• 제목/요약/키워드: Low-value care

검색결과 167건 처리시간 0.028초

전이암 환자의 예후 판단 인자로서 생체전기 임피던스 분석을 이용한 위상각의 역할 (Phase Angle Using Bioelectrical Impedance Analysis for Predicting Survival in Patients with Metastatic Cancer)

  • 윤성수;윤성우;류한성;김은혜;이지영
    • 대한한방내과학회지
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    • 제39권4호
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    • pp.463-470
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    • 2018
  • Objectives: The aim of this study was to identify the validity of phase angle as a prognostic factor for survival in patients with metastatic cancer. Methods: Data of patients with metastatic cancer who visited the Korean medicine cancer center at Kyung Hee University Hospital in Gangdong from April 2016 to February 2018 were collected for this study. The values of phase angle (PhA) and blood hemoglobin (Hb), C-reactive protein (CRP), and serum albumin levels were also investigated by bioelectrical impedance analysis (BIA). Results: In total, 86 patients were analyzed. The cut-off value of the phase angle was determined as 5.0. Univariate and multivariate analysis revealed that phase angle (HR 3.15, 95% CI 1.79-5.54) and CRP (HR 2.15, 95% CI 1.24-3.73) predicted survival with statistical significance. The median overall survival of the low PhA group ($PhA{\leq}5.0$) was 1.8 months (95% CI 0.6-2.9 months) and 7.2 months (95% CI 5.2-9.2 months) in the high PhA group (PhA>5.0)(p<0.001). Conclusions: The phase angle could be an independent prognostic factor for patients with metastatic cancer. Further research is required to confirm these findings and their correlation with other indexes.

Effect of Enhancers on in vitro and in vivo Skin Permeation and Deposition of S-Methyl-ʟ-Methionine

  • Kim, Ki Taek;Kim, Ji Su;Kim, Min-Hwan;Park, Ju-Hwan;Lee, Jae-Young;Lee, WooIn;Min, Kyung Kuk;Song, Min Gyu;Choi, Choon-Young;Kim, Won-Serk;Oh, Hee Kyung;Kim, Dae-Duk
    • Biomolecules & Therapeutics
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    • 제25권4호
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    • pp.434-440
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    • 2017
  • S-methyl-$\small{L}$-methionine (SMM), also known as vitamin U, is commercially available as skin care cosmetic products for its wound healing and photoprotective effects. However, the low skin permeation expected of SMM due to its hydrophilic nature with a log P value of -3.3, has not been thoroughly addressed. The purpose of this study thus was to evaluate the effect of skin permeation enhancers on the skin permeation/deposition of SMM. Among the enhancers tested for the in vitro skin permeation and deposition of SMM, oleic acid showed the most significant enhancing effect. Moreover, the combination of oleic acid and ethanol further enhanced in vitro permeation and deposition of SMM through hairless mouse skin. Furthermore, the combination of oleic acid and ethanol significantly increased the in vivo deposition of SMM in the epidermis/dermis for 12 hr, which was high enough to exert a therapeutic effect. Therefore, based on the in vitro and in vivo studies, the combination of oleic acid and ethanol was shown to be effective in improving the topical skin delivery of SMM, which may be applied in the cosmetic production process for SMM.

Smoking Cessation Treatment and Outcomes in Medium to Heavy Cigarette Smokers being Treated for Cancer in Jordan

  • Hawari, Feras Ibrahim;Obeidat, Nour Ali;Ayub, Hiba Salem;Dawahrah, Sahar Sattam;Hawari, Saif Feras
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6875-6881
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    • 2013
  • Background: Studies evaluating smoking cessation treatment outcomes in cancer patients are scarce, despite smoking cessation importance in cancer care. We sought to add to the literature by evaluating smoking cessation in a challenging group of cancer patients (medium-to-heavy smokers) visiting an out-patient smoking cessation clinic (SCC) in a cancer center in Amman, Jordan. Materials and Methods: Patients smoking >9 cigarettes per day (CPD) and referred to the SCC between June 2009 and May 2012 were studied. Clinic records were reviewed to measure demographic and baseline clinical characteristics, and longitudinal (3-, 6- and 12- month) follow-up by phone/clinic visit was conducted. At each follow-up, patients were asked if they experienced medication side-effects, if they had returned to smoking, and reasons for failing to abstain. Descriptive and multivariable logistic regression analyses were performed. Results: A total of 201 smokers were included in the analysis. The 3-month abstinence was 23.4% and significantly associated with older age, being married, and presenting with lower (${\leq}10ppm$) baseline carbon monoxide (CO) levels. On a multivariable level, lower CO levels, a higher income (relative to the lowest income group), being older, and reporting severe dependence (relative to dependence reported as 'somewhat' or 'not') were significant predictors of higher odds of abstinence at three months. Reasons for failing to quit included not being able to handle withdrawal and seeing no value in quitting. Long-term ARs did not reach 7%. Conclusions: In a sample of Jordanian smokers (>9CPD) with cancer and receiving smoking cessation treatment, ARs were low and further declined with time. Results underscore the need for more aggressive patient management and rigorous follow-up during and after smoking cessation treatment, particularly when this takes place in challenging settings. Observed reasons for failure to abstain should be used to tailor counseling practices.

