• 보건행정학회지
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• 제25권3호
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• pp.197-206
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• 2015

Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

• 대한치과교정학회지
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• 제49권6호
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• pp.360-371
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• 2019

Objective: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. Methods: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. Results: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = -0.506, -0.494, and -0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = -0.900, p < 0.05). Conclusions: The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

• 보건행정학회지
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• 제31권3호
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• pp.301-311
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• 2021

Background: This study purposed to analyze the relationship between the local extinction index and medical service uses of chronic diseases. The local extinction index is an indicator of the demographic structure and population aging of the region. Methods: The 2014-2018 statistics of National Health Insurance Corporation and Korean Statistical Information Service data were used for the analysis. First, descriptive statistics were used to analyze the general status of research variables. Second, a panel analysis was performed to analyze the relationship between the local extinction index and medical service uses of chronic diseases (hypertension, diabetes mellitus, periodontal disease, arthritis, mental health, epidemic disease, liver disease). Medical service uses were measured by the number of visits/inpatient days and medical charges of seven chronic diseases. Results: Panel analysis results showed that higher local extinction risks (meaning lower local extinction index) had a positive relationship with the number of visits/inpatient days and medical charges of chronic diseases. But the relationships were varied when the seven chronic diseases were analyzed separately. Conclusion: This study showed a significant relationship between the local demographic structure and medical service uses of chronic disease. Analyzing the local demographic structure will be an essential prerequisite step for implementing appropriate regional health care policies.

• 대한응급의학회지
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• 제29권6호
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• pp.616-623
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• 2018

Objective: The shock index (SI), as a trauma triage tool, is a capable clinical indicator of hemodynamic instability and hypovolemic shock, but the conception of SI is contradictory to shock. The reverse shock index (RSI) was introduced recently, but its utility has not been sufficiently proven. Methods: This study examined the RSI utility by evaluating the procedures performed at an emergency department (ED) and the associated outcomes when the RSI is used alone or in combination with the Korean Triage and Acuity Scale (KTAS). This was a retrospective study conducted by including data of 4,789 adult trauma patients for a year. The clinical variables, procedures performed on patients, and outcomes were investigated. The median RSI was 0.9 in the RSI<1 group. Results: Patients in the RSI<1 group had a higher odds of requiring procedures at the ED and for experiencing worse outcomes: intubation (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.3-13.1; P<0.001), chest tube insertion (OR, 6.5; 95% CI, 0.4-111.84; P<0.001), use of emergency drugs (OR, 3.6; 95% CI, 1.5-8.5; P<0.001), circulatory support (OR, 5.4; 95% CI, 2.3-12.9; P<0.001), intensive care unit admission (OR, 3.5; 95% CI, 1.8-6.8; P<0.001), and mortality during the ED stay (OR, 20.4; 95% CI, 5.5-75.7; P<0.001). In the group with KTAS 1-3, trends similar to those in the RSI<1 group were observed. Patients with RSI<1 had more severe injuries and poorer outcomes than those with $RSI{\geq}1$, regardless of whether the RSI was used alone or in combination with KTAS. Conclusion: RSI can provide an appropriate triage with concurrent KTAS use.

• 대한건축학회논문집:구조계
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• 제36권5호
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• pp.177-185
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• 2020

The building energy performance indicator, called Energy Performance Index (EPI), has been used for the past decades in South Korea. It has a list of design variables assigned with weighting factors (a, b). Unfortunately, the current EPI method is not performance-based but very close to a prescriptive rating. With this in mind, this study aims to propose a new performance-based EPI method. For this purpose, a global sensitivity analysis method, Sobol, is employed. The Sobol method is suitable for complex nonlinear models and can decompose all the output variance due to every input. The Sobol sensitivity index of each variable is defined as 0 to 1 (0 to 100%), and the sum of all sensitivity indices is equal to 1 (100%). In this study, an office building was modeled using EnergyPlus and then the Latin Hypercube Sampling (LHS) was conducted to generate a surrogate model to EnergyPlus. The sensitivity index was suggested to replace weight (a) in the existing EPI. In addition, the discrete weight (b) in the existing EPI was replaced by a set of continuous regression functions. Due to the introduction of the sensitivity index and the continuous regression functions, the new proposed approach can provide far more accurate outcome than the existing EPI (R²: 0.83 vs. R²: 0.01 for cooling, R²: 0.66 vs. R²: 0.01 for total energy). The new proposed approach proves to be more rational, objective and performance-based than the existing EPI method.

• 한국환경과학회지
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• 제29권12호
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• pp.1223-1237
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• 2020

This study focused on comparing the meteorological conditions in the Atmospheric Boundary Layer (ABL) on high-event days and non-event days in the Seoul Metropolitan Area (SMA). We utilized observed PM10 and meteorological variables at the surface as well as at the upper heights. The results showed that high-event days were consistently associated with lower wind speed, whereas wind direction showed no particular difference between high-event and non-event days with frequent westerlies and northwesterlies for both cases. During high-event days, the temperature was much warmer than the monthly normal values with a sharp increasing trend, and Relative Humidity (RH) was higher than the monthly normal, especially on high-event days in February. During high-event days in spring, a double inversion layer was present at surface and upper heights. This indicates that stability in the multi-layer is an important indicator of higher PM10 concentrations. Net radiation in spring and winter is also closely associated with higher PM10 concentrations. Strong net radiation resulted in large sensible heat, which in turn facilitated a deeper mixing height with diluted PM10 concentrations; in contrast, PM10 concentrations were higher when sensible heat in spring and winter was very low. We also confirmed that convective and friction velocity was higher on non-event days than on high-event days, and this was especially obvious in spring and winter. This indicated that thermal turbulence was dominant in spring, whereas in winter, mechanical turbulence was dominant over the SMA.

