• Title/Summary/Keyword: Nursing cost

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Recent Advances in Amino Acid and Energy Nutrition of Prolific Sows - Review -

  • Boyd, R.D.;Touchette, K.J.;Castro, G.C.;Johnston, M.E.;Lee, K.U.;Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.13 no.11
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    • pp.1638-1652
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    • 2000
  • Prolific females require better nutrition and feeding practice because of larger litter size and the substantial decline in body fat. Life-time pig output will be compromised if body protein and fat are not properly managed. First litter females are especially vulnerable because they can loose ${\geq}15%$ of whole-body protein. Conservation of body protein mass during first lactation minimizes wean to estrus interval and increases second litter size (up to 1.2 pigs). The ability to influence litter-size by amino acid nutrition is a new dimension in our understanding. A P2 fat depth below 12 mm at farrow and below 10 mm at wean compromised wean to estrus interval (>2 d) and next litter size (0.5 to 1.5 pigs) in sows. It is now clear that a 'modest' excess of feed during the first 72 h of pregnancy decreases embryo viability so that the potential for an increased litter size at birth is not realized. The capacity for milk production by prolific young sows is 25% higher than the standard used previously (NRC, 1988). First litter females averaged 9.82 kg milk/d for a 21 d lactation. Second and third litter counterparts averaged 10.35 kg/d. Milk production was 95% of peak by 10 d of lactation and sows were in greatest negative energy and lysine balance during the first 6 d. Nearly 45% of the total loss in body protein occurred within the first 6 d, but this could reduced to 30-35% by using a more aggressive feeding strategy after parturition. There appear to be 2 phases in lactation for lysine need (d 2-12 vs 12-21). Feeding to the higher level alleviates the second litter size decline. The lysine requirement for lactation can be predicted with accuracy, but we are not able to predict the second limiting amino acid. Mammary uptake of valine relative to lysine and recent work with practical diets suggest that the recent NRC (1998) pattern is realistic and that threonine and valine could be co-limiting for corn-soy diets for prolific sows nursing 10-11 pigs. Empirical studies are needed to refine the ideal pattern so that synthetic lysine can be used with more confidence. Milk fat output for the elite sow is extraordinary and poses an unnecessarily high energetic cost. Methods that reduce mammary fat synthesis will benefit the sow and may enhance piglet growth.

Evaluation of Health-related Quality of Life for Hypothesized Medical States Associated with Cervical Cancer

  • Murasawa, Hideki;Konno, Ryo;Okubo, Ichiro;Arakawa, Ichiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9679-9685
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    • 2014
  • Background: When evaluating health-economics for cervical cancer prevention policies in Japan, it is important to use Japanese value settings. This study aimed to obtain preference-based measures (preference measures) for hypothesized health states among healthy Japanese women, and to examine differences between the EuroQol-5D (EQ-5D) and standard gamble (SG) instruments. Materials and Methods: The investigation was performed among female students at a nursing university. We used written hypothetical scenarios describing three grades of cervical intraepithelial neoplasia (CIN) and eight stages of cervical cancer, both at diagnosis and after medical intervention. Preference measures were evaluated using both EQ-5D and SG. Results: We received responses from 136 women. The mean number of respondents per stage was 24.6 (SD: 2.7). At diagnosis, average EQ-5D scores for CIN1, CIN2, CIN3, IA1, IA2, IB1, IB2, IIA, IIB, III, and IV stages were 0.84 (0.14), 0.78 (0.12), 0.73 (0.10), 0.78 (0.12), 0.72 (0.12), 0.63 (0.13), 0.64 (0.12), 0.68 (0.08), 0.62 (0.13), 0.55 (0.21), and 0.18 (0.24), respectively. Using one-way analysis of variance with the Tukey-Kramer method for multiple comparisons (each stage vs. CIN1), we found significant differences for IB1 and more advanced stages (p<0.05). After medical intervention, corresponding EQ-5D scores were 0.84 (0.12), 0.81 (0.12), 0.84 (0.12), 0.80 (0.15), 0.78 (0.11), 0.64 (0.15), 0.63 (0.15), 0.71 (0.15), 0.50 (0.17), 0.52 (0.17), 0.21 (0.28). The multiple comparisons identified significant differences for IB1 and more advanced stages, excepting IIA (p<0.05). SG evaluations were more variable and relatively higher than EQ-5D evaluations. Conclusions: We obtained preference measures for three grades of CIN1-3 and eight stages of cervical cancer. In combination with appropriate sensitivity analyses, these preference measures will provide a basis for an economic evaluation of cervical cancer prevention in Japan. We suggest that EQ-5D is appropriate for cost-utility analysis of this topic.