Efficacy of Using Sequential Primary Circulating Prostate Cell Detection for Initial Prostate Biopsy in Men Suspected of Prostate Cancer

  • Murray, Nigel P;Reyes, Eduardo;Fuentealba, Cynthia;Jacob, Omar
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3385-3390
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    • 2016
  • Background: Sequential use of circulating prostate cell (CPC) detection has been reported to potentially decrease the number of unnecessary prostate biopsies in men suspected of prostate cancer. In order to determine the real world effectiveness of the test, we present a prospective study of men referred to two hospitals from primary care physicians, one using CPC detection to determine the necessity of prostate biopsy the other not doing so. Materials and Methods: Men with a suspicion of prostate cancer because of elevated PSA >4.0ng/ml or abnormal DRE were referred to Hospitals A or B. In Hospital A all underwent 12 core TRUS biopsy, in Hospital B only men CPC (+), with mononuclear cells obtained by differential gel centrifugation identified using double immunomarking with anti-PSA and anti-P504S, were recommended to undergo TRUS biopsy. Biopsies were classifed as cancer or no-cancer. Diagnostic yields were calculated, including the number of posible biopsies that could be avoided and the number of clinically significant cancers that would be missed. Results: Totals of 649 men attended Hospital A, and 552 men attended Hospital B; there were no significant differences in age or serum PSA levels. In Hospital A, 228 (35.1%) men had prostate cancer detected, CPC detection had a sensitivity of 80.7%, a specificity of 88.6%, and a negative predictive value of 89.5%. Some 39/44 men CPC negative with a positive biopsy had low grade small volume tumors. In Hospital B, 316 (57.2%) underwent biopsy. There were no significant differences between populations in terms of CPC and biopsy results. The reduction in the number of biopsies was 40%. Conclusions: The use of sequential CPC testing in the real world gives a clear decision structure for patient management and can reduce the number of biopsies considerably.

Pooled Analysis of the Cow's Milk-related-Symptom-Score (CoMiSSTM) as a Predictor for Cow's Milk Related Symptoms

  • Vandenplas, Yvan;Steenhout, Philippe;Jarvi, Anette;Garreau, Anne-Sophie;Mukherjee, Rajat
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제20권1호
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    • pp.22-26
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    • 2017
  • Purpose: The diagnosis of cow's milk (CM) allergy is a challenge. The Cow's Milk-related-Symptom-Score ($CoMiSS^{TM}$) was developed to offer primary health care providers a reliable diagnostic tool for CM related symptoms. The predictive prospective value of the $CoMiSS^{TM}$ was evaluated in three clinical trials. Methods: Pooled analyses of the three studies were conducted based on regressing the results of the month-1 challenge test on the month-1 $CoMiSS^{TM}$, adjusting for baseline $CoMiSS^{TM}$ using a logistic regression model. In addition a logistic regression model was also fitted to the month-1 challenge test result with the change in $CoMiSS^{TM}$ from baseline as a predictor. Results: Results suggest that infants having a low $CoMiSS^{TM}$ (median, 5) after 1 month dietary treatment free from intact CM protein have a significant risk of having a positive challenge test (odds ratio, 0.83; 95% confidence interval, 0.75-0.93; p=0.002). Pooled data suggest that the change in $CoMiSS^{TM}$ from baseline to month-1 can predict CM related symptoms as a confirmed diagnosis according to the challenge test at month-1. However, in order to validate such a tool, infants without CM related symptoms would also need to be enrolled in a validation trial. A concern is that it may not be ethical to expose healthy infants to a therapeutic formula and a challenge test. Conclusion: Pooled data analysis emphasizes that the $CoMiSS^{TM}$ has the potential to be of interest in infants suspected to have CM-related-symptoms. A prospective validation trial is needed.

