• Journal of Preventive Medicine and Public Health
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• v.26 no.2 s.42
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• pp.293-309
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• 1993

With expanded and extended coverage of the national medical insurance and fast growing health care expenditures, appropriateness of health service utilization and quality of care are concerns of both health care providers and insurers as well as patients. An accurate patient classification system is a basic tool for effective health care policies and efficient health services management. A classification system applicable to Korean medical information-Korean Diagnosis Related Groups (K-DRGs)-was developed based on the U.S. Refined DRGs, and the performance of the developed system was assessed in this study. In the process of the development, first the Korean coding systems for diagnoses and procedures were converted to the systems used in the definition of the U.S. Refined DRGs using the mapping tables formulated by physician panels. Then physician panels reviewed the group definition, and identified medical practice patterns different in two countries. The definition was modified for the differences in K-DRGs. The process resulted in 1,199 groups in the system. Several groups in Refined DRGs could not be differentiated in K-DRGs due to insufficient medical information, and several groups could not be defined due to procedures which were not practiced in Korea. However, the classification structure of Refined DRGs was retained in K-DRGs. The developed system was evaluated fur its performance in explaining variations in resource use as measured by charges and length of stay(LOS), for both all and non-extreme discharges. The data base used in this evaluation included 373,322 discharges which was a random sample of discharges reviewed and payed by the medical insurance during the five-month period from September 1990. The proportion of variance in resource use which was reduced by classifying patients into K-DRGs-r-square-was comparable to the performance of the U.S. Refined DRGs: .39 for charges and .25 for LOS for all discharges, and .53 for charges and .31 for LOS for non-extreme discharges. Another measure analyzed to assess the performance was the coefficient of variation of charges within individual K-DRGs. A total of 966 K-DRGs (87.7%) showed a coefficient below 100%, and the highest coefficient among K-DRGs with more than 30 discharges was 159%.

• 한국노년학
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• v.37 no.1
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• pp.15-32
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• 2017

The current study aims to identify the heterogeneous changes of functional disabilities in old age rather than to identify an average longitudinal pattern and to explore the effect of health status and social status as risk factors in functional disability trajectories. The sample consisted of a representative sample of community dwellers aged 65 and older from the Korean Longitudinal Study of Ageing (2006 - 2012) was the focus of the study. Latent Class Growth Analysis was used to identify the functional disability trajectory groups. Variables regarding health status and social status changes by class were identified using multinomial logistic regression. The results showed various change patterns in functional disability, which include independent (78%), stable high (4.4%), steeply increasing (7.1%), slightly increasing (5.5%), and moderate to low (4.7%). Aggravation in depressive symptoms and cognitive functions as well as decline in social participations and social engagements were significant predictors of membership in increasing group of functional disability. The findings provide important initial empirical information to target clinical practice and have implications in the importance of conducting research on groups with different characteristics.

• 재활복지
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• v.20 no.4
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• pp.79-106
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• 2016

This study examined the meanings of the disability education of the mothers who reared their children with brain lesions. For this purpose, Rennie's hermeneutic grounded theory was applied and the consented 7 mothers participated in this study. With the in-depth interviews, 53 meaning units, 16 subordinate categories and 7 hermeneutic categories were classified. These 7 hermeneutic categories were 'wailing miserably everyday', 'social mobilization of the surroundings', 'straight forward', 'smash rock with the eggs', 'looking at a faraway', 'learning together' and 'subjectivation of disability education.' The experience of disabled children education process was concurrent experience of frustration and hoping that moving toward a big hope through the resignation stage, the chasing stage, the vision stage, the challenge stage, and the small achievement stage. Repetitive common patterns of behavior revealed three types: wishy-washy type, realistic-strategy type, and indomitable-challenge type. Moreover, the core category of educational experience was concluded to be 'a pedagogical process of turning despair from severe disabilities into hope through education.' Based on the analysis results, concrete intervention plans for social welfare practice were suggested to support the disabled children's lives with high quality of education.

• Journal of Korean Theatre Studies Association
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• no.52
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• pp.271-317
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• 2014