• Journal of Species Research
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• 제10권3호
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• pp.246-254
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• 2021

Subalpine and alpine ecosystems are especially vulnerable to temperature increases. Betula ermanii Cham. (Betulaceae) is a dominant broad-leaved tree species in the subalpine zone and is designated as a 'Climate-sensitive Biological Indicator Species' in South Korea. This study aimed to predict the potential distribution of B. ermanii under current and future climate conditions in South Korea using the MaxEnt model. The species distribution models showed an excellent fit (AUC=0.99). Among the climatic variables, the most critical factors shaping B. ermanii distribution were identified as the maximum temperature of warmest month (Bio5; 64.8%) and annual mean temperature (Bio1; 20.3%). Current potential habitats were predicted in the Baekdudaegan mountain range and Mt. Hallasan, and the area of suitable habitat was 1531.52 km², covering 1.57% of the Korean Peninsula. With global warming, future climate scenarios have predicted a decrease in the suitable habitats for B. ermanii. Under RCP8.5-2070s, in particular, habitat with high potential was predicted only in several small areas in Gangwon-do, and the total area suitable for the species decreased by up to 97.3% compared to the current range. We conclude that the dominant factor affecting the distribution of B. ermanii is temperature and that future temperature rises will increase the vulnerability of this species.

• 디지털융복합연구
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• 제19권11호
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• pp.499-509
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• 2021

본 연구는 전문상담교사가 지각하는 역할갈등과 소진의 관계에서 플로리시의 매개효과를 검증하는 데에 목적이 있다. 학교와 교육청에서 근무하는 전문상담교사 242명을 대상으로 설문조사를 수행하였으며 수집된 자료는 SPSS와 PROCESS macro 프로그램을 통해 분석되었다. 연구결과, 역할갈등과 소진은 유의한 정적 상관이 있었으며 플로리시는 역할갈등, 소진과 유의한 부적 상관이 있었다. 아울러 역할갈등의 세 가지 하위 유형인 역할기대 갈등, 개인-역할 갈등, 역할모호성 갈등에 따라 소진의 여러 하위 징후에 미치는 영향이 상이한 것으로 나타났으며 플로리시는 역할갈등의 각 요소가 소진에 미치는 영향을 모두 매개하는 것으로 나타났다. 이러한 결과는 플로리시가 전문상담교사의 전문성 관리를 위한 지표로 고려될 수 있다는 것을 시사하며 학교단위의 긍정심리학적 접근이 학생뿐만 아니라 전문상담교사에게도 긍정적으로 작용하여 학교상담의 효과성을 개선하는 데에 기여할 수 있다는 것을 보여주는 결과라고 여겨진다.

• 한국콘텐츠학회논문지
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• 제22권1호
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• pp.58-73
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• 2022

이 연구의 목적은 모바일 앱 실적 변수 간의 관계를 파악하여 예측 가능한 앱 실적 변수의 추정 모델을 구성하고 앱 리뷰가 앱 실적 지표에 미치는 영향을 검증하는 것이다. 연구1과 2에서는 상관분석과 기계학습의 랜덤 포레스트 회귀 추정을 사용하여 앱 실적 간의 관계를 도출하고 앱 실적 추정 모델링을 수행하였다. 연구3에서는 앱 리뷰를 텍스트 마이닝의 감성분석을 사용하여 일별 감성 점수를 도출한 후 다변량 시계열분석을 사용하여 앱 리뷰의 감성점수가 앱의 일일 설치 횟수에 선행하여 영향을 주는 것을 발견하였다. 앱을 개발하고 서비스하는 기업은 앱 실적 지표와 앱 리뷰에서 제기되는 불만족과 고객 니즈를 검토하여 적기에 앱을 개선하고 마케팅 판매촉진활동의 시점과 방향성을 도출할 수 있다.

• 대한의용생체공학회:의공학회지
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• 제43권3호
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• pp.161-169
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• 2022

Engagement is an important factor in the field of rehabilitation as it is a known factor that have a positive influence on functional gaining in people who receive rehabilitation therapy. Although a number of measurements for engagement have been recently developed, investigation of possible factors that may have influence on engagement is not well established. Currently available evidence suggests that engagement is affected by mood and it is hypothesized that a personal factor may contribute to engagement. Therefore, this study aims to test the hypothetical relationship between mood and engagement while performing a manual dexterity task through an experiment in healthy participants prior to investigation on people with medical condition who requires rehabilitation therapy. After inducing target mood (positive or negative mood) for study participants by asking them to recall autobiographical memories, change in muscle activity, which was operationalized as an indicator of engagement, was investigated. Electromyogram (EMG) was recorded from four muscle areas in non-dominant hand side to quantify muscle activity. The results show that the target moods were appropriately induced with the method. Although there were subtle differences in the level of engagement between different moods, certain variables derived from muscle activity were significantly different; mean amplitude for wrist extensor EMG showed significant difference between different moods (Z = -2.023, p < .05) indicating that muscle activities in the wrist extensor are greater for positive mood than negative mood region during manual dexterity task. Meanwhile, performance outcomes of Minnesota Manual Dexterity Test (MMDT), such as mean completion time and number of errors, between moods showed no significant difference in two different moods, resulting in MMDT administration may not be useful task in distinguishing the level of rehabilitation engagement.