• Title/Summary/Keyword: Low-value care

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A Study on the theory Substantial Compliance under UCP 600 (UCP 600상 상당일치론의 적용에 관한 연구)

  • Kang, Ho-Kyung;Lim, Mok-Sam
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.41
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    • pp.79-102
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    • 2009
  • L/C transaction, the most important issue for the seller and the buyer is the theory of documentary transaction and the theory of strict compliance which are the principles of L/C transactions. According to the leading cases in England and America where the practice of L/C transactions was created and developed, the descriptions of the commodities specified on all the documents which are submitted based on an L/C, should be identical to the descriptions of commodities specified in the L/C. And further, many leading cases of L/C continuously repeat to emphasize strict compliance. However, the recent leading cases in and out of the country show that the principle of strict compliance is being weakened. The leading cases in America show two trends of weakening the principle of strict compliance. That is, on the contrary to strict compliance, tends to apply substantial compliance (which puts more value on the substance of the documents). These leading cases reflect the attitudes of the judicial and the legislative authorization that don't want to approve formal approach to the commercial law. Recently, the Supreme Court of Korea is giving a decision on the principle of strict compliance, "The documents attached to an L/C should strictly comply with the conditions in the L/C, but it doesn't mean that they should be perfectly identical without any mistake in words. In case the bank can understand through reasonable care that a small mistake in words is too trivial to give different meaning or to give damage to the conditions of the L/C, the documents are regarded to comply with the conditions of the L/C. However, the judgment should be based on whether the difference between the documents and the L/C can be admitted by the international standard bank transaction practice or not." This decision tells that the principle of strict compliance is quite much modified so application of this modification can't be ignored. However, from the viewpoint of the party who requests to open an L/C, there is a criticism that a bank's arbitrary judgement can be involved. Therefore, reviewing the original purpose of L/C transactions (activating international transactions), the principle of strict compliance may be thought old-fashioned because it emphasizes a form, but in reality, for prompt transaction and payment, the principle of strict compliance should be observed in L/C transactions. And further, if a legislative device is prepared to systematically compensate for several side-effects, the principle of strict compliance will improve dynamic flow of prompt and low-costly L/C transactions. On the other hand, it will be able to protect the interested parties.

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Development of Orofacial Pains Therapy System based on Acupuncture Principles (침치료 원리를 이용한 안면 통증 치료기 개발)

  • Lee Yong-Heum;Bak Chang-Gye
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.9 no.5
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    • pp.1045-1051
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    • 2005
  • We developed an orofacial pains diagnosis/therapy system which can enlarge a therapy effect through a new stimulation. Contrary to its established method, this therapy system(DDTS-1) is a treating method which absorbs a surplus ion charge- the cause of an outbreak of a pain-of the human body using a capacitor. Absorbing a surplus ion charge of the human body with effect, it obtained optimal parameters which is control signal to control charging/discharging a capacitor to be 6Hz, and capacitance to be $0.1\~0.33{\mu}F.$ Through clinical demonstration, experimented on among patients-namely dental pain patients, joint disorders patients, and trigeminal neuralgia patients to verification of system. In result, an EAST stimulater had a very low change of abnormal potential against normal potential before/after being placed under medical care. DDTS-1 showed obvious differences that two potentials are one and the same potential or one potential is similar to the other one. DDTS-1 comparing with EAST showed the remedial value of the comparative advantage in all the medical treatment of pains. Therefore, stimulation of DDTS-1 is more effective than the existing electric stimulation. We verified its validity of ion charge absorption in the human body using capacitor which presented the present thesis. That is, we verified theoretical adequacy of control action in a pain, and its efficiency as well as confidence.

Assessment of Respiratory Problems in Workers Associated with Intensive Poultry Facilities in Pakistan

