• The korean journal of orthodontics
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• v.31 no.1 s.84
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• pp.63-69
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• 2001

Cleft lip and/or palate(CLP) is the most common congenital deformity in the craniofacial region. For a practical public health system for these patients it is necessary to have an understanding on the prevalence of CLP. However, it was difficult to estimate the exact number of CLP patients due to problems in sample selection, higher miscarriage and still birth rate, difficulty in classification, and adoptions to foreign countries. Therefore this study was to estimate the prevalence of CLP and the rate of orthodontic treatment, which is usually necessary in cleft lip and/or palate patients. The samples consisted of 218,322 Korean male adults from Seoul, Kwangju, Taegu and Pusan, all born in 1979. The screening method for recognizing the CLP patients was proceeded in steps and the results are as follows. 1. The prevalence of cleft lip and/or palate in Korean male adults born in 1979 was 0.65 out of the 1000 samples. 2. In the anteroposterior aspect of the 1000 samples, the prevalence of cleft lip, cleft lip and palate, and cleft palate was 0.26, 0.36 and 0.03 respectively. 3. In the transverse aspect of the 1000 samples, the prevalence of left, right and bilateral cleft was 0.35, 0.16, 0.12 respectively. The cleft in the left showed a much higher prevalence than in the rirht, while bilateral cleft showed a lower prevalence than unilateral cleft. 4. The orthodontic treatment rate of Korean male adults among cleft lip and/or palate Patients was $35\%$, and it was in the order of cleft lip and Palate, cleft lip, and cleft Palate, being $67\%,\;29\%\;and\;29\%$ respectively. The orthodontic treatment rate in patients with the more severe cleft lip and palate was higher than in patients solely having cleft lip or cleft palate.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.99-128
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• 2008

Nearly all Koreans are insured through National Health Insurance(NHI). While NHI coverage is nearly universal, it is not complete. Coverage is largely limited to minimal level of hospital and physician expenses, and copayments are required in each case. As a result, Korea's public insurance system covers roughly 50% of overall individual health expenditures, and the remaining 50% consists of copayments for basic services, spending on services that are either not covered or poorly covered by the public system. In response to these gaps in the public system, 64% of the Korean population has supplemental private health insurance. Expansion of private health insurance raises negative externality issue. Like public financing schemes in other countries, the Korean system imposes cost-sharing on patients as a strategy for controlling utilization. Because most insurance policies reimburse patients for their out-of-pocket payments, supplemental insurance is likely to negate the impact of the policy, raising both total and public sector health spending. So far, most empirical analysis of supplemental health insurance to date has focused on the US Medigap programme. It is found that those with supplements apparently consume more health care. Two reasons for higher health care consumption by those with supplements suggest themselves. One is the moral hazard effect: by eliminating copayments and deductibles, supplements reduce the marginal price of care and induce additional consumption. The other explanation is that supplements are purchased by those who anticipate high health expenditures - adverse effect. The main issue addressed has been the separation of the moral hazard effect from the adverse selection one. The general conclusion is that the evidence on adverse selection based on observable variables is mixed. This article investigates the extent to which private supplementary insurance affect use of health care services by public health insurance enrollees, using Korean administrative data and private supplements related data collected through all relevant private insurance companies. I applied a multivariate two-part model to analyze the effects of various types of supplements on the likelihood and level of public health insurance spending and estimated marginal effects of supplements. Separate models were estimated for inpatients and outpatients in public insurance spending. The first part of the model estimated the likelihood of positive spending using probit regression, and the second part estimated the log of spending for those with positive spending. Use of a detailed information of individuals' public health insurance from administration data and of private insurance status from insurance companies made it possible to control for health status, the types of supplemental insurance owned by theses individuals, and other factors that explain spending variations across supplemental insurance categories in isolating the effects of supplemental insurance. Data from 2004 to 2006 were used, and this study found that private insurance increased the probability of a physician visit by less than 1 percent and a hospital admission by about 1 percent. However, supplemental insurance was not found to be associated with a bigger health care service utilization. Two-part models of health care utilization and expenditures showed that those without supplemental insurance had higher inpatient and outpatient expenditures than those with supplements, even after controlling for observable differences.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.91-95
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• 2004

