• Title/Summary/Keyword: Welfare $Quality^{(R)}$

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A Study on a Direction of Improving the Health Insurance Appeal System in Korea (건강보험 권리구제제도의 개선 방향에 관한 연구)

  • Kim, Un-Mook
    • The Korean Society of Law and Medicine
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    • v.7 no.2
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    • pp.219-268
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    • 2006
  • In July 1989, Korea had achieved the national medical insurance system comprehensively covering the whole population since its inception of 12 years before, and subsequently the plural medical insurers had integrated to the unique health insurer system in July 2000. But there yet remain some problems to be improved under low contributions rates and poor benefit packages, especially the shortage of assuring beneficiaries' rights. The Health Insurance Appeal System is composed of a two-tiered system of committee. The Formal Objection Committees built in the National Health Insurance Corporation and in the Health Insurance Review Agency respectively examine the formal objections to the decisions of the Corporation, or the Review Agency. And the Dispute Mediation Committee built under the command of the Minister of Health and Welfare reviews the protests against the decisions on the formal objections by each Formal Objection Committee. To cope with the appellant in relation to the administration on the qualification of the insureds, contributions, and insurance benefits etc, is found to be unsatisfactory. There's the reason of poor function on right-relief caused by the loose composition of the Appeal Committee, the deficit of people's recognition and P.R., the lack of professional manpower and the Committee's independency, and time lag in making decisions and so on. Consequently the Appeal System should be improved to secure the rights-relief function, to empower the professionalism of the Appeal Committee, to strengthen P.R. for the beneficiaries, to build up the staff's proficiency through training, and to develop the quality of administrative services.

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Stimulation-Oriented Interventions for Behavioral Problems among People with Dementia: A Systematic Review and Meta-Analysis (치매 환자의 문제행동을 위한 자극지향적 중재의 효과 연구: 체계적 고찰과 메타분석)

  • Kim, Eun Young;Hwang, Sung-Dong;Kim, Eun Joo
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.475-489
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    • 2016
  • Purpose: This study was a systematic review and meta-analysis designed to investigate the effects of stimulation-oriented interventions for behavioral problems among people with dementia. Methods: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), a literature search was conducted using seven electronic databases, gray literature, and other sources. Methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) for randomized controlled trials (RCTs). Data were analyzed using R with the 'meta' package and the Comprehensive Meta-Analysis (CMA 2.0) program. Results: Sixteen studies were included for meta-analysis to investigate the effect of stimulation-oriented interventions. The quality of individual studies was rated as '++' for eight studies and '+' for the rest. The effect sizes were analyzed according to three subgroups of interventions (light, music, and others); Hedges' g=0.04 (95% CI: -0.38~0.46), -0.23 (95% CI: -0.56~0.10), -0.34 (95% CI: -0.34~0.00), respectively. To explore the possible causes of heterogeneity ($I^2=62.8%$), meta-regression was conducted with covariates of sample size, number of sessions, and length of session (time). No moderating effects were found for sample size or number of sessions, but session time showed a significant effect (Z=1.96, 95% CI: 0.00~0.01). Finally, a funnel plot along with Egger's regression test was performed to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, stimulation-oriented interventions seem to have a small effect for behavioral problems among people with dementia. Further research is needed to identify optimum time of the interventions for behavioral problems among dementia pateints.

Multimorbidity and Its Impact on Workers: A Review of Longitudinal Studies

  • Cabral, Giorgione G.;de Souza, Ana C. Dantas;Barbosa, Isabelle R.;Jerez-Roig, Javier;Souza, Dyego L.B.
    • Safety and Health at Work
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    • v.10 no.4
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    • pp.393-399
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    • 2019
  • Objective: This study investigates the impact of multimorbidity on work through a literature review of longitudinal studies. Methods: A systematic review was carried out in the databases Lilacs, SciELO, PAHO, PubMed/Medline, Scopus, Web of Science, and Cochrane. There were no restrictions regarding the year of publication or language to maximize the identification of relevant literature. The quality of studies was assessed by the protocol STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Results: An initial database search identified 7522 registries, and at the end of the analysis, 7 manuscripts were included in the review. Several studies have demonstrated direct and indirect impacts of multimorbidity on the health of workers. For this, the number of missed days due to health-related issues was evaluated, as well as the reduction in work productivity of the unhealthy worker, vulnerability of the worker with multimorbidity regarding higher indices of dismissal and recruitment difficulties, and incidence of early retirement and/or receipt of benefits due to disabilities. Conclusions: Multimorbidity has a negative impact on work, with damages to quality of life and work productivity, worsening the absenteeism/presenteeism indices, enhancing the chances of temporary or permanent leaves, and lowering employability and admission of individuals with multimorbidity.