  • Yasmeen, Roheela;Ali, Zulfiqar;Tyrrel, Sean;Nasir, Zaheer Ahmad
    • Safety and Health at Work
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    • v.11 no.1
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    • pp.118-124
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    • 2020
  • Background: The poultry industry in Pakistan has flourished since the 1960s; however, there are scarce data regarding the impact of occupational exposure on the pulmonary health of farm workers in terms of years working in the industry. The objective of the present study was to assess the effect of poultry environment on the health of occupationally exposed poultry farmers in countries of warm climatic regions, such as Pakistan. This study will also show the effect of exposure to poultry facilities on the health of poultry farmers in the context of low-income countries with a relatively inadequate occupational exposure risk management. Materials and methods: The lung function capacity of 79 poultry workers was measured using a spirometer. Along with spirometry, a structured questionnaire was also administrated to obtain information about age, height, weight, smokers/nonsmokers, years of working experience, and pulmonary health of farm workers. The workers who were directly involved in the care and handling of birds in these intensive facilities were considered and divided into four groups based on their years of working experience: Group I (3-10 months), Group II (1-5 years), Group III (6-10 years), and Group IV (more than 11 years). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio were considered to identify lung function abnormalities. Statistical analysis was carried out using independent sample t test, Chi-square test, Pearson's correlation, and linear regression. Results: Based on the performed spirometry, 68 (86 %) of workers were found normal and healthy, whereas 11 (14 %) had a mild obstruction. Of the 11 workers with mild obstruction, the highest number with respect to the total was in Group IV (more than 11 years of working experience) followed by Group III and Group II. Most of the workers were found healthy, which seems to be because of the healthy survivor effect. For the independent sample t test, a significant difference was noticed between healthy and nonhealthy farmers, whereas Chi-square test showed a significant association with height, drugs, and working experience. Linear regression that was stratified by respiratory symptoms showed for workers with symptoms, regression models for all spirometric parameters (FVC, FEV1, and FEV1/FVC) have better predictive power or R square value than those of workers without symptoms. Conclusion: These findings suggest that lung function capacity was directly related to years of working experience. With increasing number of working years, symptoms of various respiratory problems enhanced in the poultry workers. It should be noted that most of the poultry workers were healthy and young, the rationale being that there is a high turnover rate in this profession. The mobility in this job and our finding of 86% of the healthy workers in the present study also proposed healthy worker survivor effect.

Characteristics of RDF Char Combustion in a Bubbling Fluidized Bed (기포 유동층 내에서 RDF 촤의 연소 특성)

  • Kang, Seong-Wan;Kwak, Yeon-Ho;Cheon, Kyoung-Ho;Park, Sung Hoon;Jeon, Jong-Ki;Park, Young-Kwon
    • Applied Chemistry for Engineering
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    • v.22 no.4
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    • pp.429-432
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    • 2011
  • The feasibility of applications of the char obtained from a gasification process of municipal-waste refuse derived fuel (RDF) as an auxiliary fuel was evaluated by combustion experiments. The higher heating value of the RDF char was 3000~4000 kcal/kg and its chlorine content was below the standard requirement demonstrating its potential as an auxiliary fuel. In the combustion exhaust gas, the maximum $NO_x$ and $SO_2$ concentrations were 240 ppm and 223 ppm, respectively. If an aftertreatment is applied, it is possible to control their concentrations low enough to meet the air pollutant emission standard. The HCl concentration was relatively high indicating that a care should be taken for HCl emission from the combustion of RDF. Based on the temperature distribution within the reactor, the concentration change of $O_2$ and $CO_2$, and the amount and the loss on ignition of solid residue, it was inferred that the combustion reaction was the most reliable when the excess air ratio of 1.3 was used.

Risk factors for cancer-specific survival in elderly gastric cancer patients after curative gastrectomy

  • Liu, Xiao;Xue, Zhigang;Yu, Jianchun;Ma, Zhiqiang;Kang, Weiming;Ye, Xin;Li, Zijian
    • Nutrition Research and Practice
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    • v.16 no.5
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    • pp.604-615
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    • 2022
  • BACKGROUND/OBJECTIVES: This study aimed to investigate cancer-specific survival (CSS) and associated risk factors in elderly gastric cancer (EGC) patients. SUBJECTS/METHODS: EGC patients (≥ 70 yrs) who underwent curative gastrectomy between January 2013 and December 2017 at our hospital were included. Clinicopathologic characteristics and survival data were collected. Receiver operating characteristic (ROC) analysis was used to extract the best cutoff point for body mass index (BMI). A Cox proportional hazards model was used to determine the risk factors for CSS. RESULTS: In total, 290 EGC patients were included, with a median age of 74.7 yrs. The median follow-up time was 31 (1-77) mon. The postoperative 1-yr, 3-yr and 5-yr CSS rates were 93.7%, 75.9% and 65.1%, respectively. Univariate analysis revealed risk factors for CSS, including age (hazard ratio [HR] = 1.08; 95% confidence interval [CI], 1.01-1.15), intensive care unit (ICU) admission (HR = 1.73; 95% CI, 1.08-2.79), nutritional risk screening (NRS 2002) score ≥ 5 (HR = 2.33; 95% CI, 1.49-3.75), and preoperative prognostic nutrition index score < 45 (HR = 2.06; 95% CI, 1.27-3.33). The ROC curve showed that the best BMI cutoff value was 20.6 kg/m2. Multivariate analysis indicated that a BMI ≤ 20.6 kg/m2 (HR = 2.30; 95% CI, 1.36-3.87), ICU admission (HR = 1.97; 95% CI, 1.17-3.30) and TNM stage (stage II: HR = 5.56; 95% CI, 1.59-19.43; stage III: HR = 16.20; 95% CI, 4.99-52.59) were significantly associated with CSS. CONCLUSIONS: Low BMI (≤ 20.6 kg/m2), ICU admission and advanced pathological TNM stages (II and III) are independent risk factors for CSS in EGC patients after curative gastrectomy. Nutrition support, better perioperative management and early diagnosis would be helpful for better survival.