This study aims to analyze realities of oral health and related factors, and establish Structural Equation Modeling. The subjects of study were 9,340 elderly over age 65 who took the health examination(the first) for the local insured which National Health Insurance Corporation carried out in the survey area mentioned below from January 2002 to December 2002. The areas surveyed were 4 big cities including Seongbuk-ku, Seoul, 5 medium cities including Wonjusi, Gangwon-do, and 5 Counties including Yeong deok County, Kyeongbuk. Considering location and the scale of population, firstly, big unit areas(metropolitan city, province) were selected according to convenience, secondly, low unit areas(city, county, district) were selected randomly. The subjects were the elderly who took all tests including an oral examination and filled in the questionnaire. Major results from analysis are as follows: 1. Review of Composition Conception Validity As a result of analyzing composition conception validity of SEM including posture test, urine test, blood test, habits of eating, drinking and smoking, oral symptoms, and oral health status, using fit index such as GFI, CFI, TLI, and RMSEA, all were within fit range and composition conception validity was recognized. 2. As a result of analyzing SEM to find the relationship between each factor and oral health status, it was confirmed that all factors except urine test affected oral health status and the synthetic SEM to explain it could be established. In result, we could verify that the elderly of rural areas who had lesser experience of visiting a clinic and oral prophylaxis had a higher rate of caries, missing teeth, and denture need, and drinking and smoking negatively affected the rate of caries, periodontal, and missing teeth. Also, periodontal diseases were observed from 43.2% of the total elderly and much from the lower age. Most of oral disease can be prevented by right oral health behavior. Therefore through oral health professionals from each district public health center of the nation, oral health education for the elderly about right eating habits and oral health care should be carried out systematically and policy change to increase access to dental service is required lest that visiting a dental clinic should be impossible or oral health behaviors such as oral prophylaxis and denture wearing should be neglected by economic, geographical barriers. Also, to establish SEM to explain the relationship between oral health status and systemic health, more accurate test methods and effective index development should be preceded. Because items developed by National Health Insurance Corporation applied to this study without alteration, structuring a model had the uppermost limit. Continual study seems to be needed.

• Korean Journal of Social Welfare
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• v.59 no.1
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• pp.301-327
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• 2007

The purpose of this study is to examine the timing and the risk factors associated with the adoption of legally-free foster children. The sample of the study was drawn from foster care files of Adoption and Foster Care Analysis and Reporting System(AFCARS) in 32 states between October 1998 (FY 1999) and September 2002(FY 2002). The timing post-TPR to adoption was examined by plotting the Kaplan-Meier cumulative hazard function for adoption and by plotting the KM hazard functions stratified by child's race and child's age at TPR. Cox proportional-hazards regression analysis was used to identify risk factors for adoption of legally-free foster children after TPR. The hazard of adoption was very low immediately after TPR but increased steadily starting at 3 months and then declined after 20 months. The cumulative hazard functions for White non-Hispanic children and Black non-Hispanic children crossed over at 13 months after TPR. Racial minority status, older age, and disability were negatively associated with the hazard of adoption. Physical abuse, sexual abuse had the lower hazard for adoption compared by neglect. Caretaker's inability to cope had the slightly lower hazard for adoption whereas inadequate housing showed the slightly greater hazard for adoption. Characteristics of foster care services turned into be powerful predictors of adoption. Specifically, legally-free children placed in pre-adoptive homes, those who shared the same racial/ethnic background with their foster caretakers, and those who were placed in two-parent families have a greater likelihood of adoption. The findings highlight the importance of foster care service provisions after TPR to facilitate adoption of legally-free foster children. Furthermore, a more substantial resources and targeted support for foster children who experience physical abuse and sexual abuse in need of adoption should be provided for moving the foster children into permanency.

