• Health Policy and Management
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• v.34 no.1
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• pp.38-47
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• 2024

Background: Korea's population of children and adolescents has decreased by 2.88 million over the past decade and is expected to decline further due to the unprecedented low birth rate. In the fee-for-service compensation system, the decline in the pediatric population relates directly to the profit decrease in the pediatric clinics. This study analyzed whether the worsening profits of pediatric clinics impacted their closure. Methods: We built annual data for pediatric and other department clinics (internal medicine, otolaryngology, and family medicine) using the status of medical institute and health insurance claims data from 2012 to 2022. Then, we analyzed whether institutional variables such as annual profit and regional variables (Herfindahl-Hirschman index, the number of clinics per 100,000, etc.) affected the closure of clinics. The methods used in this study are descriptive statistics and chi-square analysis. Odds ratios for each variable were estimated by generalized estimating equations (GEE). Results: The closure rate of pediatric clinics was 2.66%-7.04% in 2012-2022, which was consistently higher than those of internal medicine, otolaryngology, and family medicine clinics. The profit gap per institution between the pediatric and the other clinics grew from 126 million won in 2012 to 245 million won in 2019. In the GEE analysis, profit decrease compared to the previous year with lower profit was the main factor that increased the closure of pediatric and other department clinics. After adjusting profit-related variables, the decrease in the pediatric population itself did not relate to the closure of pediatric clinics. The number of pediatric clinics or monopolies also did not affect the closure of pediatric clinics. Conclusion: The worsening profit is the crucial factor for the closure of pediatric clinics, while the pediatric population is decreasing. For this reason, it is necessary to actively seek ways to maintain a stable treatment system for children and adolescents.

• Health Policy and Management
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• v.34 no.2
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• pp.185-195
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• 2024

Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

• 한국노년학
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• v.30 no.4
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• pp.1179-1195
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• 2010

In this study, we investigated the effects of ego integrity on QoL(Quality of Life) of elderly living alone, where we focused on moderating role of SF36 health factors. To investigate the cause and effect of factors, we purposively collected 282 samples from senior welfare centers in Jeonju city and exploited reliability analysis, confirmatory factor analysis and SEM(Structural Equation Modeling) for 265 cases excluding some cases with missing values. As the results, first, we confirmed ego integrity was positive predictor of QoL. Second, it was proven that the effect of ego integrity on QoL of elderly living alone was stronger in the lower physical functioning group than higher physical functioning group. Third, we also verified that the group with more difficulties in activities or work as a result of poor physical health showed higher effect of ego integrity on QoL. Based on the results, we could explain the reason of conflicts regarding how elderly's health influenced on ego integrity. Also, in the practice of intervention to elderly's problem, we found the health factors could be an indicator of direction or effect of the intervention

• Health Policy and Management
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• v.10 no.3
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• pp.19-49
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• 2000

This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

• Journal of the Korean Institute of Landscape Architecture
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• v.42 no.4
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• pp.21-29
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• 2014

In terms of quality of life, leisure and health have become important issues with increasing incomes and decreasing working hours in Korea. This study empirically investigates the effects of urban open space on outdoor leisure activities, emphasizing that parks, river banks, and physical activity sites can provide opportunities such as walking, jogging, stretching, and cycling, free of charge to all residents. Based on 2010 sample survey data on leisure activities, multiple regression model as well as hierarchical linear model are estimated, taking account of both individual characteristics on demand and environmental/areal factors on supply side, including open space. Major findings include: first, urban open space significantly increases residents' outdoor leisure activities, second, the effect is more significant for the elderly and third, the effect is more valid for those with relatively low incomes and less education. These results imply that urban open space could be available as a local public good to cope with population aging and to realize health city and social welfare, since this space is not only a leisure place but also public health and welfare facilities.

• Journal of Navigation and Port Research
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• v.37 no.5
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• pp.519-526
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• 2013

In managing shipping business, the concept of seaworthiness of the vessel has developed in accordance with the development of the shipping industry. However, despite of the development of the vessel's seaworthiness, marine accident has continuously occurred at sea. International Maritime Organization(IMO) has paid attention to the research and investigation of Human Error in shipping operations in addition to physical seaworthiness of the vessel. In 1994, IMO adopted the "International Management Code for the Safe Operation of Ships and for Pollution Prevention(ISM code)" of "SOLAS 1974" Annex, to take countermeasure against this human error. In 1999, Korea adopted the 'ISM Code' and then enacted the Maritime Safety Act (previously Maritime Traffic Safety Act). The Maritime Safety Act regulates necessary qualifications of the Human Resources of shipping companies for establishment and implementation of the safety management system. However, there has been a discrepancy between shipowners and ship management companies in interpreting the legislative texts, finally causing confusion. In this paper, I would like to examine the deficiencies in the regulation on the standard of qualifications of the Designated Person under the Maritime Safety Act and thereby suggest any possible improvements in it.

