• 제목/요약/키워드: Compliance rate

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Time Series Analysis on Outcomes of Tuberculosis Control and Prevention Program between Small Areas in Korea - with Patient Registry Data of 234 City.County.District Public Health Centers - (소규모 지역간 결핵관리사업 성과에 대한 시계열분석 - 전국 234개 시.군.구 보건소의 환자등록자료를 중심으로 -)

  • Kim, Chun-Bae;Choe, Heon;Shin, Kye-Chul;Park, Jong-Ku;Ham, Soo-Keun;Kim, Eun-Mi
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.837-852
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    • 2000
  • Backgrounds : Today, tuberculosis cannot only be cured medically, but also controlled by public health. Despite the overall worldwide decline in tuberculosis, the disease continues to be a significant problem among developing countries and in the slums of large cities in some industrialized countries. Particularly, this communicable disease has come into the public health spotlight because of its resurgence in the 1990's. our country has been operating the Korean National Tuberculosis Control Program since 1962, focusing around public health centers. Therefore, this study aims to compare the effectiveness of tuberculosis control activities, one of the major public health activities in Korea, by producing indexes, such as the yearly registration rate per 100,000 population and treatment compliance of tuberculosis on in small areas (communities). Methods : This work was accomplished by constructing a time-series analytic model using data from "1980~2000: the Yearly Statistical Report" with patient registry data of 234 City. County. District public health centers and by identifying the factors influencing the tuberculosis indexes. Results : The trends of pulmonary tuberculosis positive point prevalence and pulmonary tuberculosis negative point prevalence on X-ray screening have declined steadily, beginning in 1981 and continuing to 1998 by region (city, county, district). Although the tuberculosis mortality rate steadily shows a declining trend by year and region, but Korea still ranks first among 29 OECD countries in 1998, with a tuberculosis mortality rate of 7.1 per 100,000 persons, according to the time-series analysis for fatal diseases. Conclusion : The results of the study will form the fundamental basis of future regional health care planning and the Korean Tuberculosis Surveillance System on 2000. Since the implementation of local autonomy through the Local Health Act of 1995, it has now become vita1 for each city, county, district public health centers to determine its own priorities for relevant health care management, including budget allocation and program goals.

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A Study on the Countermeasures Taken By the Korean Healthcare and Life Sciences Industry Regarding U.S. Import Refusals: Focus on the Analysis of FDA Violation Codes (한국 바이오헬스 산업의 미국 수입거부 대응 방안 연구 : FDA 위반코드 분석을 중심으로)

  • Yu-Han Lee;Hag-Min Kim
    • Korea Trade Review
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    • v.48 no.3
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    • pp.131-150
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    • 2023
  • The purpose of this study was to find a countermeasure to the U.S. import refusals for the Korean healthcare and life sciences industry. To this end, an analysis of trends during the pandemic was conducted using the KITA Border Rejection Database, which includes information on items and types of import refusals. The reason for rejection was also analyzed according to the FDA violation codes. The degree of countermeasure for import refusals was identified by measuring the unit rejection rate (URR). The results of the analysis showed that the major U.S. import refusals for the Korean healthcare and life sciences industry had expanded from contact lenses to COVID-19 diagnostic kits and drugs after the pandemic broke out. The major reasons for import refusals were non-compliance with the Predicate Device and Drugs Act and non-approval by the FDA for products and facilities. On the other hand, the unit rejection rate (URR) of major items in the Korean healthcare and life sciences industry was measured higher than the industry average. The results therefore showed a low level of response to U.S. import refusals. The results of the analysis of reasons for import refusals by item according to FDA violation codes were as follows. First of all, the main violation for contact lenses and COVID-19 diagnostic kits corresponded to misbranding. This was often due to the fact that Korean companies did not provide the relevant notices and information required by the FDA. Many cases also failed to demonstrate a substantial equivalency compared to predicate devices already on the market. On the other hand, applications for new unapproved drugs were not accepted as they had yet to pass relevant regulations that would prove their safety and efficacy. In conclusion, import refusals for the Korean healthcare and life sciences industry were found to be closely related to technical barriers to trade (TBT).