• 선박안전기술공단연구보고서
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• s.4
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• pp.1-108
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• 2007

2007. 7. 23 IMO의 NAV(항해안전전문위원회)53차 회의에서는 e-Navigation을 해상에서의 안전, 보안, 해양환경보호를 목적으로 전자적인 수단에 의해 선박과 육상에서 해양정보를 수집, 교환, 표시함으로써 항구와 항구간의 항해 및 관련된 서비스를 향상시키는 것으로 정의하고 있다.2005년 11월 영국의 교통부 장관 Stephen 박사는 Royal Institute ofNavigation에서의 연설에서 해상안전과 환경보호를 위하여 선박의 항해를 감시하는 관제소 및 항행하는 선박에 유용하고 정확한 정보가 더 많이 필요함을 역설하였다. 그리고 첨단 기술에 의해 자동화된 항공 항법분야를 예로들면서, 선박의 항법 분야도 항해와 관련된 모든 시설 및 작업을 전자적 수단으로 대체하는 개념인 e-Navigation으로 전환되어야 하며 영국은 이에 필요한 작업을 주도하겠다는 의견을 피력하였다. Stephen은 e-Navigation 도입으로 얻을 수 있는 이익으로 첫째, 항해 실수로 인한 사고 확률저감, 둘째,사고 발생 시 인명 구조 및 피해 확산을 위한 효율적 대응, 셋째, 전통적인항해시설 설치 불필요로 인한 비용 저감, 넷째 선박입출항 수속의 간편화 및항로의 효율적 운용으로 인한 상업적 이익 등을 들었다. 반면에e-Navigation 체계로 전환 시 예상되는 장애로는 첫째, 체계 구축을 위한 비용(특히 개발도상국가들의 경우 어려움 예상), 둘째, e-Navigation의 성과 달성을 위하여 세계 전 해역의 모든 선박이 e-Navigation 체계에 동참하도록유도하는 문제, 셋째, 전자해도 표시 및 선교 장비들에 대한 표준화 문제, 넷째, 육상에 설치할 e-Navigation 센터의 설계 및 구축 등을 꼽았다.IMO는 2005년 81차 MSC(해사안전위원회) 회의에서 영국이 일본, 마샬아일랜드, 네덜란드, 노르웨이, 싱가포르, 미국과 공동으로 제안한 ‘e-Navigation전략 개발’ 의제를 2006년 82차 MSC 회의에서 채택하고, NAV(항해 전문위원회)를 통하여 2008년까지 e-Navigation의 구체적 개념을 정립하고 향후 개발하여야 할 전략적 비전과 정책을 수립하기로 하였다. 이어서 영국을 의장으로 e-Navigation 전략개발 통신작업반이 구성되었는데, 지난 년간 19개국, 16개 전문기관이 참여하여 아래의 작업이 수행되었다. ○ e-Navigation 개념의 정의와 목적 ○ e-Navigation에 대한 핵심 이슈 및 우선 순위 식별 ○ e-Navigation 개발에 따른 이점과 단점의 식별 ○ IMO 및 회원국 등의 역할 식별 ○ 이행계획을 포함한 추가 개발을 위한 작업계획의 작성 IMO에서 수행되고 있는 e-Navigation 전략 개발 의제 일정은 2008년까지이다. 이 전략 개발에 있어서 중요한 요소는 e-Navigation이 포함할 서비스범위, 포함하는 서비스 제공에 필요한 인프라 및 장비의 식별, 인프라 구축및 운용비용을 부담할 주체에 대한 논의, e-Navigation으로 인한 이익과 투자비용에 대한 비교 분석 등이다. 