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Potentially Inappropriate Medications and Regimen Complexity on Readmission of Elderly Patients with Polypharmacy: A Retrospective Study

  • Sunmin Lee
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.1
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    • pp.1-7
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    • 2023
  • Background: Along with the increase in the elderly population, concerns about polypharmacy, which can cause medication-related problems, are increasing. This study aimed to find out the association between drug-related factors and readmission in elderly patients within 30 days after discharge. Methods: Data of patients aged ≥65 years who were discharged from the respiratory medicine ward of a tertiary hospital between January and March 2016 were retrospectively obtained. The medication regimen complexity at discharge was calculated using the medication regimen complexity index (MRCI) score, comorbidity status was assessed using the Charlson comorbidity index (CCI), potentially inappropriate medications (PIMs) were evaluated based on the Beer 2019 criteria, and adverse drug events (ADEs) were examined using the ADE reporting system. Multivariable logistic regression analysis was used to evaluate the effect of medication-related problems on hospital readmission after controlling for other variables. Results: Of the 206 patients included, 84 (40.8%) used PIMs, 31 (15%) had ADEs, and 32 (15.5%) were readmitted. The mean age, total medications, MRCI, CCI, and PIMs in the readmission group were significantly higher than those in the non-readmission group. Age significantly decreased the risk of readmission (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.84-0.96) after adjusting for sex, length of hospital stay, and ADEs. The use of PIMs (OR, 2.38; 95% CI, 1.10-5.16) and increased CCI (OR, 1.50; 95% CI, 1.16-1.93) and MRCI (OR, 1.04; 95% CI, 1.01-1.07) were associated with an increased occurrence of readmission. Conclusion: PIMs were associated with a significantly greater risk for readmission than MRCI.

Significance and Method for a More Balanced Development of the Restaurant Franchise Business - Focused on Performance-Sharing Examples Between Franchisor and Franchisee - (프랜차이즈 산업 균형발전의 의미와 방안 -외식 프랜차이즈 가맹본부와 가맹점 성과의 공유사례를 중심으로-)

  • Seo, Min-Gyo;Park, Jong-Hyuk
    • The Korean Journal of Franchise Management
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    • v.5 no.1
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    • pp.65-84
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    • 2014
  • The purpose of this study is to review the theories and cases of performance sharing in the franchise industry to present a method for more effective franchise performance-sharing. To that end, this study reviewed the theory on resource dependence and the theory on inequality to describe the performance-sharing between the franchisor and the franchisee and their relationship. It also looked at the cases of a week-in cooler system at 'Beer Market', the allocation of fees for alcoholic beverage sales to franchisees, the scholarship program of 'Onigiri and Ikyudon' and 'Bonsamo' which is a franchisees' committee for Bonjuk to introduce examples of performance-sharing. Through a theoretical review and case review, this study presents five types of methods for performance-sharing. First, 'the sharing of core competence by the franchise company; second, 'the establishment of a royalty culture'; third, 'scientific analysis of markets and establishment of a revenue forecast system'; fourth, 'reinforced financial support from the franchisor'; and lastly, 'the positive application of franchisees' committees'. Such methods are expected to provide a groundwork for mutual benefit and co-prosperity between franchisor and franchisee.

A Case Study of New Franchise Brand Launching Through Proactive Market Response: BEERBARKET'S Successful Story of INTO FRANCHISE SYSTEMS (선행적 대응을 통한 프랜차이즈 뉴비즈니스 런칭 사례 : (주)인토외식산업의 맥주바켓 성공사례)