Hyperfractionated Radiotherapy and Concurrent Chemotherapy for Stage III Unresectable Non Small Cell Lung Cancer : Preliminary Report for Response and Toxicity (절제 불가능한 제 3기 비소세포성 페암의 다분할 방사선 치료와 MVP 복합 항암요법의 동시 치료에 대한 예비적 결과)

  • Choi, Eun-Kyung;Kim, Jong-Hoon;Chang, Hye-Sook;Kim, Sang-We;Suh, Cheol-Won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Ko, Youn-Suk;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Song, Koun-Sik
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.157-162
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    • 1995
  • Lung cancer study group at Asan Medical Center has conducted the second prospective study to determine the efficacy and feasibility of MVP chemotherapy with concurrent hyperfractionated radiotherapy for Patients with stage III unresectable non-small cell lung cancer(NSCLC). All eligible Patients with stage III unresectable NSCLC were treated with hyperfractionated radiotherapy(120 cGy/fx BID. 6480 cGy/54fx) and concurrent 2 cycles of MVP(Mitomycin C $6mg/m^2,$ d2 & d29.Vinblastine $6mg/m^2,$ d2 & d29, Cisplatin $60mg/m^2,$ dl & d28) chemotherapy. Between Aug. 1993 and Nov. 1994, 62 patients entered this study; $6(10\%)$ had advanced stage IIIa and $56(90\%)$ had IIIb disease including 11 with pleural effusion and 10 with supraclavicular metastases. Among 62 patients, $48(77\%)$ completed planned therapy. Fourteen patients refused further treatment during chemoradiotherapy. Of 46 patients evaluable for response, $34(74\%)$ showed major response including $10(22\%)$ with complete and $24(52\%)$ with partial responses. Of 48 patients evaluable for toxicity, $13(27\%)$ showed grade IV hematologic toxicity but treatment delay did not exceed 5 days Two patients died of sepsis during chemoradiotherapy. Severe weight loss(more than $10\%)$ occurred in 9 patients$(19\%)$ during treatment. Nine patients$(19\%)$ developed radiation pneumonitis Six of these patients had grade 1 (mild) Pneumonitis with radiographic changes within the treatment fields Three other patients had grade 11 Pneumonitis, but none of these patients had continuous symptoms after steroid treatment. Concurrent chemoradiotherapy for patients with advanced NSCLC was well tolerated with acceptable toxicity and achieved higher response rates than the first study, but rather low compliance $rate(77\%)$ in this study is worrisome. We need to improve nutritional support during treatment and to use G-CSF to improve leukopenia and if necessary. supportive care will be given as in patients, Longer follow-up and larger sample size is needed to observe survival advantage.

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Improvement of Certification Criteria based on Analysis of On-site Investigation of Good Agricultural Practices(GAP) for Ginseng (인삼 GAP 인증기준의 현장실천평가결과 분석에 따른 인증기준 개선방안)