Voice Activity Detection Using Modified Power Spectral Deviation Based on Teager Energy (Teager Energy 기반의 수정된 파워 스펙트럼 편차를 이용한 음성 검출)

  • Song, J.H.;Song, Y.R.;Shim, H.M.;Lee, S.M.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.8 no.1
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    • pp.41-46
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    • 2014
  • In this paper, we propose a novel voice activity detection (VAD) algorithm using feature vectors based on TE (teager energy). Specifically, power spectral deviation (PSD), which is used as the feature for the VAD in the IS-127 noise suppression algorithm, is obtained after the input signal is transfomed by Teager energy operator. In addition, the TE-based likelihhod ratio are derived in each frame to modifiy the PSD for further VAD. The performance of our proposed VAD algorithm are evaluated by objective testing (total error rate, receiver operating characteristics, perceptual evaluation of speech quality) under various environments, and it is found that the proposed method yields better results than conventional VAD algorithms in the non-stationary noise environments under 5 dB SNR (total error rate = 2.6% decrease, PESQ score = 0.053 improvement).

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A Study on the prediction of BMI(Benthic Macroinvertebrate Index) using Machine Learning Based CFS(Correlation-based Feature Selection) and Random Forest Model (머신러닝 기반 CFS(Correlation-based Feature Selection)기법과 Random Forest모델을 활용한 BMI(Benthic Macroinvertebrate Index) 예측에 관한 연구)

  • Go, Woo-Seok;Yoon, Chun Gyeong;Rhee, Han-Pil;Hwang, Soon-Jin;Lee, Sang-Woo
    • Journal of Korean Society on Water Environment
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    • v.35 no.5
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    • pp.425-431
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    • 2019
  • Recently, people have been attracting attention to the good quality of water resources as well as water welfare. to improve the quality of life. This study is a papers on the prediction of benthic macroinvertebrate index (BMI), which is a aquatic ecological health, using the machine learning based CFS (Correlation-based Feature Selection) method and the random forest model to compare the measured and predicted values of the BMI. The data collected from the Han River's branch for 10 years are extracted and utilized in 1312 data. Through the utilized data, Pearson correlation analysis showed a lack of correlation between single factor and BMI. The CFS method for multiple regression analysis was introduced. This study calculated 10 factors(water temperature, DO, electrical conductivity, turbidity, BOD, $NH_3-N$, T-N, $PO_4-P$, T-P, Average flow rate) that are considered to be related to the BMI. The random forest model was used based on the ten factors. In order to prove the validity of the model, $R^2$, %Difference, NSE (Nash-Sutcliffe Efficiency) and RMSE (Root Mean Square Error) were used. Each factor was 0.9438, -0.997, and 0,992, and accuracy rate was 71.6% level. As a result, These results can suggest the future direction of water resource management and Pre-review function for water ecological prediction.

An Objective Estimation for Simulating of Asymmetrical Auditory Filter of the Hearing Impaired According to Hearing Loss Degree (난청인의 난청 정도에 따른 비대칭 청각 필터 구현의 객관적 평가)

  • Joo, S.I.;Jeon, Y.Y.;Song, Y.R.;Lee, S.M.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.3 no.1
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    • pp.27-34
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    • 2009
  • Hearing impaired person's hearing loss has personally various shape, so existing symmetrical auditory filter of frequency band method wasn't properly simulated the hearing impaired person's various hearing loss shape. The shapes of auditory filter are asymmetrical different with each center frequency and each input level. Hearing impaired person which has hearing loss was differently changed with that of normal hearing people and it has different value for speech of quality through auditory filter. In this study, the asymmetrical auditory filter was simulated and then some tests to estimate the filter's performance objectively were performed. The experiment as simulated auditory filter's performance evaluation method used perceptual evaluation of speech quality (PESQ) and log likelihood ratio (LLR) for speech through auditory filter. In the test, processed speech was evaluated objective speech quality and distortion using PESQ and LLR value. When hearing loss processed, PESQ and LLR value have big difference between symmetrical and asymmetrical auditory filter. It means that the difference of the shape auditory filter may affect to speech quality. Especially, when hearing loss existed, auditory filter changing according to asymmetrical shape for each center frequency affected to perceive speech quality of the hearing impaired.