Association Between Pelvic Bone Computed Tomography-Derived Body Composition and Patient Outcomes in Older Adults With Proximal Femur Fracture

  • Tae Ran Ahn;Young Cheol Yoon;Hyun Su Kim;Kyunga Kim;Ji Hyun Lee
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.434-443
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    • 2023
  • Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.

Survey on Medical Technologist Desired Wage in Primary and Secondary Medical Institutions Nationwide in the Republic of Korea (한국의 1차·2차 의료기관 임상병리사의 희망임금 실태조사)

  • Junghyun KIM;Chang-Sub SONG;Byung-Ho CHOI;Sanghee LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.4
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    • pp.314-323
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    • 2023
  • This study assessed the desired wage guidelines for medical technologists (MTs), mainly primary care providers and those in secondary medical institutions, in 16 cities and provinces in Korea. A survey of 1,327 MTs was conducted using a structured Google questionnaire from August 1, 2022, to September 30, 2022. The wage levels differed according to gender, age, education, career, region, and employment status. There were differences in wage levels according to gender and region with less than one year of career, and the wage gap was relatively larger for woman than man. An awareness of wage compensation appropriate for work performance, and technology value compensation were low at 2.01, 2.23, and 2.30, respectively. This study suggests that primary and secondary medical institutions should provide reasonable wages compensation for MTs' work in order to create an environment where MTs can receive stable jobs and work. Moreover, the Korean Association of Medical Technologists should establish a cooperative system so that the starting wage of MTs in primary and secondary medical institutions can receive the desired wage of 34 million won.

Effective Ways of Performing Surveillance Surface Cultures in Extremely Low Birth Weight Infants

  • Lee, Ju-Young;Kim, Ee-Kyung;Lee, Jin-A;Choi, Chang-Won;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.240-247
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    • 2011
  • Purpose: The rationale for skin surface cultures is that bacterial colonization precedes infection and, as a result, that identification of a potential pathogen is predictive of later systemic infection in preterm infants. We aimed to analyze results of surveillance surface cultures in extremely low birth weight (ELBW) infants and seek for effective ways of performing surveillance surface cultures. Methods: We analyzed the surveillance surface cultures of 113 ELBW infants over a 4-year period. Surveillance cultures were obtained routinely from five sites: axilla, external ear canal, nasopharynx, throat (or tracheal aspirate if intubated) and anus. Each surface culture obtained during the 13 days, prior to the date of the blood culture, was compared with the blood culture obtained when sepsis was suspected. The sensitivity, specificity and positive predictive value (PPV) of the surveillance cultures were calculated among 1894 blood-surface culture pairs by surface sites, recovered organisms and interval between surveillance samples and blood cultures. Results: The overall sensitivity, specificity and PPV of surface cultures were 45.9, 22.4 and 6.8%, respectively. The PPV was highest for the throat/tracheal cultures (11.0%) and lowest for the anal cultures (2.3%). As the time of culturing progressed toward the day of blood culturing, the sensitivity and specificity of the surface cultures significantly increased. Only axillary and throat/tracheal cultures were useful in predicting the microorganisms causing sepsis. Conclusion: Surface cultures could help to predict sepsis pathogens and infection surveillance in preterm infants could be continued with a reduced number of cultured sites focusing on the axilla and throat/trachea.