  • Yoon, Deok-Hoon;Nam, Ki-Woong;Oh, Soh-Young;Kim, Ga-Bin
    • Journal of Food Hygiene and Safety
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    • v.34 no.1
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    • pp.40-51
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    • 2019
  • Ginseng has a unique production system that is different from those used for other crops. It is subject to the Ginseng Industry Act., requires a long-term cultivation period of 4-6 years, involves complicated cultivation characteristics whereby ginseng is not produced in a single location, and many ginseng farmers engage in mixed-farming. Therefore, to bring the production of Ginseng in line with GAP standards, it is necessary to better understand the on-site practices of Ginseng farmers according to established control points, and to provide a proper action plan for improving efficiency. Among ginseng farmers in Korea who applied for GAP certification, 77.6% obtained it, which is lower than the 94.1% of farmers who obtained certification for other products. 13.7% of the applicants were judged to be unsuitable during document review due to their use of unregistered pesticides and soil heavy metals. Another 8.7% of applicants failed to obtain certification due to inadequate management results. This is a considerably higher rate of failure than the 5.3% incompatibility of document inspection and 0.6% incompatibility of on-site inspection, which suggests that it is relatively more difficult to obtain GAP certification for ginseng farming than for other crops. Ginseng farmers were given an average of 2.65 points out of 10 essential control points and a total 72 control points, which was slightly lower than the 2.81 points obtained for other crops. In particular, ginseng farmers were given an average of 1.96 points in the evaluation of compliance with the safe use standards for pesticides, which was much lower than the average of 2.95 points for other crops. Therefore, it is necessary to train ginseng farmers to comply with the safe use of pesticides. In the other essential control points, the ginseng farmers were rated at an average of 2.33 points, lower than the 2.58 points given for other crops. Several other areas of compliance in which the ginseng farmers also rated low in comparison to other crops were found. These inclued record keeping over 1 year, record of pesticide use, pesticide storages, posts harvest storage management, hand washing before and after work, hygiene related to work clothing, training of workers safety and hygiene, and written plan of hazard management. Also, among the total 72 control points, there are 12 control points (10 required, 2 recommended) that do not apply to ginseng. Therefore, it is considered inappropriate to conduct an effective evaluation of the ginseng production process based on the existing certification standards. In conclusion, differentiated certification standards are needed to expand GAP certification for ginseng farmers, and it is also necessary to develop programs that can be implemented in a more systematic and field-oriented manner to provide the farmers with proper GAP management education.

Effect of Physical Training on Pulmonary Function (체력단련(體力鍛鍊)이 폐기능(肺機能)에 미치는 효과(效果))

  • Nam, Pal-Soo;Hwang, Soo-Kwan;Kim, Hyeong-Jin;Choo, Young-Eun
    • The Korean Journal of Physiology
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    • v.15 no.1
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    • pp.37-43
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    • 1981
  • In the present study, an effort was directed to elucidate the effect of the physical training on the pulmonary function. Twenty-four male athletics major students who have undergone regular physical training for more than five years were randomly chosen as the athletic subjects, and 12 regular male students who have not been engaged in any form of regular physical exercise or training were chosen as the non-athletic subjects, and a comparison was made between the two groups. The following were mainly observed by spirometry for the study; respiratory rate, tidal volume, vital capacity, maximum voluntary ventilation(MVV), forced expiratory volume for 1 second$(FEV_1)$, percent $FEV_1$ to forced vital capacity$(FEV_1%)$, forced expiratory flow for initial 1 liter$(FEF_{0.2-1.2}L)$, and forced mid-expiratory flow$(FEF_{\;25-75}%)$. The results obtained are summarized as follow. 1) The respiratory rate, tidal volume, and vital capacity showed no significant difference between athletes and non-athletes. The MVV in athletes was significantly (p<0.01) increased to $148.1{\pm}3.1\;L/min$ comparing with $118.3{\pm}9.1\;L/min$ in non-athletes. 2) $FEV_1$ was $3.310{\pm}0.070\;L$ in athletes and $2.779{\pm}0.104$ in non-athletes; $FEV_1%\;83.63{\pm}1.29%$ in athletes and $75.33{\pm}1.75%$ in non-athletes, both showing significant(p<0.01) increase in athletes. 3) $FEF_{0.2-1.2}L$ was $297.1{\pm}13.5\;L/min in athletes and $222.7{\pm}15.0\;L/min$ in non-athletes; $FEF_{\;25-75}%$ was $3.543{\pm}0.109\;L/sec$ in non-athletes, both showing significant(p<0.01) increase in athletes. 4) Some discussions were made on these results. The lung volumes showed no significant difference between the two groups. But MVV, $FEV_1$, $FEV_1%$, $FEF_{0.2-1.2}L$ and $FEF_{25-75}%$ in athletes were significantly(p<0.01) higher than in non-athletes. It is therefore concluded that the athletes have more powerful respiratory muscles, or higher compliance of the lung and thorax than the non-athletes.

