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Chasms in Achievement of Recommended Diabetes Care among Geographic Regions in Korea
조상현,신지연,김현주,은상준,강성찬,장원모,정혜민,김윤,이진용 대한의학회 2019 Journal of Korean medical science Vol.34 No.31
Background: Although effective care for type 2 diabetes (T2DM) is well known, considerable inadequate care has been still existed. Variations in achievement of the recommended quality indicators inT2DM care among small areas are not well known in Korea. This study examined the quality of care T2DM care and its geographical variations. Methods: We used the national health insurance database and national health screening database. Seven quality indicators were used to evaluate continuity of care (medication possession ratio), process of care (hemoglobin A1c test, lipid profile, microalbuminuria test, and eye examination), and intermediate outcome (blood pressure control, and low-density lipoprotein control). Crude and age-standardized proportions were calculated for each 252 districts in Korea. Results: All quality indicators failed to achieve the recommended level. Only about 3% and 15% of the patients underwent eye examination and microalbuminuria test, respectively. Other indicators ranged from 48% to 68%. Wide variation in the quality existed among districts and indicators. Eye examination and microalbuminuria test varied the most showing tenfold (0.9%–9.2%) and fourfold (6.3%–28.9%) variation by districts, respectively. There were 32.4 and 42.7 percentage point gap between the best and the worst districts in hemoglobin A1c test and blood pressure control, respectively. Conclusion: Considerable proportion of T2DM patients were not adequately managed and quality of care varied substantially district to district. To improve the quality of diabetes care, it is necessary to identify the poor performance areas and establish a well-coordinated care system tailored to the need of the district.
조상현,유연철,김희중,장병록 대한금속재료학회(대한금속학회) 1994 대한금속·재료학회지 Vol.32 No.3
The high temperature deformation behavior of an lnvar alloy was investigated in the temperature range of 800∼1100℃ at the strain rate range of 4.0×10^(-2)∼2.6×10^0/sec. Flow curves and microstructures exhibited this alloy had restoration by dynamic recrystallization combined with dynamic recovery. The temperature(T) and strain rate(ε˙) dependence of the peak stress (σ) was described by the Zener-Hollomon parameter, Z=ε˙ exp(-335kJ/RT)=A[sinh(0.0103α)]^(4 96). The size of dynamically recrystallized grains decreased as Z increases. The distribution of precipitates (Mn, Cr, etc.) was also investigated. The strain induced precipitation was occurred during the hot deformation.
An Empirical Study on Research Model of Vicarious Fear of Crime Victimization
조상현 한국융합과학회 2019 한국융합과학회지 Vol.8 No.2
Purpose : This study aims to present a research model of fear of crime victimization on children, which is suitable for Korean society, focusing on models that describe the fear of crime victimization both at domestic and overseas. Fear of crime victimization on children was selected because the fear about crime victim to children is expected to be as significant as the fear of crime victimization by oneself in Korean society which has strong attachment to their children. Moreover, fear of crime victimization on children can be cited as an important factor in identifying the degree and importance of personal fear of crime victimization. Method : To achieve purpose of this study looked into scholars' views on the factors affecting fear of crime victimization on children. So, previous researchers were selected crime victim experience model, crime vulnerability model, community incivility model, social integration model, and police confidence model. In quantitative research, the empirical analysis was conducted using the SPSS Statistical Program 21.0 to verify the research model and research problems that were logically established through the review of literature studies. The data from this study utilized the ‘Korean Crime Victim Survey(2016)’ conducted by the Korea Institute of Criminology. Conclusion : First, models that explain personal fear of crime victimization such as crime victim experience model, crime vulnerability model, community incivility model, social integration model and police confidence model were found to be partly suitable, except for a police confidence model, to explain the fear of crime victimization on children. Second, factors that significantly explain fear of crime victimization on children statistically were restoration ability, social disorder, comparative vulnerability, indirect criminal news, community ties, informal control, physical disorder and indirect crime victim factor. Third, it was found that in explaining the fear of crime victimization on children, it was not explained by any one factor, but also by personal and environmental factors.
Fatigue and Fracture Performance of a Pedestrian Bridge with a Circular Steel Tube Girder
조상현,공천석,김영환,정원석,이희영 대한토목학회 2021 KSCE JOURNAL OF CIVIL ENGINEERING Vol.25 No.8
Pedestrian bridges with I-shaped girders exhibit frequent construction errors and difficulties in the construction of curved sections because the bridges are composed of straight girders mounted on piers. Therefore, a pedestrian bridge utilizing circular steel tubes as the main girder, which is easy to construct and more economical, is proposed to resolve these problems. When steel pedestrian bridges are used for long periods, fractures can occur owing to fatigue in the joints between the main girder and the bottom support. Full-scale circular steel tube joint test units were fabricated and subjected to two million cycles of fatigue performance tests and one million cycles of fatigue fracture tests to quantify the fatigue behavior of a new pedestrian bridge design comprising circular steel tubes. Finite element analysis (FEA) was used to verify the results of the fatigue fracture tests. The proposed pedestrian bridge exhibited excellent stability in terms of fatigue behavior. Moreover, the fatigue fracture of the bridge was successfully predicted using FEA.
조상현,Youngs Chang,Yoon Kim 대한예방의학회 2019 Journal of Preventive Medicine and Public Health Vol.52 No.1
Objectives: The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.