• Title/Summary/Keyword: benefit groups

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Utilization Patterns and Determinants of Oriental Medical Services : Focused on the Residents of Taegu City (한방의료의 이용행태 및 이용결정요인 분석 - 일부 대도시 지역주민을 중심으로 -)

  • Yoo Wang-Keun;Ryu Kyung-A
    • Journal of Society of Preventive Korean Medicine
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    • v.4 no.2
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    • pp.1-24
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    • 2000
  • This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

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Review of Allowable Condition of the Discretionary not Covered Service (임의비급여 허용요건에 관한 검토)

  • Park, Tae-Shin
    • The Korean Society of Law and Medicine
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    • v.13 no.2
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    • pp.11-38
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    • 2012
  • The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

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Commercial fishery assessment of Malaysian water offshore structure

  • Mohd, Mohd Hairil;Thiyahuddin, Mohd Izzat Mohd;Rahman, Mohd Asamudin A;Hong, Tan Chun;Siang, Hii Yii;Othman, Nor Adlina;Rahman, Azam Abdul;Rahman, Ahmad Rizal Abdul;Fitriadhy, Ahmad
    • Fisheries and Aquatic Sciences
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    • v.25 no.9
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    • pp.473-488
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    • 2022
  • To have a better understanding of the impact of the PETRONAS oil and gas platform on commercial fisheries activities, Universiti Malaysia Terengganu (UMT) examined two approaches which are data collection from satellite and data collection from fishermen and anglers. By profiling the anglers who utilize reefed oil and gas structures for fishing, it can determine if the design and location of the reef platforms will benefit or negatively impacts those anglers and fisherman. Furthermore, this assessment will be contributing to the knowledge regarding the value of offshore oil and gas platforms as fisheries resources. Collectively, the apparent fishing activity data included, combined with the findings in the reefing viability index will help to inform PETRONAS's future decommissioning decisions and may help determine if the design and proposed locations for future rigs-to-reefs candidates would benefit commercial fishing groups, further qualifying them as appropriate artificial reef candidates. The method applied in this study is approaching by using a data satellite known as Google's Global Fishing Watch technology, which is one of the applications to measure commercial fishing efforts around the globe. The apparent commercial fishing effort around the selected twelve PETRONAS platforms was analyzed from January 2012 to December 2018. Using the data collection from fishermen which is the total estimation of commercial fish value cost (in Malaysia ringgit, MYR [RM]) in Peninsular Malaysia Asset, Sabah Asset, and Sarawak Operation region. The data were extracted every month from 2016 to 2018 from the National Oceanic and Atmospheric Administration database. Most of the selected platforms that show a high frequency of vessels around the year are platform KP-A, platform BG-A and platform PL-B. The estimated values of commercial fishes varied between platforms, with ranged from RM 10,209.92 to RM 89,023.78. Thus, platforms with high commercial fish value are selected for reefing in-situ and will serve multi-purposes and benefit the locals as well as the country. The current study has successfully assessed the potential reefing area of the Malaysian offshore environment with greater representativeness and this paper focused on its potential as a new fishing ground.

Prospective Randomized Trial for Postoperative Adjuvant Chemotherapy in Gastric Cancer Patients without Serosal Invasion -Preliminary Report- (장막 침윤이 없는 위암 환자에서 수술 후 보조적 화학 요법에 대한 전향적 연구 -중간 보고-)

  • Kim Yong-Ho;Kim Byung-Sik;Lee Chang-Hwan;Kim Wan Su;Yook Jung-Whan;Oh Sung-Tae;Park Kun-Choon
    • Journal of Gastric Cancer
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    • v.1 no.4
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    • pp.221-227
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    • 2001
  • Purpose: We have carried out prospective randomized clinical trial to compare survival benefit and side effect among three postoperative adjuvant chemotherapeutic regimens in serosa-negative gastric cancer patients. Materials and Methods: Total 317 cases were recognized as serosa negative and randomized into three groups at operating room. Out of them, 172 cases were excluded because of various reasons and 135 cases were analyzed finally; Group A 36 cases, Group B 49 cases, Group C 50 cases. Group A were treated with intravenous FP combination therapy, group B with MF combination therapy and group C with oral $UFT^{(R)}$ (mixture of Tegafur and Uracil) for one year. The median follow-up period was 30 months. Results: $88.9\%$ of Group A, $83.7\%$ of Group B and $90.4\%$ of Group C received adequate chemotherapy. The complication rates of Group A ($44.4\%$) was significantly higher than group B ($20.4\%$) and group C ($24.0\%$)(P<0.05). Most frequent complications were nausea and vomiting. The 3-year survival rates and disease-free survival rates were $92.2\%$ and $89.9\%$ respectively (Group A: $96.6\%,\;87.8\%$, B: $90.3\%,\;87.7\%$, C: $95.7\%,\;93.8\%$). There were no significant differences in survival rate and disease-free survival rate among the three groups (P>0.05). Conclusion: This study might suggest that the survival benefit of postoperative adjuvant chemotherapy for gastric Pseudomonas aeruginosa, and therefore it may be a useful adjunct tool for detection of Pseudomonas aeruginosa infection in combination with other conventional techniques.

