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Research on Geographic Variations in Health Services Utilization in the United States: A Critical Review and Implications (미국의 지역간 의료이용의 변이 연구: 비판적 검토와 함의)

  • Do, Young-Kyung
    • Health Policy and Management
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    • v.17 no.1
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    • pp.94-124
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    • 2007
  • This paper critically reviews three decades of research on geographic variations. in health services utilization in the United States, thereby drawing policy and research implications for Korea. The recent renewed interest in variations research in the United States, precipitated by studies on regional variations in Medicare expenditures, stems mainly from the policy implication that a substantial amount of Medicare expenditures could be saved without compromising quality and access. From the research perspective, this policy implication was made tenable by integrating micro- and macro-level analysis of variations in health services utilization. Still, theoretical limitations inherent in the research pose great challenges to developing effective strategies at the health system level. Variations research in the United States can serve as a case study as to how health services research has responded to efficiency and quality issues in an ever expanding health system Considering the current health policy and research environment in Korea, the following implications can be drawn. Variations research will help formulate a national policy agenda for health care quality and also advance the framework of approaches to health policy issues. For such purposes, both relevant descriptive and hypothesis-testing studies are needed. Further advancement in variations research will require interdisciplinary explorations and methodological sophistication. To the extent that Korean health policies will strive to achieve complex goals, variations research will increasingly prove to be useful.

Cancer Chemoprevention by Dietary Phytochemicals: Rationale and Mechanisms (Dietary Phytochemical을 이용한 화학적 암에방과 그 작용 기전)

  • Surh, Young-Joon;Lee, Jong-Min
    • Environmental Mutagens and Carcinogens
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    • v.18 no.1
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    • pp.1-8
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    • 1998
  • Chemoprevention refers to the use of non-toxic chemical agents to prevent the neoplastic development by inhibiting, delaying, or reversing a multi-stage carcinogenesis. The primary goal of chemoprevention research is to identify or produce effective agents and strategies for clinical trials for applications to normal or high risk human populations. A large number of compounds have been tested for their possible chemopreventive activities, and it is of interest to note that many of them are naturally occurring substances. Thus, a variety of plant and vegetable constituents, particularly those included in our daily diet, have been found to possess substantial protective properties against experimental carcinogenesis. These substances, collectively known as dietary phytochemicals, exert their chemopreventive effects by influencing specific step(s) of multi-stage carcinogenesis: some inhibit metabolic activation or enhance detoxification of carcinogens, others interfere with covalent interactions between ultimate eloctrophilic carcinogens and the target cell DNA and still others may exert anti-promoting or anti-progressing effects. Mechanism-based interventions by use of safe dietary phytochemicals may provide one of the most practical and promising cancer chemopreventive strategies.

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Development of Power Spectreal Analysis System in the Auto Nomic Nervous System Activity.(-Effects of Respiration Frequency-) (자율신경 활성도 측정을 위한 power spectral analysis 시스템의 설계 및 제작)

  • 이준하;이상학;신현진
    • Progress in Medical Physics
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    • v.6 no.2
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    • pp.103-109
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    • 1995
  • Power spectral analysis of spontaneous heart rate fluctuations were assessed by use of autooic blocking agents and changes in posture. The total power spectral range of interest is divided amongst the various experiments so that each respiratory pattern contributes a spectral ratio of interval to respiration only over a group of frequencies for which the specific respiratory pattern has substantial, and roughly constant, spectral magnitudes. System hardware is consisted ECG preamplifier, respiratory fluctuation detect, interval time generator and IBC 486PC. High frequency fluctuation, at the respiratiory frequency, are decreased by standing and are mediated solely by the parasympathetic system. Power spectral analysis is a powerful nonivsve tool for quantitying autonomic nervous system activity.