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A Study on the Factors Affecting the Qualities of Lives in Mothers with Disabled Children in Seoul (서울 지역 장애아어머니의 삶의 질에 영향을 미치는 제 요인에 관한 연구)

  • Yoo, Hye-Kyung
    • Journal of Families and Better Life
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    • v.27 no.1
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    • pp.73-88
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    • 2009
  • The purpose of this study was to investigate the influence of the factors such as self-esteem, social supports, socio-economic status of parents, degree of disability in child, stress coping, religion, and sports.exercise on the qualities of lives in mothers with disabled children. Data were collect from 45 institutions(schools from kindergarten to senior-high, special education institutes, and social welfare institutions) by self-report questionnaire, and the subjects of the study were 386 mothers in Seoul whose children were attending the schools or institutions. Findings according to socio-demographic variables are as follows: 1. Mothers with disabled children in this study thought their quality of life as average degree. 2. The younger the mothers and children, the higher the quality of life was. 3. The higher the educational level and monthly income, the higher the quality of life was. 4. There was no statistically significant difference between the existence and nonexistence of spouse, and between the existence and nonexistence of religion as well. Findings analyzed by multiple regression are as follows: 1. Among 7 independent variables 'self-esteem'(${\beta}$=.49, p<.001), 'social supports'(${\beta}$=.15, p<.01), and 'socio-economic status'(${\beta}$=.11, p<.05) were found to be statistically significant in quality of life in mothers, while the rests were found not significant. 2. 'Self-esteem' was found to be the most influencing variable, meaning that the psychological factor such as self-esteem is more important than environmental factors in qualities of lives in mothers. 3. The total amount of explanation of the model was Adjusted R square=.301, so that it can be said about 30% can be explained among total variance of the qualities of lives in mothers with disabled children. Conclusions and recommendations based on the results above are: First, it is strongly recommended to conduct programs promoting self-esteem in mothers with disabled children, and to include 'self-esteem' hereafter in the studies related to qualities of lives in mothers with disabled children. Second, comprehensive and practical countermeasures should to be formulated to back up expenses for education and medical care, purchasing relative tools and equipments, plus helping to find jobs.

Rainfed Areas and Animal Agriculture in Asia: The Wanting Agenda for Transforming Productivity Growth and Rural Poverty

  • Devendra, C.
    • Asian-Australasian Journal of Animal Sciences
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    • v.25 no.1
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    • pp.122-142
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    • 2012
  • The importance of rainfed areas and animal agriculture on productivity enhancement and food security for economic rural growth in Asia is discussed in the context of opportunities for increasing potential contribution from them. The extent of the rainfed area of about 223 million hectares and the biophysical attributes are described. They have been variously referred to inter alia as fragile, marginal, dry, waste, problem, threatened, range, less favoured, low potential lands, forests and woodlands, including lowlands and uplands. Of these, the terms less favoured areas (LFAs), and low or high potential are quite widely used. The LFAs are characterised by four key features: i) very variable biophysical elements, notably poor soil quality, rainfall, length of growing season and dry periods, ii) extreme poverty and very poor people who continuously face hunger and vulnerability, iii) presence of large populations of ruminant animals (buffaloes, cattle, goats and sheep), and iv) have had minimum development attention and an unfinished wanting agenda. The rainfed humid/sub-humid areas found mainly in South East Asia (99 million ha), and arid/semi-arid tropical systems found in South Asia (116 million ha) are priority agro-ecological zones (AEZs). In India for example, the ecosystem occupies 68% of the total cultivated area and supports 40% of the human and 65% of the livestock populations. The area also produces 4% of food requirements. The biophysical and typical household characteristics, agricultural diversification, patterns of mixed farming and cropping systems are also described. Concerning animals, their role and economic importance, relevance of ownership, nomadic movements, and more importantly their potential value as the entry point for the development of LFAs is discussed. Two examples of demonstrated success concern increasing buffalo production for milk and their expanded use in semi-arid AEZs in India, and the integration of cattle and goats with oil palm in Malaysia. Revitalised development of the LFAs is justified by the demand for agricultural land to meet human needs e.g. housing, recreation and industrialisation; use of arable land to expand crop production to ceiling levels; increasing and very high animal densities; increased urbanisation and pressure on the use of available land; growing environmental concerns of very intensive crop production e.g. acidification and salinisation with rice cultivation; and human health risks due to expanding peri-urban poultry and pig production. The strategies for promoting productivity growth will require concerted R and D on improved use of LFAs, application of systems perspectives for technology delivery, increased investments, a policy framework and improved farmer-researcher-extension linkages. These challenges and their resolution in rainfed areas can forcefully impact on increased productivity, improved livelihoods and human welfare, and environmental sustainability in the future.