  • Seo, Min-Gyo
    • The Korean Journal of Franchise Management
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    • v.3 no.1
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    • pp.111-129
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    • 2012
  • Domestic franchise industry is a promising business to more than 10% per year growth rate and emerging as core of retail. In addition, due to the socio-cultural phenomena, including the retirement of the baby-boom generation, the growth of the franchise industry for some time expected to continue. But Domestic franchise reveals that limits to ensure for new franchisees because that few industries are concentrated to advance for franchisor and franchisees. Franchisors that within the industry came to a saturated, are for the growth and expansion of business into new industries to deploy as second, third brand. But reality is that the more success rather than failure. Therefore, in this study is a new brand development approach and case study results it focus on the BEERBARKET's successful story of INTO FRANCHISE SYSTEMS, INC. Case analysis results of this study, are reveled that franchise headquarters derived through research methods and research information, environmental survey and analysis should be continuously and objectively. Thus, based on the derived contents, the new brand Biz-Model should be established for recognition from the industry and customers. Ability to respond sensitively to changes in the environment and business activities can be associated with linking franchise headquarters belonging to the saturated competitive environment more is needed. Through proactively respond Franchise New business launching instance that BEERBARKET's successful story of INTO FRANCHISE SYSTEMS, INC. suggests the need to study about how to respond to environmental changes.

Analysis of Korean Dietary Patterns using Food Intake Data - Focusing on Kimchi and Alcoholic Beverages (식품섭취량을 활용한 우리나라 식이 패턴 분석 - 김치류 및 주류 중심으로)

  • Kim, Soo-Hwaun;Choi, Jang-Duck;Kim, Sheen-Hee;Lee, Joon-Goo;Kwon, Yu-Jihn;Shin, Choonshik;Shin, Min-Su;Chun, So-Young;Kang, Gil-Jin
    • Journal of Food Hygiene and Safety
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    • v.34 no.3
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    • pp.251-262
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    • 2019
  • In this study, we analyzed Korean dietary habits with food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Centers for Disease Control and Prevention and we proposed a set of management guidelines for future Korean dietary habits. A total of 839 food items (1,419 foods) were analyzed according to the food catagories in "Food Code", which is the representative food classification system in Korea. The average total daily food intake was 1,585.77 g/day, with raw and processed foods accounting for 858.96 g/day and 726.81 g/day, respectively. Cereal grains contributed to the highest proportion of the food intake. Over 90% of subjects consumed cereal grains (99.09%) and root and tuber vegetables (95.80%) among the top 15 consumed food groups. According to the analysis by item, rice, Korean cabbage kimchi, apple, radish, egg, chili pepper, onion, wheat, soybean curds, potato, cucumber and pork were major (at least 1% of the average daily intake, 158.6 g/day) and frequently (eaten by more than 25% of subjects, 5,168 persons) consumed food items, and Korean spices were at the top of this list. In the case of kimchi, the proportion of intake of Korean cabbage kimchi (64.89 g/day) was the highest. In the case of alcoholic beverages, intake was highest by order of beer (63.53 g/day), soju (39.11 g/day) and makgeolli (19.70 g/day), and intake frequency was high in order of soju (11.3%), beer (7.2%), and sake (6.6%). Analysis results by seasonal intake trends showed that cereal grains have steadily decreased and beverages have slightly risen. In the case of alcoholic beverage consumption frequency, some kinds of makgeolli, wine, sake, and black raspberry wine have decreased gradually year by year. The consumption trend for kimchi has been gradually decreasing as well.

Monitoring of Sugar and Low-Calorie Sweetener Content in Alcoholic Beverages (유통 주류의 당류 함량 및 저칼로리 감미료 사용 실태 조사)

  • Young-Sun Cho;Jin-A Jeong;Hye-Jung Kwon;Han-Taek Kim;Ji-Yeon Lee;Hye-Won Lim;Eun-Bin Lee;Hye-Jin Kim;Won-Joo Lee;Myung-Jin Lee
    • Journal of Food Hygiene and Safety
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    • v.39 no.3
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    • pp.281-287
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    • 2024
  • This study investigated the total sugar and low-calorie sweetener content in 72 alcoholic beverages. The samples included 10 takjus, 6 yakjus, 5 cheongjus, 5 beers, 12 fruit wines, 5 sojus, 5 general distilled alcoholic beverages, 9 liqueurs, and 15 other alcoholic beverages. Sugar and allulose content were analyzed using HPLC-RI, and the content of five sweeteners was analyzed using HPLC-UV and LC-MSMS. The average sugar content in the alcoholic beverages was 4.13±5.16 g/100 g. When categorized by type, the sugar content ranged from 0.00 to 8.92 g/100 g, 0.00 to 30.55 g/100 g, and 0.14 to 17.02 g/100 g in fermented (takju, yakju, cheongju, beer, and fruit wine), distilled (soju, general distilled alcoholic beverages, and liqueur), and other alcoholic beverages, respectively. Sugar content was the highest in liqueur, with the average content being 12.41±9.66 g/100 g. Among low-calorie sweeteners, acesulfame potassium, sodium saccharin, aspartame, and sucralose were detected in concentrations ranging from 28.6-121.5, 42.3, 34.1-141.5, and 23.3-88.1 mg/kg, respectively. Cyclamate and allulose were not detected in any of the alcoholic beverages. Sweeteners were detected in 24 out of the 72 alcoholic beverages, and their content complied with the standards stipulated for food additives.

