• Title/Summary/Keyword: German health system

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The Main Issues, Election Promises and Distribution of Votes in the 2021 German Federal Election and the Political Perspective after the Election (2021년 독일 연방의회 선거의 주요 이슈와 공약 및 지지표 분포와 향후 정치 전망)

  • Jung, Byungkee
    • Korean Journal of Legislative Studies
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    • v.27 no.3
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    • pp.35-68
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    • 2021
  • In the German federal election in 2021, the Social Democrats returned to power by a narrow margin and the Green Party emerged as the biggest winner. The two political parties took the lead by proposing policies that met the expectations of the people in the policies of climate and environment, pandemic response and health, and labor and social security. The Merkel effect did not play a significant role in the election, and it is highly likely that it will lead to government policy after the formation of a coalition. While the class cleavage in voting behavior has weakened, the generational cleavage has grown relatively large. Older people showed more support for the two major parties, while younger people showed higher support for the Green Party and the FDP. If the generational cleavage continues, it can be linked to the growth of the Green Party and the FDP, the continued weakening of the two major parties and the emergence of other new parties. In addition, the regional cleavage between the former East and West Germany still remain, which will affect the direction of the AfD and the Left and combine with other political cleavages. The 2021 German federal election can be said to be an election that heralds the realignment of the political party system.

The amendment tendency analysis of the Korean Infectious Disease Prevention Act and a recommendation for the next amendment (전염병관리 관련법령의 변화 추이분석 및 향후 개정방향에 관한 연구)

  • Whang, Chang-Yong;Ohrr, Hee-Choul;Lee, Duk-Hyoung;Park, Ki-Dong;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.540-563
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    • 1998
  • This Study has been carried out to make a recommendation for the next amendment of the Infectious Disease Prevention Act with a specific focus on the kind of notifyable disease. Korean, Japanese, German, U.S, English and French acts on infectious diseases prevention were reviewed, compared with and analized in regards of numbers and kinds of notifyable infectious diseases and their tendency of amendments. An criteria was designed to assess the level of validity of diseases to be designated in the act. Four items, the fatality (greater than 10% or not), the possibility to make a big epidemic, the availability of efficient vaccination and the usefulness of isolation, are used in the assessment. This index is applied to the diseases in Korean and other countries' Infectious Disease Prevention Acts. Results are as follows: 1. The Korean Infectious Disease Preventon Act has a unique way of classifying the notifyable infectious disease, that is, the first, the second and the third class. But the author cannot find the basis of classification. No other countries reviewed have the similar classification. 2. The ten diseases, cholera, plague, yellow fever, diphtheria, typhoid fever, poliomyelitis, rabies, tetanus, malaria, and meningococcal meningitis are designated as the notifyable diseases not only in Korea but also in Japan, Germany, United States, England and france. 3. Thirty seven diseases including small pox, Lassa fever, anthrax, influenza, German measles, Legionellosis, infection with E. coli O157:H7, Q-fever, brucellosis, Lyme disease are designated as legal disease at least one of the above mentioned countries. 4. The Korea has been coped with the change of the infectious disease occurrence for last fifty years in amendment of the Infectious Disease Prevention Act. 5. Japan has a special infectious surveillance system composed of 3,880 clinics throughout the whole country. 6. Germany has classified infectious diseases in five categories which are based on seriousness of disease. Any confirmed death, cases and suspected cases in class I should be reported within 24 hours. But only confirmed death and cases in class II, but not suspected cases, are reportable in Germarny. 7. Plague, bacillary dysentery, pertussis, mumps, Japanese encephaltis and Korean hemorrhagic fevers are diseases with high credits validity index among Korean legal disease. 8. German measles, anthrax, E. coli O157 : H7 infection, Lassa fever, Q-fever, brucellosis are high in validity index among those which are not designated in Korea but designated in other countries. In conclusion, the Korean Infectious Disease Prevention Act has well been coped with the changes of infectious disease occurrence for last fifty years, but the classification basis and the validity of diseases to be designated as legal diseases is worth reevaluating.

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Comprehensive Review of Domestic and Foreign Biomonitoring Programs and Current Status of Bio-sample Application (국내외 바이오모니터링 프로그램 및 생체시료 활용 현황)

