• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.109-119
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• 2010

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot.

• Journal of Hospice and Palliative Care
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• v.16 no.1
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• pp.10-19
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• 2013

Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

• Journal of Korean Society of societal Security
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• v.4 no.2
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• pp.73-78
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• 2011

In order to resolve the problem of change in global climate which is worsening as days go by and to preemptively cope with strengthened restriction on carbon emission, the government enacted 'Framework Act on Low Carbon Green Growth' in 2010 and selected green technology and green industry as new national growth engines. For this reason, the necessity to use the un-utilized waste heat across the whole industrial system has become an issue, and studies on and applications of recycling in the agricultural and fishery fields such as cultivation of tropical crops and flatfishes by utilizing the waste heat and thermal effluent generated by large industrial complexes including power plants are being actively carried out. In this study, we looked into the domestic and overseas examples of having utilized waste heat abandoned in the form of power plant thermal effluent, and carried out economic efficiency evaluation of sturgeon aquaculture utilizing thermal effluent of Yeongwol LNG Combined Cycle Power Plant in Gangwon-do. In this analysis, we analyzed the economic efficiency of a model business plan divided into three steps, starting from a small scale in order to minimize the investment risk and financial burden, which is then gradually expanded. The business operation period was assumed to be 10 years (2012~2021), and the NVP (Net Present Value) and economic efficiency (B/C) for the operation period (10 years) were estimated for different loan size by dividing the size of external loan by stage into 80% and 40% based on the basic statistics secured through a site survey. Through the result of analysis, we can see that reducing the size of the external loan is an important factor in securing greater economic efficiency as, while the B/C is 1.79 in the case the external loan is 80% of the total investment, it is presumed to be improved to 1.81 when the loan is 40%. As the findings of this study showed that the economic efficiency of sturgeon aquaculture utilizing thermal effluent of power plant can be secured, it is presumed that regional development project items with high added value can be derived though this, and, in addition, this study will greatly contribute to reinforcement of the capability of local governments to cope with climate change.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.2
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• pp.206-225
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• 2012

General status of pediatric dentistry in Korea is to conduct vigorous academic activities and specialized medical care centering the Korean Association of Pediatric Dentistry (KAPD) that has about 1,000 pediatric dentists as members, pediatric dentistry departments of 11 Colleges of Dentistry, numbers of pediatric dentistry training institutions and private clinics specialized in children. From 1996, the accredited pediatric dentists were produced by the KAPD and from 2008, the state began to produce the accredited pediatric dentists. Since then, doctors with expertise in pediatric care had opened private clinics in addition to the university hospitals, it became the basis of a momentum to deepen the specialty of pediatric dentistry. The Dentistry community of Korea is going through rapid and profound changes recently, and the underlying reasons for such changes can be classified largely into a few categories: (1) Decreasing population and structural changes in population (2) Increase in numbers of dentists, (3) Changes in the pattern of dental diseases and (4) Changes in medical environment. In Korea, the children population in the age range of 0 ~ 14 years old had been decreased by 2 million in 2010 compared to that of 2000 due to reduction of birth rate. The current population of children in the age range of 0 ~ 4 years old in 2010 takes up 16.2% of the total population, but it is estimated that such percentage would decrease to 8.0% by 2050. Such percentage is largely behind the estimated mean global population of 19.6% by 2050. On the other hand, the number of dentists had been largely increased from 18,000 in 2000 to 25,000 in 2010. And it is estimated that the number will be increased to 41,000 by 2030. In addition, the specialized personnel of Pediatric dentistry had been shown as increased by 2.5 times during past 10 years. For the changes in the pattern of dental diseases, including dental caries, each df rate of 5 years old children and 12 years old children had been decreased by 21.9% and 16.7% respectively in 2010 compared to 2000. Each df Index also had been decreased by 2.5 teeth and 1.2 teeth respectively. The medical expenditure of Korea is less than that of OECD and more specifically, the expenditure from the National Health Plan is less than OECD but the expenditure covered by households is larger than OECD. These facts indicate that it is considered as requiring the coverage of the national health plan to be reinforced more in the future and as such reinforcement needs continuous promotion. In medical examination pattern of Pediatric dentistry, the preventive and corrective treatment were increased whereas the restorative treatment was decreased. It is considered that such change is caused from decrease of dental caries from activation of the prevention project at national level. For the restorative treatment, the restorations in use of dental amalgam, pre-existing gold crowning and endodontic treatment had been decreased in their proportion while the restorative treatment in use of composite resin had been increased. It is considered that such changes is caused by the change of demands from patients and family or guardians as they desired more aesthetic improvement along with socio-economic growth of Korean society. Due to such changes in dentistry, the pediatric dentistry in Korea also attempts to have changes in the patterns of medical examination as follows; It tends to implement early stage treatment through early diagnosis utilizing various diagnostic tools such as FOTI or QLF. The early stage dental caries so called white spot had been included in the subjects for dental care or management and in order to do so, the medical care guidelines essentially accompanied with remineralization treatment as well as minimally invasive treatment is being generalized gradually. Also, centering the Pediatric dentists, the importance of caries risk assessment is being recognized, in addition that the management of dental caries is being changed from surgical approach to internal medicinal approach. Recently, efforts began to emerge in order to increase the target patients to be managed by dentists and to expand the application scope of Pediatric dentistry along with through such changes. The interest and activities of Pediatric dentists which had been limited to the medical examination room so far, is now being expanded externally, as they put efforts for participating in the preventive policy making process of the community or the state, and to support the political theories. And also opinions are being collected into the direction that the future- oriented strategic political tasks shall be selected and researches as well as presentations on the theoretical rationale of such tasks at the association level.

