• 모자간호학회지
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• v.2 no.1
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• pp.70-86
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• 1992

What is the meaning of menopause experienced by urban Korean women? Nurses need an under standing of menopause as it is experienced by women themselves. Nursing needs to build knowledge of womens' health experiences. This phenomenological study examined what menopause means to modern Korean woman to build a structure of knowledge useful for practice to enhance the quality of life of women throughout this experience. Traditional definition of menopause according to physiological changes, as illness and more recently as psychosociocultural phenomena were examined along with the folk lore information generally available in the society A review of the research and scientific literature was done from the perspectives of four models including the medical model of menopause as disease, the psychosocial model as positive and negative behavioral responses to menopause, a feminist model of menopause as a time of rebirth and a nursing model of the changing patterns of meaning, rythms and transformation women experience through menopause. Van Kaam's method was used to analyse data audio-recorded during interviews by the investigator with 65 women, 40 to 60 years of agey whose confidentility was assured. Interpretation of the data was enhanced luther by consultation with professional colleugues and with informants. Four rhythmical patterns of process emerged : from suffering to comfort, from oppression to freedom from being a good wife and wise mother to becoming a woman and from a hard life to an abundant life. The detailed common elements making up each of the four patterns and definitions of each pattern were presented. Each pattern was discussed critically from the point of view of medical, psychosociocultural, womens' and nursing models. The structural definition of the synthesis of the four process patterns was stated as : in spite of suffering the middle-aged urban Korean woman find she is able to help herself to feel comfortable and to realize release as she moves from oppression to liberation and freedom from being a good wife and wise mother she experiences rebirth as a woman : she begins to live a profitable and valuable life : her life becomes one of transformed abundant living. The definition transcends the medical and phychosociocultural model to embody a nursing model. The analysis was critiqued by using Parse' Human Becomming theory of nursing because the emerging themes were process patterns. Parse' theory provides and explanation of the experience of menopause consistant with the data which enhances nursing understanding of womens' experience of menopause. Parse' practice methodology provide guidance for promoting womens' quality of life throughout the experience of menopause. Feminist analysis contributes valuable critique to nursing research, richly expanding the perspective from traditional approaches to promote understanding of the meaning of womens' health experiences.

• Health Policy and Management
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• v.24 no.1
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• pp.92-99
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• 2014

Background: Korea's primary care clinics are seeking increase in consultation fees by expanding supply within the frame of the health insurance system, but inequality of physician income between regions and individuals is exacerbating. The purpose of this study lies in analyzing the distribution of patients of primary care clinics, their specialized field, and the degree of inequality between medical fee income according to region. Data was acquired from the Health Insurance Review and Assessment Service on charged bills made by clinic-size medical institutions from 2008 to 2011. Methods: By comparing the outpatient number per clinic according to the clinic's specialized field, results showed that ophthalmology, otolaryngology, dermatology, orthopedics, and internal medicine showed high numbers whereas plastic surgery, neuropsychiatry, cardiothoracic surgery had fewer outpatients. The number of outpatients for clinic according to region showed Chuncheonnam-do, Jeju-do, Gangwon-do, Chungcheongbuk-do, Ulsan to have higher numbers of outpatients. For those four years, clinics in the Seoul area had a rather lower number. Results: As a result of comparing the decile hierarchy distribution ratio between specialized fields according to primary care clinics income from National Health Insurance, the inequality degree showed that obstetrics and gynecology and general medicine were each 0.130, 0.280 for the decile distribution ratio, which was the highest degree of inequality within the specialized field. Their Gini coefficient were also relatively high at 0.691, 0.528 respectively. On the other hand, the decile distribution ratio for otolaryngology and orthopedics were 0.510, 0.468, respectively, while their Gini coefficient each at 0.318, 0.314 makes their inequality degree relatively lower than other fields. Conclusion: This study is limited in that the data used was the health insurance charges submitted by clinics, which does not provide total information of the doctors' income. However, because most clinics are largely dependant on their income to come from health insurance reimbursements. Therefore, the results of this study can be used effectively. In the future, research that includes data on non-covered service income should be conducted to closely examine policy plans with a new medical fee policy which can resolve the medical fee income inequality issue between clinics as well as revitalize primary medical care.

• Horticultural Science & Technology
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• v.30 no.3
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• pp.308-324
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• 2012

The aim of this study is to develop and construct the elements of a new evaluation tool to assess the effectiveness of a horticultural therapy. Delphi method was applied to classify the realms of evaluation and specify their components and constituting items. Delphi process was performed through three rounds and 24 professionals attended all the rounds as panel members. Some of the items were revised or removed according to the results of such tests as content validity ratio, agreement rate, convergency and stability of each item. On the contrary, a few new items were added by accepting the opinions of the professional panels. Previous to the Delphi, the realms of evaluation were classified into physical, cognitional, psycho-emotional and social ones on the basis of literature review, professionals' consultation and in-depth interview with practitioners. At the first round, 112 items constituting four realms were reviewed. The numbers of items to be reviewed were reduced to 107 at the second round and to 102 at the third round. As a result, 98 items in 4 realms were decided as proper evaluation points of horticultural therapy. The compositions of the four respective realms are as follows: 5 components and 27 items in physical realm; 4 components and 25 items in cognitional realm; 2 components and 24 items in psycho-emotional realm; and 4 components and 22 items in social realm. These realms, components and specific items derived from this study constitute indices to evaluate the effectiveness of horticultural therapy. In addition, they might be utilized as good guidelines for planning horticultural therapy programs.