This essay studied the acting theories of Diderot, Delsarte, Meyerhold, and Artaud to know the historical formation of 'sign acting' and its theoretical and aesthetic appropriateness. The sign acting so far discussed shows the repetitive patterns of idea as follows. The sign acting (1) emphasizes the physical expression such as gesture and movement, (2) assumes that the physical expression functions as a sign evoking special emotion and thought, (3) thus recommends the imitation of the outer sign, (4) uses a tableau for the effective reception of outer sign, (5) aims for the spectator oriented aesthetics as it stresses the result of outer sign rather than the creative process of a role, (6) assumes that the emotional reaction or the intellectual understanding springs from the physical experience, (7) thus emphasizes the physical language rather than speech, (8) can attain the appropriateness of physical language by the recent theories of cognitive science. Besides having such commonness, the sign acting also reveals the individual differences. For instance, the intended sign for Diderot and Delsarte was the sign of emotion, for Meyerhold the stylized sign of circus and acrobatics, and for Artaud the spiritual sign. If Diderot and Meyerhold demands the cool consciousness for the correct sign acting, Artaud's sign acting tends to pursue the state of trance. And if Diderot, Delsarte, and Meyerhold think the sign acting on the level of sensory appeal, Artaud insists that the sign acting should dismantle the spectator's sense. As such the discussion of sign acting shows both recurrent ideas and new visions, forming an unity out of diversity. Perhaps the sign acting is a matter of practice before we consider it as a theory. It is not only supposed to have been existed practically since ancient theatre, but also used by actors consciously and unconsciously in expressing certain emotion and thought. We need to study the sign acting more academically, considering its long history and aesthetic potentials. In fact the sign acting has been an essential element of acting, in spite of bad reputation judging it as a banal and worn-out style. It is true that the sign acting, in the worst case, could produce a stereotypical expression. It was this aspect of sign acting that caused a fierce negative reaction of the realists who sought the natural expression based upon psychological truth. Of course the sign acting has a serious problem when it stays banal and artificial. But we need to see this issue from a different perspective. What is the natural expression of emotion? How is it free from the learned way of expression? In some respect, we use, in reality, a learned expression of emotion that could be accepted socially. For instance, when we attend a funeral, we use the outer sign of mourning gestures learned socially. If a semiotic expression pervades various aspects of our life, the acting, being the representation of life, seems not to be free from codified expression. The sign acting could be used consciously and unconsciously in all kinds of acting.

• Journal of Genetic Medicine
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• v.15 no.2
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• Nutrition Research and Practice
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• v.13 no.4
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• pp.302-309
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• 2019

BACKGOURND/OBJECTIVES: Vascular inflammation is an important feature in the atherosclerotic process. Recent studies report that leaves and branches of Carpinus turczaninowii (C. turczaninowii) have antioxidant capacity and exert anti-inflammatory effects. However, no study has reported the regulatory effect of C. turczaninowii extract on the arterial inflammatory response. This study therefore investigated modulation of the arterial inflammatory response after exposure to C. turczaninowii extract, using human aortic vascular smooth muscle cells (HAoSMCs). MATERIALS/METHODS: Scavenging activity of free radicals, total phenolic content (TPC), cell viability, mRNA expressions, and secreted levels of cytokines were measured in LPS-stimulated (10 ng/mL) HAoSMCs treated with the C. turczaninowii extract. RESULTS: C. turczaninowii extract contains high amounts of TPC ($225.6{\pm}21.0mg$ of gallic acid equivalents/g of the extract), as well as exerts time-and dose-dependent increases in strongly scavenged free radicals (average $14.8{\pm}1.97{\mu}g/mL$ $IC_{50}$ at 40 min). Cell viabilities after exposure to the extracts (1 and $10{\mu}g/mL$) were similar to the viability of non-treated cells. Cytokine mRNA expressions were significantly suppressed by the extracts (1 and $10{\mu}g/mL$) at 6 hours (h) after exposure. Interleukin-6 secretion was dose-dependently suppressed 2 h after incubation with the extract, at $1-10{\mu}g/mL$ in non-stimulated cells, and at 5 and $10{\mu}g/mL$ in LPS-stimulated cells. Similar patterns were also observed at 24 h after incubation with the extract (at $1-10{\mu}g/mL$ in non-stimulated cells, and at $10{\mu}g/mL$ in the LPS-stimulated cells). Soluble intracellular vascular adhesion molecules (sICAM-1) secreted from non-stimulated cells and LPS-stimulated cells were similarly suppressed in a dose-dependent manner after 24 h exposure to the extracts, but not after 2 h. In addition, sICAM-1 concentration after 24 h treatment was positively related to IL-6 levels after 2 h and 24 h exposure (r = 0.418, P = 0.003, and r = 0.524, P < 0.001, respectively). CONCLUSIONS: This study demonstrates that C. turczaninowii modulates the arterial inflammatory response, and indicates the potential to be applied as a therapeutic use for atherosclerosis.