• Korean Journal of Biological Psychiatry
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• v.14 no.2
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• pp.91-98
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• 2007

Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

• Journal of Korean Tunnelling and Underground Space Association
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• v.15 no.5
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• pp.505-522
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• 2013

Previously, a new concept of indexing methodology has been proposed for quantitative assessment of tunnel collapse hazard level at each tunnel face with respect to the given geological data, design condition and the corresponding construction activity (Shin et al, 2009a). In this paper, 'linear' model, in which weights of influence factors are invariable, and 'non-linear' model, in which weights of influence factors are variable, are taken into account with some examples. Then, the 'non-linear' model is validated by using 100 tunnel collapse cases. It appears that 'non-linear' model allows us to have adapted weight values of influence factors to characteristics of given tunnel site. In order to make a better understanding and help for an effective use of the system, a series of operating processes of the system are built up. Then, by following the processes, the system is applied to a real-life tunnel project in very weak and varying ground conditions. Through this approach, it would be quite apparent that the tunnel collapse hazard indices are determined by well interlinked consideration of face mapping data as well as design/construction data. The calculated indices seem to be in good agreement with available electric resistivity distribution and design/construction status. In addition, This approach could enhance effective usage of face mapping data and lead timely and well corresponding field reactions to situation of weak tunnel faces.

• Journal of Preventive Medicine and Public Health
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• v.19 no.2 s.20
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• pp.193-202
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• 1986

The activities of general physicians (GPs) in health subcenters and their competency for clinical skills were assessed to develop a scheme to improve the training program. One hundred-twenty GPs in southern four provinces (Kyungpook, Kyungnam, Chunpook, Chunnam) were randomly selected and 97 were interviewed between January 9 and February 10, 1984. Of the 97 GPs, 86 provided all the information we requested. Average number of patient visits per health subcenter in a day was 30-40 in the demonstration project area for the class II medical insurance whereas it was 3-4 visits in other area. The interviewees were asked to rate their competency in 63 clinical skills. The skills in which over 50% of the interviewees rated themselves competent were only 12 items including IM injection, IV injection, wound dressing, etc. Less than 10% of the interviewees rated themselves competent in such skills as maternal health care, emergency medical care, preventive and promotive health services. Most part of the training program of the NIH for the GPs were not applicable to their field work as the training contents were unrealistic. Clinical training at a local general hospital was of great help in 38.8% and the rest of training was not much helpful as the training was inadequate due to lack of trainer or indifference of the trainer. For more effective training of the GPs, the training program of the NIH should be modified to be more realistic and utilize competent field workers as the instructors. It may be more effective if the training is carried out at several local centers. Ideal length of the clinical training for the GPs is 4 months. A pocketbook should be developed that includes specific skills to master during the clinical training and require the trainer to confirm the achievement. The Ministry of Health and Social Affairs should provide the training hospitals with a training guideline and evaluate the training activities and make sure that the training hospital has specialist for each of the 4 major clinical departments. The Ministry of Health and Social Affairs should provide the GPs with a continuing education to assist the problem solving in the field and motivate them to actively carry out the health program. A province may be divided into several regions and a supervisory committee may be organized with specialists in each region. The committee may hold a meeting for the GPs periodically and respond to the specific questions of the GPs by mail.