• Journal of Environmental Policy
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• v.10 no.1
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• pp.129-150
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• 2011

This paper proposes an improvement to differentiate assessment procedure for projects in consideration of their environmental impact as a means to improve efficiency in environmental impact assessment ("EIA") procedure. The targets of analysis were limited to lower impact projects. The current EA system in Korea has already attempted to introduce separate proceedings for certain projects.Tangible results from these efforts, however, have been limited. Other countries have adopted a "screening" system to determine whether EIA is applicable to a particular project, and if so, what procedure will be used therein. Therefore, this study suggests the screening as the process wherein need for EIA is determined with respect to projects which have undergone Prior Environmental Review System(PERS) and which appear to have comparatively negligible environmental impact. In this case, EIA can be omitted and the developer can then draft a mitigation plan instead. This study found that exempting certain projects deemed as having low environmental impact can considerably shorten the duration required for both environmental assessment and consultation, thereby improving efficiency. Other expected effects from the adoption of this screening include reduction in delays in project execution due to environmental assessments and reduced red tape through the provision of increased autonomy to developers and the approving authorities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.3
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• pp.190-198
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• 2020

For domestic urban railways, which have a 19.7% aging rate, a performance evaluation is necessary to establish capital improvement investment plans. The performance evaluation, which was recently enacted in the relevant law, points out the excessive time and effort for acquiring data and evaluation. This study developed a performance evaluation simulation prototype using a virtual reality (VR) method to use as training contents for railway performance evaluations. The practical use of the VR technique to reduce the working time under poor environment conditions was confirmed through a literature review. A survey and consultation were conducted for urban railway experts to determine the weight of the performance evaluation items and the facility breakdown structure. This information was utilized to develop performance evaluation sheets for simulation. Based on the evaluation sheet, a training content prototype that evaluates the performance of platform safety doors was developed using VR techniques with HTC VIVE equipment. VR simulation tests were conducted for six players, and the prototype was sufficiently advantageous for a visual confirmation of the facility information. The result is expected to be useful for engineers to understand the performance evaluation process efficiently before an actual performance evaluation of urban railway facilities.

• Journal of Energy Engineering
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• v.21 no.3
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• pp.265-270
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• 2012

The delay in the construction permit for the building, which obtained the approval of business proposal, may lead to a difference in the maintenance cost ranging between 20% and 30% in the neighborhood where the residents moved in, along with the new project under construction in the surrounding area amidst rigorous regulations that aim to promote energy-saving and the heightened interest of the public in energy conservation, and such problem would become the major source of serious public complaints. Thus, the energy-saving plan needs to be prepared when the approval is granted to the business plan. In order to prevent public complaints or ensure effectiveness of government's energy plan, it may be effective to apply the energy-saving plan based on current standards upon the award of construction permit when two years have elapsed since the date of the scheduled commencement of construction or when the start of construction is delayed as stipulated in the Article 18 of the Enforcement Decree of Housing Act. If the energy-saving plan and related technologies are merely the parts of license and permit process without fully serving their purposes and functions, it would be waste of time to deploy a lot of workforce and review and seek consultation. The government or owners of buildings need to fully understand the energy-saving aspects and exert effort to enhance the energy efficiency of buildings.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.152-158
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• 2012

Purpose: To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service. Methods: We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services. Results: In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was $34.9{\pm}0.5years$ old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty- three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001) There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively). Conclusion: In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.

• Journal of Hospice and Palliative Care
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• v.12 no.4
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• pp.220-227
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• 2009

Purpose: The purpose of the study was to investigate how much understand about artificial hydration in patients with terminal cancer, according to the subject groups, including patients, families, and general public. Methods: Data were collected from June 2007 to December 2007 and the participants included 22 hospitalized patients in the hospice unit of S Hospital, 100 families, and 101 participants who participated in a hospice education program for the general public. The questionnaire was developed through literature review, interview with patients' families, and expertise consultation. Data were analyzed using descriptive statistics with an SAS program. Results: Understanding of artificial hydration among patients, families and general public was examined from three perspectives. From an ethical perspective, 'if you receive artificial hydration, you can live longer', 45.5%, 63%, and 52.4% of the above three groups, respectively, answered "yes". From an emotional perspective, 'artificial hydration must be provided', 81.8%, 70% and 58.4%, respectively, agreed. From a cultural perspective, 'if artificial hydration is not provided for the patient, the families will feel painful', 95.5%, 83%, and 88.2%, respectively, answered "yes". Conclusion: This study found the differences in understanding of artificial hydration among patients, families and general public, and also found that less than 50 percent of the participants understood artificial hydration appropriately. We suggest, therefore, that patients' understanding about artificial hydration should be determined in the clinical setting and then followed by individualized education according to given medical situations.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.1
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• pp.85-92
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• 2000

Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

• Fire Science and Engineering
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• v.33 no.5
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• pp.66-77
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• 2019

To secure the safety and improve the work efficiency of forest firefighting crews, performance evaluation criteria for safety helmets were developed in this study. Because the standards for forest firefighting safety helmets are not available in Korea, we began our study based on the standards for firefighting safety helmets used by the Korea Fire Institute (KFI). Eleven test items were selected excluding 15 other items out of the 26 test items that, through the consultation of stakeholders and the review of foreign standards, were initially included in our study. Two types of general safety helmets and one firefighting helmet were tested by applying KFI standards, and the results were compared. The general safety helmets did not meet the standards of the retention system and chin strap. Additionally, polyethylene and acrylonitrile butadiene styrene materials were found to be especially weak under heat conditions. We compared the criteria of KFI, International Standardization Organization (ISO) 16073, National Fire Prevention Association (NFPA) 1977, NFPA 1971, and British Standards European Norm (BS EN) 443, and finally selected 11 test items and their acceptance criteria suitable for the work environment of forest firefighting crews in Korea.