A Study on Medical Fee System of the convalescent hospital -Focused on the case of patient group adjustment - (요양병원 수가제도에 대한 소고 -환자군 조정 판결을 중심으로 -)

  • Kwon, Hye Ok
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.195-218
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    • 2017
  • The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

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Association of Polymorphism Harbored by Tumor Necrosis Factor Alpha Gene and Sex of Calf with Lactation Performance in Cattle

  • Yudin, N.S.;Aitnazarov, R.B.;Voevoda, M.I.;Gerlinskaya, L.A.;Moshkin, M.P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.26 no.10
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    • pp.1379-1387
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    • 2013
  • In a majority of mammals, male infants have heavier body mass and grow faster than female infants. Accordingly, male offspring nursing requires a much greater maternal energy contribution to lactation. It is possible that the maternal-fetal immunoendocrine dialog plays an important role in female preparation for lactation during pregnancy. Immune system genes are an integral part of gene regulatory networks in lactation and tumor necrosis factor alpha ($TNF{\alpha}$) is a proinflammatory cytokine that also plays an important role in normal mammary gland development. The aim of this study was to evaluate the influence of the sex of calf and/or the -824A/G polymorphism in the promoter region of $TNF{\alpha}$ gene on milk performance traits in Black Pied cattle over the course of lactation. We also studied the allele frequency differences of -824A/G variants across several cattle breeds, which were bred in different climatic conditions. The G allele frequency decreased gradually over the course of lactation events in the Black Pied dairy cattle because of a higher culling rate of cows with the G/G genotype (p<0.001). In contrast to the genotypes A/A and A/G, cows with G/G genotype showed significant variability of milk and milk fat yield subject to sex of delivered calf. Milk yield and milk fat yield were significantly higher in the case of birth of a bull calf than with a heifer calf (p<0.03). The G allele frequency varies from 48% to 58% in Grey Ukrainian and Black Pied cattle to 77% in aboriginal Yakut cattle. Our results suggest that the $TNF{\alpha}$-824A/G gene polymorphism may have an influence on the reproductive efforts of cows over the course of lactation events depending on the sex of progeny. Allocation of resources according to sex of the calf allows optimizing the energy cost of lactation. This may be a probable reason for high G allele frequency in Yakut cattle breeding in extreme environmental conditions. Similarly, the dramatic fall in milk production after birth of a heifer calf increases the probability of culling for the cows with the G/G genotype in animal husbandry.

A Study on the Management and Living Environment of the Group-homes for the Elderly -Focusing on Jeonju and Kwangju- (노인그룹홈의 운영과 생활환경에 관한 연구 -전주시와 광주시를 중심으로-)

  • Ahn, Kyung-Ohn
    • Korean Journal of Human Ecology
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    • v.18 no.4
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    • pp.841-855
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    • 2009
  • The main objective of this study is to examine the situations of group-homes for the elderly and clarify the problems of them. This study investigates the present conditions of welfare facilities and supply conditions. 4 group-homes were surveyed in Jeonju and Kwangju cities. Data was collected through various ways including the survey conducted by facility operators, the measurement of living space, and photo-takings. The major results of this study are as follows: 1) With the introduction of nursing care insurance in 2008, the increase of the demand and supply to group-home will be expected, due to less cost for recuperation. The care of elderly in homelike atmosphere is effective to the elderly suffering from dementia. Therefore, it is proper that the supply of group-homes for dementia will be needed. 2) Group-homes for the elderly are being supplied under the standards of welfare facilities in the present. Separate supply standards, however, are needed because they are not suitable for small scale group-homes. 3) To supply Group-homes for the elderly on a one-unit basis would cause various problems such as economical unreality, personnel distribution and so on. It is necessary to supply more than two units for more efficient management. 4) The management of group-homes for the elderly is financially unstable because the operating funds heavily depend on the users or people who are connected with the facilities through private networks. Therefore, additional support is needed to settle the financial problem. It would be helpful to build the public networking that provides information about the group-home for the elderly for the public. 5) In case of the increase in the supply of the group-home in a residential area, it could be helpful to promote the group-home to the public. 6) The operators state that the main problems of group homes for the elderly lie in financial difficulties and the shortage of professionals and volunteers. The financial, personnel, and material support for personnel and the supervision of management are required for the transparency and effectiveness of the facility management. In addition, the closer network and cooperation system with the community is required. 7) The present living environments for group-homes for the elderly leave much room for improvement, considering the physical condition of the elderly. The more careful selections in the color, shape, material, and equipment of the facilities should be made for the convenience of the elderly users.

An Analysis of Accreditation Preparation Process and Costs in Hospitals (의료기관들의 인증평가 준비와 비용지출에 대한 실태분석)

  • Kim, Minji;Jung, Yumin;Kim, Kyungsook;Lee, Sunhee
    • Korea Journal of Hospital Management
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    • v.20 no.3
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    • pp.45-55
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    • 2015
  • While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

A Comparative Study of Knowledge, Attitude, and Experience towards Dental Tourism between Indonesian and Korean People (한국과 인도네시아의 치과 의료관광에 대한 지식, 태도, 경험의 비교)