Evaluation of Biogenic Amines in Korean Commercial Fermented Foods (국내 유통 발효식품 중 biogenic amines 함량 분석)

  • Han, Gyu-Hong;Bahn, Kyeong-Nyeo;Son, Yeong-Wook;Jang, Mi-Ran;Lee, Chang-Hee;Kim, So-Hee;Kim, Dae-Byoung;Kim, Seon-Bong;Cho, Tae-Yong
    • Korean Journal of Food Science and Technology
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    • v.38 no.6
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    • pp.730-737
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    • 2006
  • High performance liquid chromatographic methods for the simultaneous determination of 12 biogenic amines were developed and contents of biogenic amines in 23 varieties of Korean commercial fermented food were analyzed. Dansyl derivatives of biogenic amine were very stable and had good peak resolution. Except agmatine, the recovery of biogenic amines from soybean paste with extraction of 0.1 N HC1 added biogenic amines to soybean paste was greater 85%. The calibration curve showed good linearity over a concentration range up to 50 ${\mu}g/mL$. In the determination of biogenic amine level in Korean commercial fermented foods, doenjang and chungkukjang (fermented soybean pastes), soy sauce, anchovy and pacific sand lance liquid jeotkal (fermented fish sauce products), and cabbage kimchi had high level biogenic amines. Especially, traditional doenjang had a histamine (HIS) level of 952.0 mg/kg, a tyramine (TYR) level of 1,430.7 mg/kg. Most cheese had low level of biogenic amines, but one Gouda cheese had a tyramine (TYR) level of 97.5 mg/kg. A low level of biogenic amines was detected in wines, beer, yoghurt, and sausage. Putrescine (PUT), cadaverine (CAD), tryptamine (TRY), histamine (HIS), tyramine (TYR), and 2-phenylethylamine (PHE) were mainly formed in fermented foods by the action of microorganism, so their levels were high with a range. On the other hand, spermidine (SPD), spermine(SPM), serotonin (SER), noradrenaline (NOR), and dopamine (DOP) were formed originally via biosynthesis with consequent low level.

Electrokinetic Studies on Nylon and Wool/Acid Dye System (나일론과 양모/산성염료계에 대한 계면동전위적 연구)