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Nonpharmacological management and psychosocial support for children and adolescents with type 1 diabetes

  • Yoo, Jae-Ho
    • Clinical and Experimental Pediatrics
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    • v.54 no.2
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    • pp.45-50
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    • 2011
  • Compared to that in the Caucasian population, type 1 diabetes mellitus (T1DM) incidence rates are very low in Koreans. Therefore, compared to the recent development of pharmacological therapy applicable to Korean children with T1DM, interest in nonpharmacological therapy and psychosocial support systems remains low, as is the development of Korean-style T1DM education programs for therapeutic application. Children who have been newly diagnosed with diabetes are placed in completely new environments for treatment. For appropriate control of diabetes, patients have to self-monitor blood glucose levels and inject insulin several times a day and must use extreme self-control when they eat foods to avoid increases in blood glucose levels. Blood glucose excursions resulting from impaired pancreatic ${\beta}$ cell functions cause mental stress due to vague fears of chronic complications of diabetes. In addition, children with diabetes cannot be excluded from the substantial amount of studies required of Korean adolescents, and the absolute shortage of time for ideal control of diabetes adds to their mental stress. Many of these patients are psychologically isolated in school where they spend most of their time, and they are not appropriately considered or supported with respect to blood glucose control in many cases. In this respect, this author will introduce some of the newest views on nonpharmacological therapy and psychosocial support systems that account for important parts of T1DM management and seek measures to apply them in conformity with the social characteristics of Korea.

Risk and Opportunity of Interest Conflict Settlement : Introduction of Consumer Collective Lawsuit (Verbandsklage) (이해관계 갈등조정의 위기와 기회 - 소비자단체소송제도의 도입 -)

  • Min, Hyeon-Seon;Jang, Ju-Seong
    • 한국디지털정책학회:학술대회논문집
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    • 2006.06a
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    • pp.39-44
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    • 2006
  • The purport of this paper is to deduce political implication and significance of the proposed redress scheme of 'Consumer Collective Lawsuit (hereinunder "CCL")' under way to be introduced by the Korean government via various assessments per each phase of policy implementation process. To this end, the paper classifies the subject policy (referring to CCL) implementation process into 4 phases: policy origination, policy enactment, policy advertisement, and policy execution. Based on the said classification, assessments per each phase together with pros and cons analysis have been conducted. Through the aforementioned analysis, the paper concludes the following political implication and significance of CCL under way of introduction: - 1. In the case of policy origination led by external parties, a social consensus by and from involved parties with various interests is the most critical; 2. Prior feasibility and/or suitability study is also crucial in the policy implementation procedure; 3. To mitigate inter-ministerial conflicts that might arise from the due policy making procedure, democratization of conflict settlement mechanism, and institutionalization of participation in and disclosure of policy making process are cal led upon; and 4. Prior planning wi th respect to the public relation and advertisements of the subject policy on the table poses substantial significance.

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Usage of Human Mesenchymal Stem Cells in Cell-based Therapy: Advantages and Disadvantages

  • Kim, Hee Jung;Park, Jeong-Soo
    • Development and Reproduction
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    • v.21 no.1
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    • pp.1-10
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    • 2017
  • The use of human mesenchymal stem cells (hMSCs) in cell-based therapy has attracted extensive interest in the field of regenerative medicine, and it shows applications to numerous incurable diseases. hMSCs show several superior properties for therapeutic use compared to other types of stem cells. Different cell types are discussed in terms of their advantages and disadvantages, with focus on the characteristics of hMSCs. hMSCs can proliferate readily and produce differentiated cells that can substitute for the targeted affected tissue. To maximize the therapeutic effects of hMSCs, a substantial number of these cells are essential, requiring extensive ex vivo cell expansion. However, hMSCs have a limited lifespan in an in vitro culture condition. The senescence of hMSCs is a double-edged sword from the viewpoint of clinical applications. Although their limited cell proliferation potency protects them from malignant transformation after transplantation, senescence can alter various cell functions including proliferation, differentiation, and migration, that are essential for their therapeutic efficacy. Numerous trials to overcome the limited lifespan of mesenchymal stem cells are discussed.

A FOLLOW-UP STUDY ON THE INTERNATIONAL ASTRONOMY OLYMPIAD PARTICIPANTS (국제천문올림피아드 참가자에 대한 추적연구)

  • Yim In-Sung;Shim Jae-Young;Kim Ohn-Juh;Mihn Byeong-Hee
    • Publications of The Korean Astronomical Society
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    • v.21 no.1
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    • pp.11-20
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    • 2006
  • We carried out a follow-up study on the students who participated in International Astronomy Olympiad(IAO). We surveyed home and school environment, personal characteristics with regard to four high school student and five college students who participated in IAO from 2002 to 2005. In the home environment variable of science elite students who took part in the IAO, we found out significant corelation between science elites and their parent's educational career. In their personal characteristics, we found out considerably their motivation capacity, intelligent curiosity, flexible and creative thinking ability. This study illuminated that the experience of IAO participation offered the opportunity for the students to gain mare self-esteem and positive confidence on scientific study. The IAO experience is construed to effect greatly the students' future. Through the IAO experience, the participating students are expected to major in astronomy and become excellent astronomers in the future. We expect that the interest of student will increase greatly in the area of astronomy and it will contribute to the substantial development of Korean astronomy. In this respect, with the constant support to the IAO participants, the effort to cultivate outstanding astronomers and follow-up study on those participants of the IAO should be continued.