이 과정에서 정부, 선주, 항만운영자, 선원등의 입장 차이와 선진국과 개발도상국 간의 경제 수준 차이는 전략 개발에있어 큰 어려움을 줄 것이므로, 이들이 합의된 전략을 만들기 위해서는 예정된 기간보다 다소 늦어질 가능성도 있다.e-Navigation 전략 개발이 완료되면 1단계로는 해상교통 관제시스템, 선박선교 장비, 무선 통신장비 등에 대한 표준화 작업이 이루어질 것이다. 이 과정에서 각국 간에 자국 보유 기술을 표준화시키기 위한 경쟁이 치열할 것으로 예상된다. 2단계에서는 e-Navigation 체계 하에서의 다양하고 풍부한 서비스 제공을 위한 관련 소프트웨어 및 하드웨어의 개발이 이루어질 것으로전망되는데, 이는 지난 10년간 육상에서 인터넷망 설치 후 이루어진 관련 서비스 산업의 발전을 돌아보면 쉽게 짐작할 수 있을 것이다.e-Navigation 체계 하에서 선박의 항해는 현재와는 전혀 다른 패러다임으로 바뀔 것이다. 예를 들어 현재 입출항 시 요구되던 복잡한 절차는one-stop 쇼핑 형태로 단순화되고, 현재 선박 중심의 항해에서 육상e-Navigation 센터가 적극적으로 관여하는 항해 체계로 바뀔 것이며, 해상정보의 공유와 활용이 무선 인터넷을 통해 보다 광범위하게 이루어질 것이 다.e-Navigation의 잠재적 시장 규모는 선박에 새로이 탑재될 지능형 통합 항법시스템 구축과 육상 모니터링 및 지원 시스템 등 직접 시장이 약 50조원,전자해도, 통신장비, 관련 서비스 컨텐츠 등 간접 시장의 규모가 150조원으로 총 200조원으로 대략 추산하고 있다. 향후 이 거대한 시장을 차지하기 위한 전략 수립이 필요한 시점이다. 지금까지 항해 장비 관련 산업은 선진국의일부 업체들에 의해 독점되어 왔다. 우리나라는 조선과 해운에서 모두 선진국임에도 불구하고 이 분야에서는 대부분 수입에 의존해 왔다. e-Navigation체계 하에서는 전체 시장이 커지고 장비의 사양이 표준화됨에 따라 어느 소수 업체가 현재처럼 독점하기는 더 이상 어려울 것으로 예상된다. 따라서e-Navigation은 우리나라도 항해 장비 분야 시장을 차지할 수 있는 좋은 기회라고 할 수 있다. 특히 조선 1위의 장점을 적극 활용한다면 다른 나라보다우위의 경쟁력을 확보할 수도 있다. 또한, 서비스 분야의 시장은 IT 기술과밀접한 관계가 있으므로 IT 강국인 우리나라가 충분한 경쟁력을 갖고 있다고 할 수 있다.그러나, EU를 비롯한 선진국에서는 이미 e-Navigation 에 대비한 연구를10여년 전부터 수행해 왔다. 앞에서 언급한 EU의 MarNIS 사업은 현재 거의마무리 단계로 당장 실용화 할 수 있는 수준에 있는 것으로 보인다. 늦었지만 우리도 이를 따라잡기 위한 연구를 서둘러야 할 것이다. 국내에서도e-Navigation의 중요성을 깊이 인식하고, 2006년에는 관련 산학연 전문가들로 작업반을 구성하여 워크숍 등을 개최한 바 있다. 또한 해양수산부에서도e-Navigation 핵심기술 개발을 위한 연구사업을 기획 추진하고 있다.그러나 현재 항해통신장비들의 기술기준은 ITU의 전파규칙(RR)과 IMO결의 및 SOLAS 협약을 따르고 있는데 이들 규약이나 결의에 대한 국제적인 추이와 비교할 때 국내의 기술은 표준화되지 못한 부분이 많은 실정이다.본 연구에서는 e-Navigation sytem중 표준화가 필요한 요소와 전자해도,AIS 등 e-Navigation(통합전자항법시스템)관련 국내산업현황 실태조사를 통해 국내 e-Navigation기술개발 동향에 대해 조사하고자 한다.