  • Deasy, Rosalina;Kim, Jong-Yeon;Hong, Seong-Ae
    • Journal of Digital Convergence
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    • v.12 no.3
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    • pp.299-308
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    • 2014
  • Nowadays, dental tourism becomes phenomenon because of its cost-effectiveness, improvement of quality and technology, dental infrastructure, and attractive tourism. Korea as one of popular destination country had established dental system. On the other hand, Indonesia with high number of population is potential market for dental tourism. The aim of this study is to compare the knowledge, attitude, and experience towards dental tourism among Indonesian and Korean. Two cross-sectional descriptive surveys were conducted to collect the data. This study was used one questionnaire in two different languages due to nature of the study population. Data from a total 923 of Indonesian from 33 provinces in Indonesia was collected during the period from April through July 2010. On the other hand, during May until August 2010 data from a total of 312 Korean were obtained. It was found that the majority of participants in both countries had never heard about dental tourism. Among those who had heard about dental tourism, the most common source was internet. Ownership of dental insurance had significant relationship with knowledge of dental tourism among Indonesian while level of education and monthly internet usage had it among Korean (p<0.05). Attitudes of Indonesian and Korean people about dental tourism were negative due to assumption that dental services in their home country were satisfactory. 100% of Korean had no experience on dental treatment in other countries while 2.4% of Indonesian had experience with it. In conclusion, regarding all these evidences, comprehensive and positive information about dental tourism is needed to enhance people's knowledge, attitude, and experience.

Effects of Mobile based-Healthcare Service using Human Coaching to the Self-care of Diabetes (당뇨병 환자의 자가관리를 위한 모바일 기반의 휴먼코칭 헬스케어서비스의 효과)

  • Lee, Mi-Joon;Kang, Hee-Kyung
    • Journal of Convergence for Information Technology
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    • v.7 no.4
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    • pp.83-89
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    • 2017
  • This study aims to investigate the impact of a mobile-based human coaching healthcare service provided for diabetic patients by nurses on their self-management ability. This study collected data from 311 persons who were diagnosed with diabetes from all over the country, and the collected data were analyzed through SPSS Win 23. The results of the study are summarized as follows: First, it was found that the utilization of a glucose meter by the provision of the mobile-based human coaching healthcare service was men group, and there was a statistically significant difference (${\chi}^2=6.059$, p= .048*). Second, there was a positive correlation in the utilization between the glucose meter and an activity tracker band by the provision of the mobile-based human coaching healthcare service, which was statistically significant (r=.660, p< .001). Third, as a result of checking the changes of the utilization of the glucose meter by the provision of the mobile-based human coaching healthcare service, it was maintained between 79% and 41% from Week 1 through 49. In conclusion, this study partially confirmed that the mobile-based human coaching health service was easily accessible and cost-effective in enhancing the participants'self-healthcare ability.

A Comparison between Korean and English News Editorials with Focus on U.S.-North Korea Summit Based on Expressive Language (언어표현 기반의 북미 정상회담에 관한 한미 신문사설의 비교)

  • Noh, Bokyung;Ban, Hyun
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.3
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    • pp.125-130
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    • 2019
  • This research is about alternative measure of main components for sprinkler system like automatic wet pipe sprinkler system, dry pipe sprinkler system, pre-action sprinkler system, vacuum sprinkler system, deluge sprinkler system, and so on. By replacing the alarm check valve, dry valve, pre-operated valve, and deluge open valve with a solenoid valve, it be can be simplifed the various processes of the manufacturing process into one process, it creates an environment in which one standardized product can be produced simultaneously on a single machine. Therefore, it could improve the price competitiveness of products, reduce the maintenance cost, and help the adaptability of new sprinkler systems in the future. There is a benefit when it comes to apply to sprinkler system. Only replace the valve which is used to control primary and secondary valve such as wet, dry, pre operated, vacuum, deluge system valve. Other components such as retarding chambers, automatic air compressors, accelerators or adjusters, supervisory panels, vacuum pumps, and manual starters can be used as they are, so they can be easily applied to existing sprinkler system. It is needed to legal and institutional study for solenoid valve applied sprinkler system to commercialize.

A Study of Perceptions among Middle-aged and Older Koreans about Dying Well: Focusing on Typology (중노년층의 좋은 죽음에 대한 인식: 유형화를 중심으로)

  • Lee, Sunhee;Chung, Kyunghee
    • 한국노년학
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    • v.39 no.2
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    • pp.305-323
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    • 2019
  • In recognition of the increasing social attention paid to the notion of how to die well, this study explored what it is that middle-aged and older Koreans think of as "dying well." Specifically, it was aimed at classifying the perceptions people middle-aged and older have regarding dying well. To this end, we used data from the National Survey on Well-Dying, which was conducted in 2018 by the Korea Institute for Health and Social Affairs, and employed Latent Class Analysis. The demographic characteristics of each of the classified subgroups were identified through technical statistics. The types identified were multilayered depending on the imminence of death, perspectives of the last stages before dying, and the meaning of death in the context of social relationships. These types differed according to gender and subjective health conditions. Based on our findings in this study, we put forward policy suggestions about awareness improvement of personal and social levels, promoting on comprehensive death preparation, providing a system to reduce the cost of medical and nursing expense at the end of one's life, promoting of the right to self-determination regarding death, raising social attention to groups that are least prepared for dying well.