• The Korea Journal of Herbology
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• v.33 no.5
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• pp.105-110
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• 2018

Objectives : We tried to observe the fluorescence anisotropy and intensity of ethidium ion in the intercalating binding interaction between DNA and ethidium ions in the presence of berberine, and then tried to explain the effect of berberine on the intercalating interaction of ethidium ion with DNA. Methods : DNA(calf thymus DNA), berberine and ethidium bromide(EtBr) were purchased from Sigma-Aldrich Co. Proper amount of each compound was dissolved in 20 mM sodium phosphate buffer(pH 7.0) containing 100 mM of NaCl to prepare stock solutions. Collections of the fluorescence anisotropy and intensity data were performed on JASCO FP-8300 spectrofluorometer equipped with a polarizer and a Peltier temperature controller. The excitation of ethidium ion was done at 550 nm and the emission data were collected at 600 nm. For Stern-Volmer plot, the fluorescence data were collected at $18^{\circ}C$ and $30^{\circ}C$. Results : According to the results of this research, the weak competitive binding pattern between ethidium ion and berberine appeared in binding with DNA at low ratio of DNA to ethidium ion. But at high ratio of DNA to ethidium ion, this weak competition disappeared. Instead, berberine might bind to DNA by intercalating way. In other words, berberine could de-intercalate ethidium ion from DNA at low concentration of DNA relative to ethidium ion, but could not at high concentration of DNA relative to ethidium ion. In addition, the mechanism of fluorescence quenching of ethidium ion could also proceed differently, depending on the ratio of the amount of DNA to that of ethidium ion. Conclusions : The effect of berberine on the DNA-ethidium ion intercalating interaction could work differently, depending on the relative ratio of the amount of DNA to that of ethidium ion. This study also showed that fluorescence anisotropy analysis is very useful method to obtain detailed information for investigation of the complex binding interactions. In order to fully understand the mechanism of action of the pharmacological effect by berberine, studies on the effect of berberine on the action of proteins such as various enzymes closely related to berberine-induced medicinal effects should be continued.

• 한국노년학
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• v.29 no.3
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• pp.789-803
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• 2009

We investigated the influences of positive thought about social capital on social participation of the elderly Koreans. The study design was cross-sectional analysis of the National Statistic Office Study of Korean Society Statistics Survey 2003. Participants were total of 8,586 representative samples. Two types of social participation were investigated: meeting attendance and volunteer obligations. The base model included five thoughts about social capital that must be settled as a priority in Korea, i.e., reducing the differences between the rich and the poor, reducing the crime rate, reducing regulations and corruption, improving the moral level, eliminating environmental pollution. Social participation was influenced by positive thoughts about social capital, and different kinds of thoughts had different influences on different types of social participation. The elderly who responded positively to 'reducing the differences between the rich and the poor' attended all two types of social participation more. Along with education and health status, positive thought about social capital is another important factor that influences increased social participation. It may also compensate for deteriorating health with increasing age by promoting social participation. Encouraging social participation is a good way to improve the health of the elderly, as are efforts to change thought about social capital positively.

• 한국노년학
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• v.39 no.2
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• pp.213-229
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• 2019

The purpose of this study was to examine various factors influencing the needs of Seoul's newly implemented outreach community services for older adults, and to suggest the direction of the outreach community health services in Seoul. A multi-level regression was conducted using data collected by face-to-face interviews from 1,000 individuals aged 65 and 70 in 17 districts, where participated in the Seoul's outreach community services. The results demonstrated that socioeconomic status (higher income and living alone), health status (having multiple chronic conditions and depression, lower health literacy), limited experience of the outreach community services, and low government trust at the individual level were associated with higher unmet need for the community outreach services. In addition, shorter participation period of the outreach services and financial independency at the district level were associated with higher unmet need for the services. The findings from this study implies the need for improving the quality of services by focusing on vulnerable groups such as individuals with lower income and worse health status. In addition, the outreach community health services may need to target individuals aged 66 to increasing efficiency of the services through utilizing results of life-cycle health checkup by the National Health Insurance Corporation.

• Journal of the Korean Applied Science and Technology
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• v.40 no.4
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• pp.773-785
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• 2023

This study is a descriptive research conducted to identify the factors influencing patient safety management activities of geriatric hospitals nurses and use basic data to prevent patient safety accidents. Subjects were 220 nurses and data were collected by questionnaires from february 1 to 28, 2023. Data were analyzed using t-test, ANOVA, Scheffe's test, Pearson correlation coefficients and Multiple regression analysis using the SPSS 29.0 program. Patient safety motivation was positive correlated with degree of patient safety(r=.41, p<.001), and degree of patient safety was positive correlated with patient safety nursing activity(r=.18, p<.01). Degree of patient safety(𝛽=.21, p<.001) and patient safety guidelines(𝛽=.16, p<.001) were main factors that affect patient safety nursing activity, and its explanatory power was 7.5%(Adj R²=.075, p<.001). For patient safety nursing activity, it is proposed to develop and apply a education program that strengthens practical training for effective coping after safety accidents along with risk prediction training to prevent before safety accidents.