• Korean Journal of Poultry Science
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• v.47 no.4
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• pp.247-254
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• 2020

This study examined how consumer choices (i.e., selecting food safety certified products, health-related products, and familiar brands) affect the purchase of Korean native chicken (KNC) and the demographics that influence KNC purchases using secondary consumer panel data from the Rural Development Administration of Korea. The grocery purchase data from 654 Korean households between 2017 and 2019 were used; the propensity for food safety certified products was measured by the purchasing frequency of Good Agricultural Practice (GAP) and Hazard Analysis and Critical Control Point (HACCP) products, and the propensity for health-related products was measured by the purchasing frequency of home meal replacement (HMR) and hedonic products. The propensity to purchase familiar brands was measured using a questionnaire. Logistic regression was used to examine the determinants of the KNC purchase experience, and multiple linear regression was used to determine the factors that influenced the KNC purchase frequency. The results showed that unemployed women purchased more safety certified products, health-related products, familiar brands, and KNC. These findings suggest that targeting consumers with differential marketing strategies may help promote KNC consumption. This study identified factors that influence KNC purchases, which is important for understanding consumer behavior and revitalizing the market.

• The korean journal of orthodontics
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• v.52 no.1
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• pp.3-19
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• 2022

Objective: The purpose of this study was to investigate the accuracy of one-step automated orthodontic diagnosis of skeletodental discrepancies using a convolutional neural network (CNN) and lateral cephalogram images with different qualities from nationwide multi-hospitals. Methods: Among 2,174 lateral cephalograms, 1,993 cephalograms from two hospitals were used for training and internal test sets and 181 cephalograms from eight other hospitals were used for an external test set. They were divided into three classification groups according to anteroposterior skeletal discrepancies (Class I, II, and III), vertical skeletal discrepancies (normodivergent, hypodivergent, and hyperdivergent patterns), and vertical dental discrepancies (normal overbite, deep bite, and open bite) as a gold standard. Pre-trained DenseNet-169 was used as a CNN classifier model. Diagnostic performance was evaluated by receiver operating characteristic (ROC) analysis, t-stochastic neighbor embedding (t-SNE), and gradient-weighted class activation mapping (Grad-CAM). Results: In the ROC analysis, the mean area under the curve and the mean accuracy of all classifications were high with both internal and external test sets (all, > 0.89 and > 0.80). In the t-SNE analysis, our model succeeded in creating good separation between three classification groups. Grad-CAM figures showed differences in the location and size of the focus areas between three classification groups in each diagnosis. Conclusions: Since the accuracy of our model was validated with both internal and external test sets, it shows the possible usefulness of a one-step automated orthodontic diagnosis tool using a CNN model. However, it still needs technical improvement in terms of classifying vertical dental discrepancies.

• Journal of the Daesoon Academy of Sciences
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• v.39
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• pp.175-214
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• 2021

In the Joseon Dynasty, Confucian literati sacralized their daily lives through ritual practices across the three dimensions of time, place, and humanity. 1) In the dimension of time, they cultivated in their personal lives by accepting and thoroughly practicing the ethical principles of the Elementary Learning (『小學』). These practices of self-cultivation developed into ritualized practices of daily routine from the perspective of neo-Confucianism. 2) In the spatial dimension, local public schools (鄕校), local private academies (書院), and village private schools (書塾) were constructed as the symbolic places for disseminating Confucian norms through intensive seminar activities and collective learning sessions (講會). These places were also used for the pious recitations of selected Confucian proverbs that had been ritualized by Confucian literati. 3) In the dimension of humanity, pious consciousness, reinforced by the ritualized practice of periodic sacrifices or intensive reading, was subconsciously deepened and projected onto dreams individuals reported of their deceased fathers or teachers. According to the Confucian ritualization process, people were seen as being able to sanctify their daily lives by thoroughly internalizing and effectively realizing Confucian values.

• Journal of Korea Entertainment Industry Association
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• v.15 no.8
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• pp.337-349
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• 2021

This study tried to develop a lifestyle redesign program that can be applied to college students. For program development, the Delphi research method was implemented with 8 experts. Based on previous studies on lifestyle and time use, the first Delphi survey investigated the prioritization of occupations through evaluation instruments, lifestyle types, and living time survey tables. In the second Delphi survey, it was constructed based on the opinions of experts, and when the content validity ratio was low, it was reconstructed by modifying and supplementing it. In the third Delphi survey, while maintaining the framework of the secondary content, the experts' own responses from the second time and the second average score with other experts were presented together. As a result of this study, a program with an average score of 3.88~4.00, a content validity ratio of 1.00, and a convergence of 0.00 was finally derived. In the lifestyle redesign program for college students, the first step of the pre-intervention evaluation is to identify the lifestyle type, apply evaluation tools, and select occupations. In the second step, the lifestyle is redesigned by the intervention execution, and the facilitator intervenes to help college students do well their tasks. The program was developed by encouraging them to practice, checking the lifestyle type change as a result of the intervention in step 3, applying evaluation instruments after the intervention, and ending the program in the last step. This study provided a rationale for using lifestyle redesign program as an intervention to change their occupational performance patterns in order to successfully carry out the life they want.