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Study of Downward Speed Limit of Main Roads on Traffic Accident and Effect Analysis - In Busan Metropolitan City - (간선도로 최고속도제한 하향이 교통사고에 미치는 영향 및 효과분석 - 부산광역시를 중심으로 -)

  • Lim, Chang-Sik;Choi, Yang-Won
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.38 no.1
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    • pp.81-90
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    • 2018
  • The purpose of this study is to evaluate the effect of downward speed limit of urban arterial roads at 29 sites in Busan Metropolitan Police Agency to reduce road traffic accidents from '10 to '15. As a result of analyzing the traffic accidents occurred for 1~3 years after the decrease in the speed limit, the number of traffic accidents decreased by 3.09% and the number of injured persons decreased by 8.76%, but the number of deaths decreased by 36.73% The results of this study are as follows. The average speed reduction rate of 6.31km/h was decreased by investigating the change of the vehicle speed before and after the downward speed limit, and the change of average speed was statistically significant in most of the sections. The rate of compliance with the speed limit increased by 10.26% p, which is considered to have greatly improved overall traffic safety. A survey conducted by residents near the target area with a lower speed limit showed that 57.9% of the respondents felt the driving speed of the vehicle was lowered. However, this project was focused on vehicles with limited speed road signs and traffic safety signs, Only 25.8% of respondents said walking safety was improved. In the future, it is necessary to consider the safety of pedestrians by improving roads around roads such as road curvature and separation. In addition, there is a clear positive result in terms of decreasing the fatal accidents in the downward speed limit zone of Busan Metropolitan Subway. However, more detailed analysis is needed for the 29 accidents. Therefore, it is expected that traffic practitioners will be able to utilize it as a basis to increase the accident reduction effect by setting an appropriate speed limit based on the easy and objective grounds.

Comparison of Two Methods of Recruiting the Acutely Injured Lung (급성 폐손상에서 폐를 Recruit시키는 방법간의 비교 연구)

  • Suh, Gee-Young;Kang, Kyeong-Woo;Park, Sang-Joon;Kim, Ho-Choel;Young, Lim-Si;Chung, Man-Pyo;Han, Jeong-Ho;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.500-512
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    • 2000
  • Background : To evaluate the efficacy of two methods of obtaining lung recruitment to reduce ventilator-induced lung injury(VILI). Methods : Fifteen New-Zealand white rabbits were ventilated in the pressure-controlled mode while maintaining constant tidal volume(10 ml/kg) and fixed respiration rate. Lung injury was induced by repeated saline lavage (PaO2<100 mmHg), and the pressure-volume curve was drawn to obtain Pflex. The animals were then randomly assigned to three groups and ventilated for 4 hours. In the control group(n=5), positive end-expiratory pressure(PEEP) less than that of Pflex by 3 mmHg was applied throughout the study. In the recruitment maneuver(RM) group(n=5), RM(CPAP of 22.5 mmHg, for 45 seconds) was performed every 15 minutes in addition to PEEP level less than Pflex by 3 mmHg This phrase is unclear. In the Pflex group, PEEP of Pflex was given without RM. Gas exchange, lung mechanics, and hemodynamics parameters as well as pathology were examined. Results : 1) Both the control and RM groups showed decreasing tendency in PaO2 with time. There was significantly decreased PaO2 at 4 hr compared to Ihr(p<0.05). But in the Pflex group, PaO2 did not decrease with time(p<0.05 vs other groups at 3, 4 hr). PaCO2 did not show significant difference among the three groups. 2) There was no significant difference in static compliance and plateau pressure. Mean blood pressure and heart rate also did not show any significant difference among the three groups. 3) The pathologic exam showed significantly less neutrophil infiltration in the Pflex group than in the control group(p<0.05). There was borderline significant difference in hyaline membrane score among the groups (p= 0.0532). Conclusion : Although recruitment maneuver of the injured lung may be important in decreasing VILI, it alone may not be sufficient to minimize VILI.