  • Kim, Da Hae;Kim, Sungkyoon;Lee, Seungho;Choi, Yoon-Hyeong;Kim, Jin Hee
    • Journal of Environmental Health Sciences
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    • v.47 no.3
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    • pp.205-226
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    • 2021
  • Objectives: Biomonitoring programs have been widely implemented in the field of environmental health, both in Korea and worldwide. Recently, it has been suggested that the storage, management, and utilization of biosamples collected from biomonitoring programs should be organized based on a biobank system. Therefore, we attempted to review the current status of representative biomonitoring programs and biobank systems that have been implemented in Korea and in other countries. Methods: We searched for bio-samples collected in domestic and foreign biomonitoring programs and their applications. For this, we referred to research papers, homepages hosted by biomonitoring programs, and project reports. We also checked information for biobanks related with biomonitoring programs, including the operating systems, facilities, technologies, and regulations of biobanks. Results: We summarized six domestic and 32 foreign biomonitoring programs. These biomonitoring programs collected bio-samples to determine the relationship between environmental chemicals and diseases. Domestically, bio-samples from KoNEHS, KorSEP, MOCEH, KoCHENS, and KorEHS-C were stored at -80℃ in a deep freezer at the National Institute of Environmental Research, while KNHANES samples were stored at Korea Biobank, which has a stabilized biobanking system with a well-established database. Nine foreign biomonitoring programs (JECS, China-NHBP, CKB, CHMS, NHANES, GerES, Germaan ESB, MoBa, and UK Biobank) were ongoing for large populations. Among them, CKB, GermanESB, and UK biobank have been maintained for at least 10 years with their own biomonitoring programs as well as advanced systems for the safe storage of bio-samples. Conclusion: Currently on-going biobanks have devoted considerable efforts to managing bio-samples for public purposes. The preceding domestic and foreign biomonitoring programs and biobanks will be great references for constructing biobank facilities and systems for environmental public health in Korea in the future.

Analysis of the dynamical behavior of piezoceramic actuators using piezoelectric isogeometric finite elements

  • Willberg, Christian
    • Advances in Computational Design
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    • v.1 no.1
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    • pp.37-60
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    • 2016
  • In this paper an electromechanically coupled isogeometric finite element is utilized to analyse Lamb wave excitation with piezoceramic actuators. An effective actuator design reduces the energy needed for Lamb wave excitation, which is beneficial if a structural health monitoring system should be applied for a structure. For a better understanding of the actuator behavior the piezoeceramics are studied both free and bonded at a structure. The numerical part of the analysis is performed utilizing isogeometric finite elements. To obtain the optimal performance for the numerical analysis the effect of k-refinement of the isogeometric element with respect to the convergence is studied and discussed. The optimal numerical setup with the best convergence rate is proposed and is validated with free piezoeceramic actuators. The validated model is then utilized to study the impact of actuator shape and adhesive bondline effect to the wave amplitude. The study shows that simplified analytical equations do not predict the optimal excitation frequencies for all piezoceramic designs accurately.

Review the Governance of Graduate Medical Education (대학(대학원) 졸업 후 의사 수련교육 거버넌스 고찰)

  • Park, Hye-Kyung;Park, Yoon-Hyung
    • Health Policy and Management
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    • v.29 no.4
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    • pp.394-398
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    • 2019
  • Education on the physician continues with undergraduate medical education, graduate medical education, and continuous medical education. The countries such as the United States, Japan, the United Kingdom, German, and others are required to undergo training in the clinical field for 2 years after completing the national medical examination, and to become doctors after passing the clinical practice license test. Korea can obtain a medical license and become a clinical doctor at the same time if it passes written and practical tests after completing 6 years of undergraduate medical education or 4 years of graduate school. About 90% of medical school graduates replace clinical practice with 4-5 years of training to acquire professional qualifications, but this is an option for individual doctors rather than an extension of the licensing system under law. The medical professional qualification system is implemented by the Ministry of Health and Welfare on the regulation. In fact, under the supervision of the government, the Korean Hospital Association, the Korean Medical Association, and the Korean Academy of Medical Sciences progress most procedures. After training and becoming a specialist, the only thing that is given to a specialist is the right to mark him or her as a specialist in marking a medical institution and advertising. The government's guidelines for professional training are too restrictive, such as the recruitment method of residents, annual training courses of residents, dispatch rule of the residents, and the quota of residents of training hospitals. Although professional training systems are operated in the United States, the United Kingdom, France, and Germany, most of them are organized and operated by public professional organizations and widely recognize the autonomy of academic institutions and hospitals. Korea should also introduce a compulsory education system after graduating from medical education and organize and initiate by autonomic public professional organization that meets global standards.

The separation of arsenic metabolites in urine by high performance liquid chromatography-inductively coupled plasma-mass spectrometry

  • Chung, Jin-Yong;Lim, Hyoun-Ju;Kim, Young-Jin;Song, Ki-Hoon;Kim, Byoung-Gwon;Hong, Young-Seoub
    • Environmental Analysis Health and Toxicology
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    • v.29
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    • pp.18.1-18.9
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    • 2014
  • Objectives The purpose of this study was to determine a separation method for each arsenic metabolite in urine by using a high performance liquid chromatography (HPLC)-inductively coupled plasma-mass spectrometer (ICP-MS). Methods Separation of the arsenic metabolites was conducted in urine by using a polymeric anion-exchange (Hamilton PRP X-100, $4.6mm{\times}150mm$, $5{\mu}m$) column on Agilent Technologies 1260 Infinity LC system coupled to Agilent Technologies 7700 series ICP/MS equipment using argon as the plasma gas. Results All five important arsenic metabolites in urine were separated within 16 minutes in the order of arsenobetaine, arsenite, dimethylarsinate, monomethylarsonate and arsenate with detection limits ranging from 0.15 to $0.27{\mu}g/L$ ($40{\mu}L$ injection). We used G-EQUAS No. 52, the German external quality assessment scheme and standard reference material 2669, National Institute of Standard and Technology, to validate our analyses. Conclusions The method for separation of arsenic metabolites in urine was established by using HPLC-ICP-MS. This method contributes to the evaluation of arsenic exposure, health effect assessment and other bio-monitoring studies for arsenic exposure in South Korea.