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Anti-adherence of Antibacterial Peptides and Oligosaccharides and Promotion of Growth and Disease Resistance in Tilapia

  • Peng, K.S.;She, R.P.;Yang, Y.R.;Zhou, X.M.;Liu, W.;Wu, J.;Bao, H.H.;Liu, T.L.
    • Asian-Australasian Journal of Animal Sciences
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    • v.20 no.4
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    • pp.569-576
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    • 2007
  • Four hundred and fifty tilapias ($6.77{\pm}0.23$ g) were assigned randomly to six groups to evaluate the feasibility of the tested antibacterial peptides (ABPs) and oligosaccharides as substitutes for antibiotics. The control group was fed with a commercial tilapia diet; other five groups were fed with the same commercial diet supplemented with konjac glucomannan (KGLM), cluster bean galactomannan (CBGAM), and three animal intestinal ABPs derived from chicken, pig and rabbit at 100 mg/kg respectively. After 21 days of feeding, growth, disease resistance, and in vivo anti-adherence were determined. Furthermore, the inhibitory effect of tested agents on adhesion of Aeromonas veronii biovar sobria (A.vbs) strain BJCP-5 to tilapia enteric epithelia in vitro was assessed by cell-ELISA system. As a result, the tested agents supplemented at 100 mg/kg show significant benefit to tilapia growth and disease resistance (p<0.05), and the benefit may be correlated with their interfering in the contact of bacteria with host mucosal surface. Although none of the tested agents did inhibit the growth of BJCP-5 in tryptic soy broth at $100{\mu}g/ml$, all of them did inhibit the adhesion of A.vbs to tilapia enteric epithelia in vivo and in vitro. In vitro mimic assays show that three ABPs at low concentrations of $25{\mu}g/ml$ and $2.5{\mu}g/ml$ have the reciprocal dose-dependent anti-adherence effect. The inhibition of ABPs may be correlated with a cation bridging and/or receptor-ligand binding, but not with hydrophobicity. The KGLM and CBGAM inhibited the adherence of BJCP-5 to tilapia enteric epithelia with dose-dependent manner in vitro, and this may be through altering bacterial hydrophobicity and interfering with receptor-ligand binding. Our results indicate that the anti-adherence of the tested ABPs and oligosaccharides may be one of the mechanisms in promoting tilapia growth and resistance to A.vbs.

A Prospective Study with Cage-Only or Cage-with-Plate Fixation in Anterior Cervical Discectomy and Interbody Fusion of One and Two Levels

  • Kim, Sam Yeol;Yoon, Seung Hwan;Kim, Dokeun;Oh, Chang Hyun;Oh, Seyang
    • Journal of Korean Neurosurgical Society
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    • v.60 no.6
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    • pp.691-700
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    • 2017
  • Objective : The authors prospectively analyzed the effect of one-level or two-level anterior cervical discectomy and fusion (ACDF), comparing stand-alone cages and cage-with-plate fixation constructs with respect to clinical outcomes and radiologic changes. Methods : A total of 84 patients who underwent one-level (n=52) or two-level ACDF (n=32) for cervical disc disease and who completed 2 years of follow-up were included in this study. The patients were divided by cervical level and grouped into ACDF-Cage-only and ACDF-Cage-with-plate groups. The following parameters were assessed using radiographs : subsidence, C2-C7 lordosis angle, fusion segment angle, adjacent disc space narrowing, and fusion status. Clinical outcomes were assessed using the neck disability index (NDI) and visual analog scale scores for arm pain. Results : In the comparison of one-level ACDF-cage-only and ACDF-cage-with-plate groups, the NDI score was better in the cage-only group at the 3-, 12-, and 24-month follow-ups : however, no significant difference in clinical outcomes was observed. In the comparison of two-level ACDF-cage-only and ACDF-cage-with-plate groups, no difference in any clinical outcome was observed between the two groups. At the 24-month follow-up, subsidence was observed in 45.8% of patients in the one-level cage-only group and 32.1% of patients in the one-level cage-with-plate fixation group. There was no statistically significant difference in the incidence rate between the two groups (p=0.312). Subsidence in the two-level cage-only group (66.6%) was significantly more frequent than in the two-level cage-with-plate fixation group (30%; p=0.049). The fusion rate for patients in the one-level cage-only group was not significantly different from that in the one-level cage-with-plate fixation group (cage-only, 87.5%; cage-with-plate fixation, 92.9%; p=0.425) ; fusion rate in the two-level patients were also similar between groups (cage-only, 83.3%; cage-with-plate fixation, 95%; p=0.31). Conclusion : Our clinical results showed that for single-level cases, plate fixation had no additional benefit versus cage-only; for two-level ACDF cases, the fusion rate and clinical outcomes were similar, although the cage-with-plate fixation group had a lower incidence of cage subsidence than did the cage-only group. We conclude that physicians should be aware of this possible disadvantage associated with using cervical plates in one-level ACDF. However, in two-level ACDF, subsidence is more likely to occur without plate fixation, and thus the addition of plate fixation should be considered.