소비자의 시간압박 수준에 따른 패션정보원, 추구혜택, 구매기준 비교연구 (Comparison on Fashion Information Sources, Clothing Benefits Sought & Purchase Criteria according to Consumers' Time Pressure Level)

  • 김칠순;이진화
    • 한국의류학회지
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    • 제30권1호
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    • pp.20-30
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    • 2006
  • The purposes of this study were to investigate demographic profiles between the consumer group under high time pressure(HTP) and the group under low time pressure(LTP) during the shopping, to examine the level of association between the fashion information sources and time pressure variable, to determine the difference in clothing benefits sought between HTP and LTP, and to determine the difference in purchase criteria. We distributed questionnaires to 600 women aged in 20-65. The reliable 562 questionnaires were used for a statistical analysis. Data analyses were conducted with SPSS program on t-test, cluster analysis, factor analysis, and Chi square test. We obtained the following results: There was a significant association between demographic variables such as age, occupation, education, residence area, & family cycle and time pressure variable. Fashion information sources were classified into 4 factors. HTP searched information on fashion products using more various sources than LTP did. There was also a significant difference between HTP and LTP in clothing benefit sought. Four clothing benefit factors such as trendy/social position, economic value, protection/comfort, and makeup of body shape were sought more by HTP than by LTP. In addition, HTP considered significantly more purchase criteria such as color/pattern, comfort, quality, suitability, material, sewing finishing, coordination, price, brand, easy care, and country of origin than LTP.

한우산업의 발전전략 (Development Strategies of The Hanwoo [Korean Native Cattle] Industry)

  • 김진석
    • 한국작물학회:학술대회논문집
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    • 한국작물학회 1998년도 21세기 한반도 농업전망과 대책(한국작물학회.한국육종학회 공동주관 심포지움 회보)
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    • pp.68-111
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    • 1998
  • The structure of the Hanwoo (Korean Native Cattle) Industry remains very weak and vulnerable to the WTO/IMF system. Considering that the majority of cattle farmers are small sized, and that marketing systems are outdated and inefficient, rapid expansion of lower priced beef imports by WTO system and rapid increasing of production costs by IMF system would lead to the deprivation of a regular source of farm income and threaten the stability of rural life. Accordingly, the Hanwoo industry should be expanded in accordance with progress in the implementation of (1) programs for the structural adjustment and (2) measures to compensate for the loss. Efforts for lowering major production factor costs needs to continue, In order to increase the supply of calves at low cost, the programs of collective cow-calf farms should be expanded, thereby reducing the cost of calf purchase, which constitutes the largest share of Hanwoo production cost. Also, feedlot operations should be encouraged for small herd farms in order to achieve a substantial saving in beef production costs by integrated operations from calf production to cattle fattening. A substantial saving would also be made by collective purchase and distribution of various inputs through the cooperatives' channels. Extension services should be strengthened for cattle farm management, cattle care and feeding, prevention of cattle disease, etc. In order to minimize cash outlays for commercial mixed feeds, utilization of far by-products as feeds should be enhanced and production of forage crops productive of resources, such as land and rural labor, during the farm o(f-season, needs to be encouraged. Also, technological development for enhancing the nutritional value of farm by-products should be encouraged. Measures for successful segregation of the Hanwoo beef market should be implemented, thereby enhancing incentive for quality beef producers and protecting consumers willing to pay higher price for quality beef. For development of the Hanwoo industry, a considerable time frame would be required in order for (1) small livestock farmers to make a successful adjustment by staying in the enterprise and achieving increased price efficiency (2) livestock farmers to acquire know-how for producing quality Hanwoo beef, (3) the ongoing Government policy of enhancing price-quality competitiveness, and for improving the quality Hanwoo beef marketing to take root. (4) consumers to increase their ability to distinguish meat quality, and others.

