to-peer Networks (구조화된 Peer-to-Peer 네트워크를 위한 적응적 링크 복구 주기 결정 알고리듬)

  • Kim, Seok-Hyun;Kim, Tae-Eun
    • Journal of Digital Contents Society
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    • v.12 no.1
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    • pp.133-139
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    • 2011
  • Structured P2P (peer-to-peer) networks have received much attention in research communities and the industry. The data stored in structured P2P networks can be located in a log-scale time without using central severs. The link-structure of structured P2P networks should be maintained for keeping log-scale search performance of it. When nodes join or leave structured P2P networks frequently, some links become unavailable and search performance is degraded by these links. To sustain search performance of structured P2P networks, periodic link recovery scheme is generally used. However, when the link recovery period is short or long compared with node join and leave rates, it is possible that sufficient number of links are not restored or excessive messages are used after the link-structure is restored. We propose the adaptive link recovery determination algorithm to maintain the link-structure of structured P2P networks when the rates of node joining and leaving are changed dynamically. The simulation results show that the proposed algorithm can maintain similar QoS under various node leaving rates.

Nucleophilic Displacement at Sulfur Center (ⅩⅢ). Solvolysis of para-Substituted Benzenesulfonyl Chlorides in MeOH-MeCN Mixtures (황의 친핵성 치환반응 (제13보). 메탄올-아세토니트닐계에서의 파라치환 염화벤젠술포닐의 가용매 분해반응)

  • Ikchoon Lee;In Sun Koo
    • Journal of the Korean Chemical Society
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    • v.25 no.1
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    • pp.7-12
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    • 1981
  • Solvolysis of $p-CH_3, p-H, p-Cl and p-NO_2$-benzenesulfonyl chlorides have heen studied in MeOH-MeCN mixtures. A nonlinear Hammett plot with a ratio order of p-NO_2 > p-CH_3 > p-H > p-Cl was obtained; the reaction was thought to proceed by an S_N1-S_N2 borderline mechanism. In all cases the reactivity was a maximum at 90∼95%(v) methanol, whereas methanol monomer selectivity defined as fi = \frac{k1}{ki}i (k1; observed pseudo-first order rate constant: ki; hypothetical rate constant for MeOH solution having the same polymer structure as in the pure MeOH) was a maximum at 80% methanol with a decreasing order of fi as p-NO_2 > p-Cl > p-H > p-CH_3.$ This was interpreted as the decrease in tightness of transition state; the larger the fi, the tighter is the MeOH attached to the substrate, and hence the more susceptible the substrate becomes to the approaching monomer methanol.

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Reactions of Thianthrene Cation Radical Perchlorate with N-Arylbenzene- and N-Aryl-p-toluenesulfonamides. Synthesis of 5-(p-N-Arylbenzenesulfonamidephenyl)- and 5-(p-N-Aryl-p-toluenesulfonamidophenyl)thianthrenium Perchlorate (티안트렌 양이온 자유라디칼 과염소산염과 N-아릴벤젠술폰아미드 및 N-아릴-p-톨루엔술폰아미드의 반응. 5-(p-N-아릴술폰아미드페닐)티안트렌이움 과염소산염과 5-(p-N-아릴-p-톨루엔술폰아미드페닐)티안트렌이움 과염소산염의 합성)

  • Sung Hoon Kim;Kyongtae Kim
    • Journal of the Korean Chemical Society
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    • v.25 no.6
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    • pp.383-389
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    • 1981
  • Thianthrene cation radical perchlorate reacts with N-arylsulfonamides such as p-toluenesulfonanilide, benzenesulfonanilide, N-(2-methylphenyl)benzenesulfonamide, and N-phenyl-p-toluenesulfonanilide to give 5-(p-N-p-toluenesulfonamidophenyl)-(1a), 5-(p-N-benzenesulfonamidophenyl)-(1b), 5-(4-N-benzenesulfonamido-3-methylphenyl)-(1c), and 5-(p-N-phenyl-N-p-toluenesulfonamidophenyl thianthrenium perchlorate (1d), respectively. In the meantime, 1d reacts further with thiathrene cation ratical to form diperchlorate(1e). The structure of 1a~1e is very similar to 5-(p-acetamidophenyl) thianthrenium perchlorate which has been obtained from the reaction with acetanilide. However, the discrepancy in the stoichiometry between two reactions indicates that the reaction with sulfonamide appears not to proceed with a single mechanism.

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The Comparison of the Effectiveness of Pelvic Floor Muscle Exercise and Biofeedback Treatment for Stress Incontinence in Korean Women (한국여성의 복압성요실금에 대한 골반저근육훈련운동과 바이오피드백요법의 효과 비교)