Evaluation of Nutrient Intake and Bone Status of Female College Students according to the Calorie Consumption from Coffee Containing Beverage (중부 지역 여대생의 커피 음료를 통한 열량 섭취 수준에 따른 영양 섭취 상태와 골밀도 평가)

  • Yeon, Jee-Young;Bae, Yun-Jung;Kim, Myung-Hee;Jo, Hye-Kyung;Kim, Eun-Young;Lee, Ji-Sun;Kim, Mi-Hyun
    • The Korean Journal of Food And Nutrition
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    • v.22 no.3
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    • pp.430-442
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    • 2009
  • This study was designed to investigate the relationship between the dietary intake according to calorie intake from a coffee containing beverage and the bone health status of 189 female collegians. The study was conducted through questionnaires, anthropometric checkup, 3-days food records and ultrasound measurement of calcaneus bone mineral density. Subjects were divided into three groups: students not drinking coffee(non-coffee group, N=56), students consuming <100 kcal daily from coffee(low-calorie coffee group, N=84), and students consuming $\geq100$ kcal of their total daily calories from coffee(high- calorie coffee group, N=49). There were no significant differences in weight, height, body mass index, body fat and calcaneus bone mineral density among the three groups. The low-calorie coffee group usually drank black coffee or instant coffee mix, and the high-calorie coffee group habitually drank coffee with milk or sugar syrup. There were no significant differences in the mean daily energy and food intake among the three groups. However, vitamin $B_2$(p<0.05) and calcium (p<0.01) intake in the high-calorie coffee group were higher than in the non-coffee group. Also, mean intake of sugars, fish and shellfishes, milks and beverages in the high-calorie coffee group were also significantly higher than in non coffee group(p<0.05). There was no significant difference in the Korean Dietary Diversity Score(KDDS) among the three groups. The main calcium source was milk in all three groups, and milk intake(total and included with coffee) was highest in the high-calorie coffee group. Although no significant difference was apparent between the high-calorie and non-coffee groups concerning anthropometric factors and calcaneus bone mineral density, consumption of coffee may have influenced food and nutrient intake. The results suggest that consumption of milk-supplemented coffee may be of nutritional benefit.

The multi-frequency characteristics of anchovy schools in the east of South Sea of South Korea (남해 동부 멸치어군의 다중주파수 특성)

  • Park, Yeongguel;Seo, Young-Il;Oh, Taeg-Yun;Park, Junseong;Jang, Choong-Sik;Kang, Myounghee
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.51 no.2
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    • pp.235-244
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    • 2015
  • The multi-frequency characteristics of anchovy schools were investigated using six acoustic lines collected at 38 and 120 kHz while a primary trawl survey was conducted from 14 April and 18 April of 2014 in off the coast of Tongyeong and Geo-je. Here, the frequency characteristics mean ${\Delta}MVBS$ that is the difference of Mean Volume Backscattering Strength at two frequencies. To use the characteristics effectively, the optimal cell size ($10{\times}2m$) was determined by examining several different cell sizes in consideration with the shapes of fish schools and the ${\Delta}MVBS$ pattern. By examining 6 histograms of ${\Delta}MVBS$, afternoon groups were occupied more in the ${\Delta}MVBS$ range of -6~-4 dB than that of -4~-2 dB, comparing to morning groups. The ${\Delta}MVBS$ range of the morning groups was between -16.9 dB and 11.6 dB, and that of the afternoon groups -16.7 dB and 13.0 dB. The average and standard deviation were $-3.9{\pm}3.6$ dB in the morning and $-4.1{\pm}3.4$ dB in the afternoon, suggesting that morning groups were 2 dB higher than afternoon groups. The ${\Delta}MVBS$ range of all anchovy schools regardless of morning and afternoon was between -16.9 dB and 13.0 dB, their average ${\Delta}MVBS$ was $-4.1{\pm}3.5$ dB. The characteristics can support to identify anchovy species in the waters where multiple fish species are distributed. It is hoped that this study presents the availability and benefit of acoustic data from a primary trawl survey.