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In-House Subcontracting and Industrial Relations in Japanes Steel Industry (일본 철강산업의 사내하청과 노사관계)

  • Oh, Haksoo
    • Korean Journal of Labor Studies
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    • v.24 no.1
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    • pp.107-156
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    • 2018
  • This article examines the history of the in - house subcontracting and the stabilization of labor - management relations in the steel industry in Japan. The ratio of in-house subcontract workers among steel workers has increased steadily until the mid-2000s, and about 70% in case of the largest company. In-house subcontracting was used as a strategy of the company to increase the quantity flexibility of employment and to save labor costs. The in-house subcontracting company needed company-specialized skills, and the internal labor market was formed because the rate of full-time workers was high and the turnover rate was low. The in-house subcontractor introduced long-term business relationship with the steel factory by introducing the equipment and materials necessary for the performance of the work, and the factory implemented the productivity improvement policy of the in-house subcontractor, and the win-win relationship between the factory and in-house subcontractor was developed. The trade union did not oppose the idea that the expansion of in-house subcontracting contributed to corporate profits, the stability of employment of the members and maintenance of their working conditions. Since 2000, the steel factory has pursued the transformation of in - house subcontractors into subsidiaries, which has been supported by capital relations. By the way, since the mid-2000s, there has been an increase in the number of regular workers' employment. The major factors are as follows: more strengthened compliance with laws and regulations, the higher quality request of customers, stricter keeping of deadlines, and problem in recruiting of workers at in-house subcontract companies. The wage gap between the factory and in - house subcontracting was less at company B than at company S, and the wage level of in - house subcontracting was about 90% of the factory at company B. The relatively small gap at company B seems to be due to the union's movement of narrowing the gap, low market dominance and unfavorable labor market. The internal labor market has been formed in the in-house subcontracting, and the wage gap is not large, and the possibility of labor disputes is low. Industrial relations are stable in the in-house subcontract company as well as the factory. The stabilization of labor-management relations in the steel industry in Korea is required to reduce the wage gap between the factory and in-house subcontract enterprises by raising productivity and expanding the internal labor market at in-house subcontract enterprises.

Optimal Scheme of Postoperative Chemoradiotherapy in Rectal Cancer : Phase III Prospective Randomized Trial (직장암의 근치적 수술 후 화학요법과 방사선치료의 순서)

  • Kim Young Seok;Kim Jong Hoon;Choi Eun Kyung;Ahn Seung Do;Lee Sang-Wook;Kim Kyoung-Ju;Lee Je Hwan;Kim Jin Cheon;You Chang Sik;Kim Hee Cheol
    • Radiation Oncology Journal
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    • v.20 no.1
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    • pp.53-61
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    • 2002
  • Purpose : To determine the optimal scheme of postoperative chemoradiotherapy in rectal cancer by comparing survival, Patterns of failure, toxicities in early and late radiotherapy groups using a Phase III randomized prospective clinical trial. Materials and Methods : From January 1996 to March 1999, 307 patients with curatively resected AJCC stage II and III rectal cancer were assigned randomly to an 'early (151 patients, arm 1)' or a 'late (156 patients, arm II)' and were administered combined chemotherapy (5-FU $375\;mg/m^2/day$, leucovorin $20\;mg/m^2$, IV bolus daily, for 3 days with RT, 5 days without RT, 8 cycles with 4 weeks interval) and radiation therapy (whole pelvis with 45 Gy/25 fractions/5 weeks). Patients of arm I received radiation therapy from day 1 of the first cycle of chemotherapy and those of arm II from day 57 with a third cycle of chemotherapy. The median follow-up period of living patients was 40 months. Results : Of the 307 patients enrolled, fifty patients did not receive scheduled radiation therapy or chemotherapy. The overall survival rate and disease free survival rate at 5 years were $78.3\%\;and\;68.7\%$ in arm I, and $78.4\%\;and\;67.5\%$ in arm II. The local recurrence rate was $6.6\%\;and\;6.4\%$ (p=0.46) in arms I and II, respectively, no significant difference was observed between the distant metastasis rates of the two arms ($23.8\%\;and\;29.5\%$, p=0.16). During radiation therapy, grade 3 diarrhea or more, by the NCI common toxicity criteria, was observed in $63.0\%\;and\;58.2\%$ of the respective arms (p=N.S.), but most were controlled with supportive care. Hematologic toxicity (leukopenia) greater than RTOG grade 2 was found in only $1.3\%\;and\;2.6\%$ of patients in each respective arm. Conclusion : There was no significant difference in survival, patterns of failure or toxicities between the early and late radiation therapy arms. Postoperative adjuvant chemoradiation was found to be a relatively safe treatment but higher compliance is needed.