• The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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• v.12 no.3
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• pp.170-177
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• 2007

In this study, the long-term predictability of El Nino and La Nina events of Pusan National University Coupled General Circulation Model(PNU/CME CGCM) developed from a Research and Development Grant funded by Korea Meteorology Administration(KMA) was examined in terms of the correlation coefficients of the sea surface temperature between the model and observation and skill scores at the tropical Pacific. For the purpose, long-term global climate was hindcasted using PNU/CME CGCM for 12 months starting from April, July, October and January(APR RUN, JUL RUN, OCT RUN and JAN RUN, respectively) of each and every years between 1979 and 2004. Each 12-month hindcast consisted of 5 ensemble members. Relatively high correlation was maintained throughout the 12-month lead hindcasts at the equatorial Pacific for the four RUNs starting at different months. It is found that the predictability of our CGCM in forecasting equatorial SST anomalies is more pronounced within 6-month of lead time, in particular. For the assessment of model capability in predicting El Nino and La Nina, various skill scores such as Hit rates and False Alarm rate are calculated. According to the results, PNU/CME CGCM has a good predictability in forecasting warm and cold events, in spite of relatively poor capability in predicting normal state of equatorial Pacific. The predictability of our CGCM was also compared with those of other CGCMs participating DEMETER project. The comparative analysis also illustrated that our CGCM has reasonable long-term predictability comparable to the DEMETER participating CGCMs. As a conclusion, PNU/CME CGCM can predict El Nino and La Nina events at least 12 months ahead in terms of NIino 3.4 SST anomaly, showing much better predictability within 6-month of leading time.

• Journal of Chest Surgery
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• v.52 no.4
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• pp.248-329
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• 2019

Background: Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods: This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors-primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results: CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion: Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

• Ecology and Resilient Infrastructure
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• v.8 no.1
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• pp.64-78
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• 2021

This study was conducted to find out the effect of the construction and operation of river-crossing structures on the habitat landscape characteristics in the Geum-gang River, South Korea. A total of three study reaches were selected in the downstream of the Daecheong Dam: the Buyong-ri reach, which is a control that is not affected by the construction and operation of the weir of the Four Rivers Project and Sejong-bo Weir reach and Gongju-bo Weir reach of the upper and lower sections of each weir that are affected by the weir construction and operation. The habitat type was classified, and then the structural characteristics of the landscape were analyzed using aerial photographs taken before and after the construction of the Daecheong Dam, before and after the construction of the weir, and before and after the weir gate operation. After the construction of Daecheong Dam in Geum River, the area of the bare land greatly decreased, and the area of grassland and woodland increased in the downstream of the dam. In addition, the patch number in the river landscape increased, the patch size decreased, and the landscape shape index and the habitat diversity increased. Therefore, after the construction of the dam, the bare land habitat was changed to a vegetated habitat, and the habitat was fragmented and diversified in the downstream of the dam. After the construction of the weirs, the area of open water increased by 18% in the Sejong-bo reach and by 90% in the Gongju-bo reach, and the landscape shape index of the open water decreased by 32% in the Sejong-bo reach and by 35% in the Gongju-bo reach, and the habitat diversity index decreased to 25% in the Sejong-bo reach and to 24% in the Gongju-bo reach. Therefore, the open water habitat was expanded, the shape of the habitat was simplified, and the habitat diversity decreased according to the construction of the weirs. After water-gate opening of the weir, the bare land that disappeared after the construction of the weir reappeared, and the landscape shape index and habitat diversity index increased in both terrestrial and open water habitats. Therefore, it was found that the landscape characteristics of the river habitats were restored to the pre-construction of the weir by the operation of the weir gate. The effect of weir gate opening was delayed in the downstream than in the upstream of the weir. Although the characteristics of the landscape structure in the river habitat changed due to the construction of the river-crossing structures, it is thought that proper technology development for the ecological operation of the structures is necessary as the habitat environments can be restored by the operation of these structures.