  • 최영희;성명숙;홍재엽
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.34-47
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    • 1999
  • This study evaluated the Comparison of the Effectiveness of Pelvic Floor Muscle exercise and Biofeedback treatment for Genuine Stress Incontinence I assigned 60 participants to 2 groups : 30 to the pelvic floor muscle exercise group and 30 to the biofeedback group. Treatment protocol lasted for 6 weeks. Peak pressure, and duration time of pelvic muscle contraction were evaluated by a perineometer. Lower urinary symptoms, sexual matter and life style scores were achieved by using Jackson's scale. The treatment efficacy of the pelvic floor muscle exercise is compared with the biofeedback group and the main results of the comparison are as follows : 1. Pelvic muscle contraction 1) The peak pressure in the biofeedback group was significantly increased(P=0.000). 2. The frequency and quantity of incontinence 1) The frequency of incontinence in the biofeedback group was significantly decreased(P=0.000). 2) The quantity of incontinence in the biofeedback group was significantly decreased(P=0.000). 3. The lower urinary symptoms Daily frequency(P=0.000), nocturia(P=0.000), urgency(P=0.000), bladder pain(P=0.000), unexplained incontinence(P=0.048), wearing protection(P=0.022), changing outer clothing(P=0.005), hesitancy(P=0.008), intermittent stream(P=0.000), abnormal strength of stream(P=0.004), retention(P=0.000), incomplete emptying(P=0.000), and inability to stop mid stream(P=0.006) of the lower urinary symptoms in the biofeedbatk group were significantly decreased. 4. The sexual matters The dry vagina (P=0.004) and pain during sexual Intercourse (P=0.002) in the biofeedback group was significantly decreased. 5. The life style The fluid intake restriction(P=0.007), affected daily task(P=0.003), avoidance of places & situation(P=0.003), interference in Physical activity (P=0.002), interference in relationship with other people(P=0.01), and feeling about the rest of life with urinary symptom(P=0.000) in the biofeedback group were significantly decreased. In conclusion, the biofeedback treatment was more effective than the pelvic floor muscle exercise in genuine stress incontinence.

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Oxidation Stability Model of Fish Oil (어유의 산화안정성 예측)

  • Jeong-Hwa Hong;Jin-Woo Kim;Dae-Seok Byun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.3
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    • pp.384-388
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    • 1995
  • High content of polyunsaturated fatty acid in fish oil makes it very susceptible to oxidation, which prevent fish oil from successful application to food processing or functional foods. To resolve this problem, oxidation stability model of fish oil was developed using the following differential equation : $dp/dt=k{\cdot}p(t){\cdot}[P_{max}\;-\;p(t)]$. This differential equation can be intergrated using analytical techniques to give : $p(t)=P_{max}/[1\;+\;[(P_{max}/P_{(0)})\;-\;-1]{\cdot}EXP(-K_p{\cdot}t)]$. At 50, 60, 70 and $80^{\circ}C,\;K_p$ were 0.00535, 0.01345, 0.02516 and 0.04675, respectively. The proposed model was well agreed with the measured data except for some minor deviations. In addition, $K_p$ was expressed as a function of temperature : $K_p=(1/P_{max})EXP\;[1\;-\;(8148/T)+20.1]$. Where T is absolute temperature($^{o}K$).

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Residue Levels of Organochlorine Pesticides on Paddy Field Soils in the Chungnam Area (충남지역(忠南地域) 논토양중 유기염소계(有機鹽素系) 농약(農藥)의 잔류수준(殘留水準))

  • Choi, Jong-Woo;Lee, Kyu-Seung;Lee, Jung-Kil;Noh, Kil-Bong
    • Korean Journal of Environmental Agriculture
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    • v.6 no.2
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    • pp.12-21
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    • 1987
  • Residues of some organo-chlorine pesticides on 108 solis collected from 5 sites of Chungnam avea during March 20-April 6, 1986 were investigated. 12 different kinds of Chemical components were detected showing the highest detection frequency with P.P'-DDE(67.6%) and the lowest with Heptachlor(1.8%). 4 different chemicals, ${\alpha}-BHC$, ${\gamma}-chlordane$, P.P'-DDD and P.P'-DDD and P.P'-DDE showed their average contents in the soils of 0.001 ppm and 0.005ppm for ${\beta}-BHC$, respectively. On the other hand, ${\alpha}-BHC$, ${\gamma}-chlordane$, P.P'-DDT. O.P'-DDT and P.P'-DDD showed 0.002ppm for their average contents of residues, respectively.

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Multi-Source Media Streaming based Contents Distribution in P2P Network Environment (P2P 네트워크에서 멀티소스 스트리밍을 이용한 컨텐츠 분배)

  • Lee, Sung-Yong;So, Yang-Seon;Lee, Jae-Gil;Choi, Chang-Yeol
    • The KIPS Transactions:PartA
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    • v.11A no.5
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    • pp.325-332
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    • 2004
  • For a P2P network, the contents distribution is a very important service because the contents provider is not fixed. And in the P2P media streaming, a request peer replays and saves media data simultaneously, and after streaming it acts as a new source peer providing media files to other peers. Therefore streaming and file saying operations should be simultaneously carried out in order to distribute contents through the P2P network. In this paper, a P2P multi-source media streaming system which can replay the contents data during downloading is proposed and implemented. The system reduces the user response time and the number of simultaneous user increases more than two times. Moreover, transmitting a part of media file makes fast distribution and diffusion of contents possible.

A taxonomic study of Korean Platanthera with a special reference to external morphology (한국산 제비난초속(Platanthera)의 분류학적 검토: 외부형태학적 형질을 중심으로)

  • Lee, Jin-Sil;Choi, Byoung-Hee
    • Korean Journal of Plant Taxonomy
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    • v.35 no.1
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    • pp.25-46
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    • 2005
  • External morphology focusing on the flower structure of Korean Platanthera was examined. The genus Tulotis was included to the genus Plathanthera as previously suggested by many workers, because the diagnostic character to distinguish the two genera was not distinct enough. It is revealed that the taxon previously recognized as P. metabifolia was the misidentification of P. chlorantha and P. neglecta should be treated as a distinct species from P. mandarinorum. In result, Korean Platanthera were rearranged into 8 species; P. chlorantha, P. mandarinorum, P. neglecta, P. hologlottis, P. japonica, P. ophrydioides, P. ussuriensis, and P. fuscescens. A key to the species of Korean Plathanthera and taxonomic discussion of each species were provided.