A Prospective Randomized Trial Comparing the Seciuence of Adiuvant Chemotherapy and Radiotherapy following Curative Resection of Stage II, III Rectal Cancer (직장암의 근치적 수술 루 방사선치료와 화학요법의 순서에 대한 고찰 -전향적 무작위 3상 임상연구 중간 결과 보고-)

  • Kim Kyoung Ju;Kim Jong Hoon;Choi Eun Kyung;Chang Hyesook;Ahn Seung Do;Lee Je Hwan;Kim Jin Cheon;Yu Chang Sik
    • Radiation Oncology Journal
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    • v.18 no.1
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    • pp.17-25
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    • 2000
  • Purpose : To evaluate the side effects, pattern of failure, and survival rate according to the sequence of postoperative adjuvant radiotherapy and chemotherapy, patients with stages II and III rectal cancer who had undergone curative resection were randomized to 'early radiotherapy group (arm I)' or' late radiotherapy group (arm II)', then we intend to determine the most effective sequence of the radiotherapy and chemotherapy. Materials and Methods . From January 1996 to March 1999, 313 patients with curatively resected stages II and III rectal cancer have been randomized to' early' or' late' radiation therapy group and received combined chemotherapy (5-FU 375 mg/m$^{2}$/day, ieucovorin 20 mg/m$^{2}$, IV bolus daily Dl-5, 8 cycles) and radiation therapy (whole pelvis with 45 Gy/25 fractions/s weeks). Arm I received radiation therapy from day 1 with first cycle of chemotherapy and arm II received radiation therapy from day 57 with third cycle of chemotherapy after completion of first two cycles. Preliminary analysis was peformed with 228 patients registered up to Jun 1998. Two out of the 228 patients were excluded because of double primary cancer. Median follow-up period was 23 months. Results :Local recurrence occurred in 11 patients (9.7$\%$) for arm I and 9 patients (8$\%$) for arm 11. There was no significant difference between both groups ( p=0.64). However, distant metastasis was found in 22 patients (19.5$\%$) for arm I and 35 patients (31.0$\%$) for arm II and which showed statistically significant difference between the two groups ( p=0.046). And neither 3-year disease-free survival (70.2$\%$ vs 59.2$\%$, p=0.2) nor overall survival (89.4$\%$ vs 88.0$\%$, p=0.47) showed significant differences. The incidence of leukopenia during radiation therapy and chemotherapy was 78.3$\%$ and 79.9$\%$ respectively but leukopenia more than RTOG grade 3 was only 2.1$\%$ and 6.0$\%$ respectively. The incidence of diarrhea more than 10 times per day was significantly higher in the patients for arm I than for arm II (71.2$\%$ vs 41.6$\%$, p=0.02) but this complication was controlled with supportive cares. Conclusion : Regardless of the sequence of postoperative adjuvant radiation therapy and chemotherapy after curative resection for rectal cancer, local recurrence rate was low with combined chemoradlotherapy. But distant metastasis rate was lower in early radiation therapy group than in late radiation therapy group and the reason is unclear. Most patients completed these treatments without severe complication, so these were thought to be safe treatments but the treatment compliance should be improved.

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