A Study on the Treatment of Combine Electron Beam in the Treatment of Breast Cancer Tumor Bed (유방암 Tumor bed 치료 시 혼합 전자선 치료 방법에 대한 고찰)

  • Lee, Geon Ho;Kang, Hyo Seok;Choi, Byoung Joon;Park, Sang Jun;Jung, Da Ee;Lee, Du Sang;Ahn, Min Woo;Jeon, Myeong Soo
    • The Journal of Korean Society for Radiation Therapy
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    • v.31 no.1
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    • pp.51-56
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    • 2019
  • Purpose: The usefulness of using single-electron radiation for secondary radiotherapy of breast cancer patients after surgery is assessed and the use of a combine of different energy. Methods and materials : In this study, 40 patients (group A) using energy 6 MeV and 9 MeV, and 19 patients (group B) using a combine of 9 MeV and 12 MeV were studied among 59 patients who performed secondary care using combine electronic radiation. Each patient in each group, 6 MeV, 9 MeV, Combine(6 MeV / 9 MeV) and 9 MeV, 12 MeV, Combine (9 MeV / 12 MeV) were developed in different ways, and the maximum doses delivered to the original hospital, D95, D5, and $V_3$, $V_5$, $V_{10}$ were compared. Result: The D95 mean value of Group A treatment plan was $785.33{\pm}225.37cGy$, $1121.79{\pm}87.02cGy$ at 9 MeV, and $1010.98{\pm}111.17cGy$ at 6 MeV / 9 MeV, and the mean value at 6 MeV / 9 MeV was most appropriate for the dose. The mean values of the low dose area $V_3$ and $V_5$ in the lung of the breast direction being treated were $3.24{\pm}3.49%$ and $0.72{\pm}1.55%$ at 6 MeV, the highest 9 MeV at $7.25{\pm}4.59%$, $3.07{\pm}2.64%$, the lowest at 6 MeV. Maximum and average lung dose was $727.78{\pm}137.27cGy$ at 6 MeV / 9 MeV, $49.16{\pm}24.44cGy$, highest 9 MeV at $998.97{\pm}114.35cGy$, $85.33{\pm}41.18cGy$, and lowest 6 MeV at $387.78{\pm}208.88cGy$, $9.27{\pm}6.60cGy$. The value of $V_{10}$ was all close to zero. Group B appeared in the pattern of Group A. Conclusion: Relative differences in low-dose areas of the lungs $V_3$ and $V_5$ were seen and were most effective in the dose transfer of tumor bed in the application of combined energy. It is thought that the method of using electronic energy in further radiation treatments for breast cancer is a more effective way to use the energy effect of limiting energy resources, and that if you think about it again, it could be a little more beneficial radiation treatment for patients.

A STUDY ON 4 TYPE CONSTITUTION AND SIFE CHARACTER OF OBESE PATIENTS (비만인의 생활특성과 사상체질에 관한 연구)

  • KIM, DAL RAE
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.1
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    • pp.303-313
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    • 1997
  • Disease depends on the three factors, agent, host and environment. According to history of disease, by early 1900s the case of deaths is infectious disease, in late 1900s care of infectious diseases and tremendous scale of chronic disease, i.e., heart disease, diabetes, cancers and etc, makes care of chronic diseases be a most important theme. Now, life-style of diet is being westernized and in high industry-oriented society, obesity makes attack fate remarkably increase and life-expectancy become short, so that it causes severe problem of health. Chronic disease, such as obesity, is not affected by specific agent, but depends of interaction between host and environmental factors. There is the theory of constitutional medicine in Korean Medicine. According to it, all the people have constitutional specificity and disease. Because obesity is a kind of disease, there is the corresponding constituent being apt to be fat. Oriental Medicine utilizes herb-medication, acupuncture, and massage-therapy in treating obesity. Therefore study on relationship between constituent and obesity for OPD patients of Sangji-Oriental Medicine Hospital is carried out. The results are summarized as followings. 1. 70.2% of obesity patients are Taeumin(太陰人), 26.9% of those are Soyangin(少陽人), 2.9% of thoese are Soeumin(少陰人). 2. Most cases, high value of Free Fat Acid and Triglyceride not that of Total Cholesterol and Low Density Lipoprptein is meaningful in obesity patient blood. The corelationship between lipid test and Constitution is meaningful in Triglyceride and Free Fatty Acid. 3. Obesity is not related with gene. 4. Obesity is not related with Boyak(Herb-Med : 補藥). 5. Obesity mostly happens after delivery, contraception and operation. 6. Obese Patients are apt to eat between meals, especially food of wheat flour such as a snack. 7. The aim of treating obesity is not persuit of beauty but of keeping healthy. 8. 2.2Kg of body weight is lost after 4 week-treatment. 9. Common cause of obesity is overeating of carbohydrate and lipid than meat.

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