• Korea journal of population studies
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• v.35 no.2
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• pp.209-232
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• 2012

The purposes of this study is to calculate the gender-based Life Expectancy and Disability Free Life Expectancy of 65-year-olds in accordance with the regions of 16 in Korea based on the years 2005 and 2010 by using the Sullivan method. We used the Census in 2005, 2010, the Korea National Statistical Office(10% sample). We also reviewed examining the changes in LE and DFLE and understanding the relevance between the DFLE of 65-year-olds of the year 2010 and related factors. As a result of this study, it was shown that the LE of the group of all 65-year-old in Korea increased from 18.15 years in 2005 to 19.75 years in 2010 and DFLE increased from 11.41 years in 2005 to 11.64 years in 2010. Regionally, the highest LE for total of 65-year-olds was found to be the entire Jeju area and DFLE was the highest in the city of Seoul. And the highest LE and the highest DFLE for 65-year-old male were found to be in the city of Seoul. Regarding the regional LE of 65-year-old female, both in 2005 and 2010 Jeju area was seen to be the highest. The results of a correlation analysis showed that the DFLE of 65-year-olds in 2010 was found to be increasing with high LE and high population density and in regions with low average temperatures, low number of beds and low age standardized death rates of malignant neoplasms and circulatory disease.

• 한국노년학
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• v.36 no.4
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• pp.1003-1024
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• 2016

The human rights of older people have gotten more attention recently in South Korea, a country that is in transition to a super-aged society. This study aimed to systematically review studies on elder abuse and related factors among community-dwelling older adults in South Korea over twenty years (1994-2016). We searched major databases (Riss, DBpia, KISS, KMbase, and PubMed) and identified published studies relevant to the topic. Based on inclusion and exclusion criteria related to study quality, a total of 31 studies were selected for this review. We examined types, measurements, and risk factors of elder abuse as well as study designs in the selected studies, guided by Johannesen's theoretical framework on elder abuse. All of the reviewed studies on elder abuse in Korea were cross-sectional studies, most of which focused on older people living in urban areas, using a non-random sampling method. All of the studies focused on certain types of elder abuse only. Some adopted elder-abuse instruments that were not validated, and others used self-developed instruments without psychometric tests. As for the risk factors of elder abuse in South Korea, the physical and mental health of the victims and aggressors impacted the risk of elder abuse, but general sociodemographic factors such as age, sex, and education were less likely to be related to the risk. In addition, decreasing caregiver burden and building elder-friendly communities are important for the prevention of elder abuse. Needed are further empirical studies on elder abuse with a theoretical framework that gives consideration to the unique sociocultural contexts of Korea. It is also recommended to develop instruments to measure elder abuse reflecting the sociocultural contexts of Korea, and to examine the multi-dimensional risk factors of elder abuse.

• Journal of Nutrition and Health
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• v.52 no.5
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• pp.475-487
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• 2019

Purpose: With the increase of going out to eat, reducing the sodium in restaurant foods has a crucial impact on reducing sodium intake. This study aimed to assess the current status and perceptions of restaurant staffs related to reducing sodium use in restaurants. Methods: Restaurant managers and chefs (n = 312) in Seongnam area completed a questionnaire on the current status related to sodium use, the barriers to practice for reducing sodium use, support needs, and the practicability of methods for reducing sodium use in restaurants. Results: The percentage of restaurants in the preaction stage (including the precontemplation, contemplation, and preparation stages) for reducing sodium use was 79.7%. Logistic regression analysis showed that measuring salinity while cooking was associated with measuring seasoning (OR, 4.761; 95% CI, 2.325 ~ 9.751), action/maintenance stages of behavior change (OR, 2.829; 95% CI, 1.449 ~ 5.525) and providing salinity information of restaurant foods (OR, 6.314; 95% CI, 2.964 ~ 13.45). Maintaining taste and hindering the cooking process were the main barriers to reduce sodium use. The total practicability of actions for reducing sodium was higher in staffs who worked in restaurants that measured seasoning and salinity while cooking (p < 0.05 and p < 0.01, respectively). The hardest item to practice was 'purchase foods after comparing sodium content in the nutrition labeling'. 'Avoid serving salt-fermented foods as side dishes', 'serve small portions of kimchi and less salty kimchi', and 'put up promotional materials for reducing sodium intake' were selected as easy items to perform. The majority (82%) was willing to reduce sodium in restaurant foods under the support of local government and they desired the promotion of participating restaurants and education on cooking skills to reduce sodium. Conclusion: Measuring seasoning and salinity while cooking is a meaningful practice that is associated with stages of behavior change and the practicability of actions for reducing sodium. It is necessary to provide support and education with a gradual approach to staffs for reducing sodium in restaurant foods.