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백화점 카드 소지자의 의복구매행동 연구 (A Study on Clothing Purchasing Behavior of Department Store Credit Card Holders)

  • 신수아;이선재
    • 한국의류학회지
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    • 제23권2호
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    • pp.250-261
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    • 1999
  • This study is designed to classify consumer groups based on their perception toward department store credit cards and the behavior they exhibit during the purchase of clothing. This classification is based on the study of factors taken into consideration during shopping and disparities in credit cared usage., The specific goals of this study are the following : First it is to classify female consumers over age 20 into "shopping orientation" types and "clothing purchase behavior" types according to their perception towards department store credit care usage. Second it is to discover the degree of perceived utility of department store credit card in clothing purchases. Third finally it is to assist a department store credit card market researcher establish a marketing strategy to best address consumers; needs and wants in credit card purchases The study methodology utilized and the results found were that : 1. The division of consumers into positive and negative groups based on factor analysis with the positive group found to have favorable attitudes towards department store credit card usage. 2. Classification of female consumers into three " shopping orientations" : fashion purchasing economic value purchasing and convenience purchasing. The positive group were predominantly fashion convenience purchasers who valued low cost and convenience over "fashionability" 3. The three classes of "purchase behavior" used were impulse buying planned buying and unplanned buying. The positive group those who had favorable attitudes toward department store credit cards. made mostly impulse and unplanned purchases while the negative group made largely planned purchasee the negative group made largely planned purchase.

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진료비용 지역보정지수의 산출 및 국내 적용의 타당성 (The Calculation of Geographic Practice Cost Index and the Feasibility of Using It in Korean Payment System)

  • 김한상;정설희
    • 보건행정학회지
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    • 제29권2호
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    • pp.130-137
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    • 2019
  • The fee-for-service system is used as the main payment system for health care providers in Korea. It has been argued that it can't reflect differences in the medical practice costs across regions because the fee schedule is calculated based on the average cost. So, some researchers and providers have disputed that there is need for adopting geographic practice cost index (GPCI) used in the United States for the Medicare program for the elderly to the fee-for-service payment system. This study performed to identify whether the difference in the practice costs among regions exists or not and to examine the feasibility of applying GPCI to Korea payment system. For this purpose, we calculated modified-GPCI and examined considerations to introduce GPCI in Korea. First we identified available data to calculate GPCI. Second, we made applicable GPCI equations to Korea payment system and computed it based on four types of regions (metropolitan, urban, suburban, and rural). We also categorize the regions based on the availability of the medical resources and the capability of utilizing them. As a result, we found that there wasn't any significant difference in the GPCI by regional types in general, but the indices of rural areas (0.91-0.98) was relatively low compared to the indices of other regions (0.96-1.07). Considering the need to use GPCI floor, the pros and cons of using GPCI, and the concern of the regional imbalance of resources, the introduction of GPCI needs to be carefully considered.

스마트 IT 융합 플랫폼을 위한 지능형 센서 기술 동향 (Intelligent Sensor Technology Trend for Smart IT Convergence Platform)

  • 김혜진;진한빛;염우섭;김이경;박강호
    • 전자통신동향분석
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    • 제34권5호
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    • pp.14-25
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    • 2019
  • As the Internet of Things, artificial intelligence and big data have received a lot of attention as key growth engines in the era of the fourth industrial revolution, data acquisition and utilization in mobile, automotive, robotics, manufacturing, agriculture, health care and national defense are becoming more important. Due to numerous data-based industrial changes, demand for sensor technologies is exploding, especially for intelligent sensor technologies that combine control, judgement, storage and communication functions with the sensors's own functions. Intelligent sensor technology can be defined as a convergence component technology that combines intelligent sensor units, intelligent algorithms, modules with signal processing circuits, and integrated plaform technologies. Intelligent sensor technology, which can be applied to variety of smart IT convergence services such as smart devices, smart homes, smart cars, smart factory, smart cities, and others, is evolving towards intelligent and convergence technologies that produce new high-value information through recognition, reasoning, and judgement based on artificial intelligence. As a result, development of intelligent sensor units is accelerating with strategies for miniaturization, low-power consumption and convergence, new form factor such as flexible and stretchable form, and integration of high-resolution sensor arrays. In the future, these intelligent sensor technologies will lead explosive sensor industries in the era of data-based artificial intelligence and will greatly contribute to enhancing nation's competitiveness in the global sensor market. In this report, we analyze and summarize the recent trends in intelligent sensor technologies, especially those for four core technologies.