The Effects and Development of a Hospital Based Community Reintegration Support Program for Patients with Spinal Cord Injury (척수손상 환자를 위한 병원기반 사회복귀지원 프로그램의 개발 및 효과)

  • Ho, S.H.;Yu, S.Y.;Kim, Y.S.;Bang, M.S.;Lee, B.S.;Kim, D.A.;Kim, E.J.;Kim, H.K.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.9 no.2
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    • pp.89-103
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    • 2015
  • The purpose of this research attempted to developed the Community Reintegration support Program(H-CRsP) on patients with Spinal Cord Injury(SCI) and identity the effect. To assess the effectiveness of a Hospital based H-CRsP with a comprehensive team approach for treating inpatients with Spinal Cord Injury(SCI), offered by the Korea National Rehabilitation Hospital. Participants with SCI were recruited from the Korean National Rehabilitation Hospital. Twenty-five participants who met inclusion criteria were provided with a H-CRsP. A H-CRsP with modules related to the training of daily living skills, driving, vocations and school support activities, leisure or recreational activities, peer counseling, sexual rehabilitation, and others support activities. The 25 enrolled patients had been treated with average of 6.1 programs 2 times a week for over 2 or 3months. COPM, HADS, WHOQOL-BREF, AD-R were administered before the treatment(pre-test) and also at the time of discharge(post-test) to compare the treatment outcomes in the 25 program participants. Measured level of community integration by CIQ at discharge. The data were analyzed by such statistical methods as frequency and paired t-test analysis. Significant improvements were found on the Occupational Performance and Satisfaction, Acceptance of Disability, Quality of Life score in the COPM, AD-R, WHOQOL-BREF (p<0.05). In addition, 10 of the 25 patients returned to home, work or school. These results demonstrated the effectiveness of the H-CRsP in helping patients with SCI return their communities to which they belong. It considered development of the variety of programs and prepare systematically related system.

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Factors Influencing Safe Nursing Activities of Public Hospital Nurses (공공병원 간호사의 안전간호활동에 미치는 영향 요인)

  • Lee, Ok Kil;Jeong, Suyong
    • Journal of muscle and joint health
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    • v.28 no.3
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    • pp.283-292
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    • 2021
  • Purpose: In this descriptive study, we aimed to identify factors influencing safe nursing activities of nurses working at public hospitals. Methods: We collected data in March 2021 through an online survey. The subjects were 199 nurses who had worked for at least six months at public hospitals. The self-reported questionnaire consisted of items pertaining to safe nursing activities, perception of patient safety culture, and the general characteristics of the subjects. To examine the differences in the safe nursing activities and perception of patient safety culture by general characteristics, we employed a t-test and ANOVA. We conducted a multiple linear regression analysis to explore the factors affecting safe nursing activities. Results: The mean score for safe nursing activity was 4.59±0.39. Perception of patient safety culture and age group were found to be the main factors affecting the safe nursing activities of nurses working at public hospitals (F=17.24, p<.001, Adj. R2=.40). When the score for perception of patient safety culture increased by 1 point, the score for safe nursing activities increased by 0.58 points. In addition, the score for safe nursing activity in the 40s age group was 0.16 points higher than for those in the 20s age group. Conclusion: Effective management and leadership in public hospitals is needed to improve the culture of patient safety at various levels so as to ensure safe nursing activities.