  • 박병기;김진우;김찬영
    • Textile Coloration and Finishing
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    • v.1 no.1
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    • pp.19-25
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    • 1989
  • In past, dye diffusion and dyeing rate in fibers have been emphasized in dyeing phenomena. However, in the light of the properties of colloids in the surface of disperse phase and dispersion, there exist specific characters such as adsorption or electric double layer, which seems to play important roles in determining the physiochemical properties in the dyeing system. Electrostatic bonding, hydrogen bonding and Van der Waals adsorption are common in dyeing as well as covalent bonding. Particularly, electrostatic bonding is premised on the existance of ionic radicals in fibers. The present study was aimed to clarify the electrokinetic phenomena of dyeing through the role of electric double layer by ion in amphoteric fibers with different ionic effects under different pH. Spectrophotometric analysis method was used to compare dyeing condition of surface, which can be detected by electrokinetic phenomena and the inner of fibers after deceleration of dyed fibers. Nylon and wool, the typical amphoteric fibers were dyed with monoazo acid dyes such as C.I. Acid Orange 20, and C.I. Acid Orange 10. Various combinations were prepared by combining pH, temperature and dye concentration, in order to generate streaming electric potential which were measured by microvolt meter and specific conductivity meter. The results were transformed to zeta potential by Helmholtz-Smoluchowski formular and to surface electric charge density by Suzawa formular, surface dye amount, and effective surface area of fibers. The amount of dyes of inner fibers were also measured by the Lambert-Beer’s law. The main results obtained are as follows. 1. By measuring zeta pontential, it was possible to detect the dyeing mechanism, surface charge density, surface dye amount and effective surface area concerning dye adsorption of the amphoteric fibers. 2. Zeta pontential increases in negative at low pH and high dye concentration in the process of dyeing. This implied that there existed ionic bond formation in the dyeing mechanism between acid dyes and amphoteric fibers. 3. Dibasic acid dye had little changing rate in zeta potential due to the difference in solubility of dye and in number of dissociated ions per dye molecule to bond with amino radicals of amphoteric fibers. The dye adsorption of mono basic acid dye was higher than that of dibasic acid dye. 4. The effective surface areas concerning dyeing were $6.3E+05\;cm^2/g$ in nylon, $1.6E+07\;cm^2/g$ in wool fiber being higher order of wool then nylon.

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Nutrient intakes and frequently consumed foods among Korean adults according to the intake frequency of Baechu (Chinese cabbage) kimchi: Based on the 2012~2013 Korea National Health and Nutrition Examination Survey (한국 성인의 배추김치 섭취 빈도에 따른 영양소 섭취 및 다소비 식품 섭취에 관한 연구: 2012~2013년 국민건강영양조사 식품 섭취 빈도 조사 자료를 이용하여)

  • Ha, Ae-Wha;Ju, Se-Young
    • Journal of Nutrition and Health
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    • v.49 no.2
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    • pp.125-133
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    • 2016
  • Purpose: The purpose of this study is to analyze nutrient intake and frequently consumed foods according to the intake frequency of Baechu (Chinese cabbage) kimchi by Korean adults. Methods: Data from analysis of 7,122 subjects aged 19~64 years from 2012, 2013 KNHANES were obtained from health behavior interviews and the 24-hour dietary recall method. Results: With the daily intake frequency of Baechu kimchi, subjects with two times a day were the highest proportion among total subjects. As Baechu kimchi intake frequency of breakfast, lunch, and dinner increased, the rate of skipping meals decreased significantly (p < 0.05). In addition, all food intake and daily nutrient intake increased significantly with increasing frequency of daily Baechu kimchi intake (Crude p for trend < 0.05, Adjusted p for trend < 0.05). With the frequently consumed foods by daily Baechu kimchi intake frequency in 2012 and 2013, among 509 foods top ranked foods were white rice, Baechu kimchi, beer, distilled alcoholic drink, milk, and pork. Conclusion: The results of this study could be used in the future to promote consumption of kimchi in the Korean population.

Breast Cancer in Bedouin-Arab Patients in Southern Israel: Epidemiologic and Biologic Features in Comparison with Jewish Patients