Future Direction of National Health Insurance (국민건강보험 발전방향)

  • Park, Eun-Cheol
    • Health Policy and Management
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    • v.27 no.4
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    • pp.273-275
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    • 2017
  • It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

Combining GPS and accelerometers' records to capture torsional response of cylindrical tower

  • AlSaleh, Raed J.;Fuggini, Clemente
    • Smart Structures and Systems
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    • v.25 no.1
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    • pp.111-122
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    • 2020
  • Researchers up to date have introduced several Structural Health Monitoring (SHM) techniques with varying advantages and drawbacks for each. Satellite positioning systems (GPS, GLONASS and GALILEO) based techniques proved to be promising, especially for high natural period structures. Particularly, the GPS has proved sufficient performance and reasonable accuracy in tracking real time dynamic displacements of flexible structures independent of atmospheric conditions, temperature variations and visibility of the monitored object. Tall structures are particularly sensitive to oscillations produced by different sources of dynamic actions; such as typhoons. Wind forces induce in the structure both longitudinal and perpendicular displacements with respect to the wind direction, resulting in torsional effects, which are usually more complex to be detected. To efficiently track the horizontal rotations of the in-plane sections of such flexible structures, two main issues have to be considered: a suitable sensor topology (i.e., location, installation, and combination of sensors), and the methodology used to process the data recorded by sensors. This paper reports the contributions of the measurements recorded from dual frequency GPS receivers and uni-axial accelerometers in a full-scale experimental campaign. The Canton tower in Guangzhou-China is the case study of this research, which is instrumented with a long-term structural health monitoring system deploying both accelerometers and GPS receivers. The elaboration of combining the obtained rather long records provided by these two types of sensors in detecting the torsional behavior of the tower under ambient vibration condition and during strong wind events is discussed in this paper. Results confirmed the reliability of GPS receivers in obtaining the dynamic characteristics of the system, and its ability to capture the torsional response of the tower when used alone or when they are combined with accelerometers integrated data.

The Design of 2.2X Galilean Telescopic Spectacles (2.2X 갈릴레이식 망원안경의 설계)

  • Cha, Jung-Won;Lee, Dong-Hee;Choi, Kyong-Seo
    • Journal of Korean Ophthalmic Optics Society
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    • v.10 no.3
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    • pp.247-253
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    • 2005
  • We tried to design a Galilean telescopic spectacles for low vision which is with reference to goods of German. The design bases are that the magnification is 2.2X for general using and the diameter of aperture stop is 3mm. The Galilean telescopic spectacles is designed by using Sigma 2100 made in Kidger Optics Ltd. As a result, we have got the system that the MTF-value is more than 0.25 at 0.25 cycles/arc-minute and the distortion is under 1%. This system is judged to be useful for low vision.

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Genetic Association of the Porcine C9 Complement Component with Hemolytic Complement Activity

  • Khoa, D.V.A.;Wimmers, K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.9
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    • pp.1354-1361
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    • 2015
  • The complement system is a part of the natural immune regulation mechanism against invading pathogens. Complement activation from three different pathways (classical, lectin, and alternative) leads to the formation of C5-convertase, an enzyme for cleavage of C5 into C5a and C5b, followed by C6, C7, C8, and C9 in membrane attack complex. The C9 is the last complement component of the terminal lytic pathway, which plays an important role in lysis of the target cells depending on its self-polymerization to form transmembrane channels. To address the association of C9 with traits related to disease resistance, the complete porcine C9 cDNA was comparatively sequenced to detect single nucleotide polymorphisms (SNPs) in pigs of the breeds Hampshire (HS), Duroc (DU), Berlin miniature pig (BMP), German Landrace (LR), Pietrain (PIE), and Muong Khuong (Vietnamese potbelly pig). Genotyping was performed in 417 $F_2$ animals of a resource population (DUMI: $DU{\times}BMP$) that were vaccinated with Mycoplasma hyopneumoniae, Aujeszky diseases virus and porcine respiratory and reproductive syndrome virus at 6, 14 and 16 weeks of age, respectively. Two SNPs were detected within the third exon. One of them has an amino acid substitution. The European porcine breeds (LR and PIE) show higher allele frequency of these SNPs than Vietnamese porcine breed (MK). Association of the substitution SNP with hemolytic complement activity indicated statistically significant differences between genotypes in the classical pathway but not in the alternative pathway. The interactions between eight time points of measurement of complement activity before and after vaccinations and genotypes were significantly different. The difference in hemolytic complement activity in the both pathways depends on genotype, kind of vaccine, age and the interaction to the other complement components. These results promote the porcine C9 (pC9) as a candidate gene to improve general animal health in the future.