Quadratic inference functions in marginal models for longitudinal data with time-varying stochastic covariates

  • Cho, Gyo-Young;Dashnyam, Oyunchimeg
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.3
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    • pp.651-658
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    • 2013
  • For the marginal model and generalized estimating equations (GEE) method there is important full covariates conditional mean (FCCM) assumption which is pointed out by Pepe and Anderson (1994). With longitudinal data with time-varying stochastic covariates, this assumption may not necessarily hold. If this assumption is violated, the biased estimates of regression coefficients may result. But if a diagonal working correlation matrix is used, irrespective of whether the assumption is violated, the resulting estimates are (nearly) unbiased (Pan et al., 2000).The quadratic inference functions (QIF) method proposed by Qu et al. (2000) is the method based on generalized method of moment (GMM) using GEE. The QIF yields a substantial improvement in efficiency for the estimator of ${\beta}$ when the working correlation is misspecified, and equal efficiency to the GEE when the working correlation is correct (Qu et al., 2000).In this paper, we interest in whether the QIF can improve the results of the GEE method in the case of FCCM is violated. We show that the QIF with exchangeable and AR(1) working correlation matrix cannot be consistent and asymptotically normal in this case. Also it may not be efficient than GEE with independence working correlation. Our simulation studies verify the result.

Effects of Tax Investigators' Pride, External Image, and Organization Identification on Organizational Commitment (세무조사자들의 자긍심, 외부이미지, 조직 동일시가 조직몰입에 미치는 영향)

  • Hong, Soon-Bok
    • The Journal of the Korea Contents Association
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    • v.8 no.5
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    • pp.215-223
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    • 2008
  • This study is an empirical research on what effects public tax officers' pride, external image, and organization identification as tax specialists have on their organizational commitment. The results of the verification showed that their organizational commitment gets deeper as their satisfaction about pride, external image, and organization identification get greater. In order to meet the public interest in taxation and the demand of the time with positive attitudes and facilitate the functions of the taxation administration, public tax officers' organizational commitment should be intensified by increasing their pride as tax specialists, enhancing external images of the taxation administration, making substantial and realistic efforts, and letting public tax officers have organization identification.

Photoreactivation Study of Wastewater Treatment Effluent Disinfected by UV-disinfection for Water Reuse (용수재이용을 위한 하수처리 유출수의 UV 소독 후 광회복 조사)

  • 윤춘경;정광욱;함종화;전지홍
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.45 no.3
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    • pp.84-93
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    • 2003
  • Photoreactivation of microorganism following UV-disinfection is one of the research topics of interest in assessing the UV-disinfection performance. Apparent photoreactivation was examined under fluorescent lamp and solar radiation as well as in darkness. Total coliform, fecal coliform, and Escherichia coli were used as indicator microorganisms, and their concentration was monitored with time after UV-disinfection. Under the darkness, their initial concentration of 10∼30 MPN/100 mL increased to the level of 100 MPN/100 mL after 24 hours, which implied that part of damaged microorganisms by UV-disinfection might be repairable with time. Under the fluorescent lamp, photoreactivation was more apparent that their concentration increased up to 1,000 MPN/100 mL which might significantly impair the water uses specially in reuse of reclaimed wastewater. However, their concentration further decreased down to below 2 MPN/100 mL under the solar radiation primarily due to additional disinfection by solar radiation rather than photoreactivation. Samples not disinfected by UV-disinfection also demonstrated substantial decrease of their concentration under solar radiation from about 5,000 MPN/100 mL to less than 30 MPN/100 mL in 24 hours. But direct reuse of effluent without disinfection is not recommended because natural decay by solar radiation may take time and be affected by climatic conditions. The result suggests that photoreactivation of pathogenic microorganisms may not be concerned in agricultural reuse of reclaimed wastewater because solar radiation may provide further disinfection after UV-disinfection.