• 한국노년학
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• v.36 no.4
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• pp.1037-1058
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• 2016

This study aims to investigate the female caregivers'experiences of aggression by nursing home residents, and to identify the policy strategies for violence prevention referred by the female caregivers. A total of 121 female caregivers with more than 6 months of working experiences had participated in this study. Of these, 56.2% had experienced verbal aggression, 51.2% physical aggression, and 27.3% sexual aggression, which reveals that client violence toward caregivers in nursing homes was at an alarming level. Although, physical and verbal violences were mostly caused unintentionally, about a half of the sexual aggression were caused deliberately. Aggression occurred the most when caregivers were providing the following services: changing the diapers or clothes, giving a bath, and serving meals. It was found that 'hitting' was the most common form of physical aggression and it was 'swearing' and 'touching or physical contacting' in the case of verbal and sexual aggression, respectively. Though there was a difference depending on the type of aggression, the most frequent reactions against client violence were to start a conversation or calm down the nursing home residents, and to leave the scene or ignore the incident. This means that the caregivers are coping very passively through resolving the aggressions by themselves, or overlooking the situation. The most frequently recommended strategy to prevent resident aggression was to provide educational programs on violence prevention to nursing home residents and caregivers(42.7%). Compared to the previous studies, this study indicates some differentiated strategies to prevent violence in nursing homes, which include hiring male caregivers, assuring directors to pay closer attention toward caregivers, using refined language between caregivers and residents, and keeping caregivers to wear appropriate clothes. Based on the study results, some policy recommendations on the prevention of client violence in nursing homes were suggested.

• Maritime Security
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• v.4 no.1
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• pp.57-82
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• 2022

The objective of this treatise is to explore the limitations of the current navy manpower utilization system and the ways to improve it from the perspective of Generation Z. As Generation Z, following Millennials, has finally come of age, this new group is constituting a gradually greater proportion of military personnel. Due to the typical characteristics of naval operations, the harmony between Millennials and Generation Z, which is differentiated from Generation X in view of dispositions and traits, is one of the essential issues to be discussed. Generally, in a naval vessel, there are numerous pieces of equipment necessary to carry out a wide range of missions and a large number of crew members who operate them with consistent levels of fighting power. This is all while members are living together within the narrow space throughout the 24 hours of each day. Under such particular circumstances, any inter-generational conflicts may have a disruptive effect on the successful accomplishment of naval missions. Currently, new generations of military personnel are facing social difficulties in different aspects compared with the previous generations, and also have different viewpoints on the military. In this regard, in order to foster true harmony between generations, it is considered necessary to take a closer look at the inter-generational differences from their respective standpoints and to examine whether the military organization has taken adequate steps to respond to such changes. Accordingly, Chapters 1 and 2 cover the environments in which Millennials and Generation Z were raised during their childhood to young adulthood, which are distinct from those of older generations, their viewpoints formed based on such backgrounds, and the need to resolve various conflicts between generations. In Chapter 3, the current actions taken by overseas military powers to enhance the coexistence with Generation MZ are analyzed to find the significant implications they had. Chapter 4 examines the operation environments specific to the navy; identifies the potential barriers to achieving harmony between generations by assessing the current status of personnel utilization in the Korean navy in terms of the seaman, petty officer, and the officer, as well as policy; and outlines the solutions to drive harmony. Finally, Chapter 5 emphasizes the need to establish a genuine empathy between generations based on the understanding of unique inter-generational characteristics. This section also discusses the importance of addressing difficulties in utilizing technology-centered naval manpower, and forecasts a scenario of a naval organization that resolves the problem of utilizing naval personnel and the inter-generational conflicts in the future.