  • Lazarev, Irina;Flaschner, Maayan;Geffen, David B.;Ariad, Samuel
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7533-7537
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    • 2014
  • Background: Breast cancer (BC) is the most frequent cancer type, and the leading cause of death from cancer among women in Israel. The Bedouin-Arab (BA) population in southern Israel is characterized by a high rate of consanguinity, common hereditary disorders, and transition from a semi-nomadic, traditional society to a more sedentary and urbanized society. In this hospital-based study, the demographic and the clinicopathological characteristics of BC in BA were compared with Jewish patients. Materials and Methods: 85 BA patients treated at the Soroka Medical Center, Beer Sheba, during the years 2004-2012, were studied and compared with 180 consecutive Jewish patients treated during the year 2007. Clinicopathological features compared included age, menopausal state, number of births, a history of BC in first-degree relatives, tumor size (T), extent of lymph-node involvement (N), distant metastases (M), stage, grade, estrogen and progesterone receptor (ER/PR), and Her2 status. Types of treatment, relapse rate and site, as well as outcome were also studied. Cox's regression models were applied for studying disease-free, and overall survival. Results: Compared with Jewish patients, BA patients were younger (average age $49{\pm}12$ yrs vs $59{\pm}13$, p<0.001), had a lower rate of BC in first-degree relatives (p<0.001), and a larger number of births ($6{\pm}4.2$ vs $2.5{\pm}1.9$, p<0.001). BA patients had larger tumors (p=0.02), more extensive lymph-node involvement (p=0.002), and more advanced stage (p=0.003). Grade, ER, PR, and Her2 status were similar in the two ethnic groups. Relapse type was most commonly systemic in BA patients (p=0.05), and loco-regional in Jewish patients (p=0.02). Median survival was 63, and 35 months for Jewish and BA patients, respectively (log-rank test, p=0.02). In Cox multivariate analysis, stage and PR status (HR-0.14, p<0.0001; HR-3.11, p=0.046), but not ethnicity, influenced overall survival. Conclusions: BC presents a decade earlier, and with more advanced disease in BA compared with Jewish patients. Biologic parameters including grade, ER, PR, and Her2 status were similar in both groups. Although prognosis was worse in BA than in Jewish patients, it was affected only by stage and PR status, but not by ethnicity.

Colorectal Cancer Risk Factors among the Population of South-East Siberia: A Case-Control Study

  • Zhivotovskiy, Alexey S.;Kutikhin, Anton G.;Azanov, Artur Z.;Yuzhalin, Arseniy E.;Magarill, Yuri A.;Brusina, Elena B.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5183-5188
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    • 2012
  • Colorectal cancer remains one of the most widespread malignancies in the world. However, there is a lack of comprehensive studies considering colorectal cancer risk factors among Russian populations, particularly in Siberia. The aim of this investigation was to determine the impact of various lifestyle, dietary, family, and socioeconomical factors on colorectal cancer risk in South-East Siberia. We recruited 185 Russian colorectal cancer cases and 210 gender-, age-, and ethnicity-matched asymptomatic controls with no history of any malignant tumor, using a specially designed questionnaire to obtain relevant information. After the statistical analysis, we defined several significant factors affecting colorectal cancer risk. Among these were smoking (OR=2.13, 95%CI=1.4-3.24, P=0.0004), being overweight (BMI between 25-30, OR=2.45, 95%CI=1.49-4.03, P=0.0004), alcohol drinking (OR=8.73, 95%CI=5.49-13.87, P<0.0001), beer drinking (OR=9.24, 95%CI=5.14-16.61, P<0.0001), consumption of hard liquor (OR=9.37, 95%CI=5.92-14.82, P<0.0001), excessive red meat consumption (P<0.0001), excessive intake of red meat products (P<0.0001), excessive intake of dairy products (P<0.0001), excessive sour cream and cheese consumption (P<0.0001 and 0.0002, respectively), spicy food consumption (OR=2.87, 95%CI=1.9-4.33, P<0.0001), family history of gastrointestinal malignant tumors (OR=3.99, 95%CI=2.09-7.59, P<0.0001), and income exceeding twice the subsistence minimum (OR=5.34, 95%CI=3.35-8.53, P<0.0001). Certain factors, such as high concentration of salt in the food and precancerous colonic lesions, demonstrated borderline significance (OR=3.45, 95%CI=1.68-7.1, P=0.0008, and OR=5.25, 95%CI=1.94-14.22, P=0.001, respectively). Some factors were established as protective, like consumption of rye bread and both rye and wheat bread (OR=0.32, 95%CI=0.21-0.5, P<0,0001, and OR=0.07, 95%CI=0.02-0.21, P<0.0001, respectively), and also low concentration of salt in the food, although this was of borderline significance (OR=0.43, 95%CI=0.26-0.69, P=0.0006). ABO and Rhesus blood antigens were not associated with increased colorectal cancer risk. These results should be definitely applied for elaboration of programs of colorectal cancer prevention in Russia, particularly in Siberia.