Investigation of Risk Acceptance and Expectations in Facial Allotransplantation (안면 동종이식에 대한 위험 승인도와 기대치 조사)

  • Park, Sang-Ryul;Kim, Ji-Hoon;Hwang, Jae-Ha;Kim, Kwang-Seog;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.555-560
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    • 2010
  • Purpose: Facial allotransplantation (FA) could provide an excellent alternative to current treatments for facial disfigurement. However, despite being technically feasible, there continues to be various ethical and psychosocial issues associated with the risks and benefits of performing FA. The purpose of this study is to investigate risk acceptance and expectations in FA. Methods: In a quantitative assessment of risk versus benefit with respect to FA, from 2004 to 2008, Barker et al. developed and published a questionnaire-based instrument (Louisville Instrument for Transplantation [LIFT]), which contained 237 standardized questions. In the current study, the authors assessed risk versus benefits and expectations of FA using a Korean version of the LIFT. Respondents in three study groups (lay public, n=140; medical students, n=120; doctors, n=34) were questioned about risk acceptance as related to immunosuppression and tissue rejection, and expectations as related to quality of life improvement, and functional and aesthetic outcomes. A summary of the data has been provided and statistical analyses were performed. Results: Among the three study groups, results indicated that doctors accept the least amount of risk for a facial allotransplant, followed by medical students, and finally lay public. There was a significant statistical difference in three of the four questions regarding risk acceptance between the groups (p < 0.05). In general, lay public exhibited higher expectations for facial allotransplantation than the other groups. Additionally, there was a significant statistical difference in the importance of aesthetic outcome between the groups (p < 0.05). Conclusion: The authors' data indicate the three populations have vastly different levels of risk acceptance and expectations with regard to FA. Therefore, it is very important that surgeons establish clear, open, and thorough communication with patients in their consultations regarding FA. This is particularly important with respect to whether or not a patient's level of risk acceptance and expectations are progmatic.

Clinicopathological Features of Patients with Malignant Mesothelioma in a Multicenter, Case-Control Study: No Role for ABO-Rh Blood Groups

  • Utkan, Gungor;Urun, Yuksel;Cangir, Ayten Kayi;Kilic, Dalokay;Ozdemir, Nuriye Yildirim;Oztuna, Derya Gokmen;Bulut, Erhan;Arslan, Ulku Yalcintas;Kocer, Murat;Kavukcu, Sevket;Icli, Fikri
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.249-253
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    • 2013
  • Background: Malignant mesothelioma (MM) is an aggressive tumor of mesothelial surfaces. Previous studies have observed an association between ABO blood groups and risk of certain malignancies, including pancreatic and gastric cancer; however, no information on any association with MM risk is available. The aim of this study was to investigate possible associations amoong MM clinicopathological features and ABO blood groups and Rh factor. Materials and Methods: In 252 patients with MM, the ABO blood group and Rh factor were examined and compared with the control group of 3,022,883 healthy volunteer blood donors of Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with various clinicopathological features were also evaluated in the patient group. Results: The median age was 55 (range: 27-86) and 61.5% of patients were male. While 82.8% of patients had a history of exposure to asbestos, 60.7% of patients had a smoking history. Epithelioid (65.1%) was the most common histology and 18.7% of patients had mixed histology. Overall, the ABO blood group distribution of the 252 patients with MM was comparable with the general population. The median overall survival (OS) was 14 months (95% confidence interval, 11.3-16.6 months). The median OS for A, B, AB, and O were 11, 15, 16, and 15 months respectively (p=0.396). First line chemotherapy was administered to 118 patients. The median OS of patients on pemetrexed or gemcitabine was longer than patient who was not administered chemotherapy [17 months (95%CI, 11.7-22.2) vs. 9 months (95%CI, 6.9-11.0); p<0.001]. Conclusions: The results of this study suggest that patients with MM can benefit from treatment with pemetrexed or gemcitabine in combination with cisplatin. We did not observe a statistically significant association between ABO blood group and risk of MM.