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Retrospect and Prospect of Medical Law 20th Anniversary (Medical Criminal Law) (의료법학 20주년 회고와 전망(의료형법 분야))

  • Ha, Tae Hoon
    • The Korean Society of Law and Medicine
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    • v.20 no.3
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    • pp.47-79
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    • 2019
  • The Korean Society of Law and Medicine has faithfully played the role of professional academic organizations last 20 years in terms of academic activities, accumulated achievements, diversity, professionalism, and influence on academic circles. The Korean Society of Law and Medicine and the Journal of Medical Law serve as a platform for academic information and exchange of opinions on medical law. Medical law began in the midst of increasing conflicts and disputes caused by medical malpractice and the enactment and legal coercion of medical care as pressure on medical workers. It tried to find a way to coexist with each other through the encounter and convergence of medicine and law. Medical criminal law extends from traditional crimes in the realm of life and body protection to bioethics violations caused by the development of biomedical technology, corruption and economic crime in the medical field. Medical law has evolved into a comprehensive legal area dealing with legal issues raised in medical treatment, healthcare, bioethics, and life sciences technology. On the legal side, medical law is not independent legal areas. It is overlapping with traditional law areas such as civil law, administrative law, criminal law, social law, civil and criminal procedure law. However, it is now established as a convergence study in medicine, bioethics, life science, as well as in various fields of law. It has become an area where collaboration is needed with the field of law, medicine, ethics, sociology and economics. Medical criminal law has undergone a dynamic development over the last two decades. The development of medicine and medical technology provides new and innovative methods of diagnosis and treatment. The achievements and risks of revolutionary developments in biotechnology, genetic engineering and medicine coexist. While there is a dazzling achievement that mankind has hoped for: combating disease and improving health, it also creates unwanted side effects and risks to humans. There is a need to reconsider ethical and legal principles. The discovery and development of patient identity and autonomy has changed the medical doctor-patient relationship. Furthermore, it was complicated by the triangle relationship of patients, medical doctors and insurance. Legal matters are also complicated. This is why the necessity of legislation is emerging. Criminal punishment provisions are also required. The Medical Law and Biomedical Law are systematically and coherently deformed as mosaic-based legislation that takes place whenever there are social issues, citizens' needs, and medical organizations' interests, rather than sufficient enactment and revision procedures. It needs a complete overhaul, and this is possible through interdisciplinary collaboration which is the strength of The Korean Society of Law and Medicine.

Distribution and Characteristics of Culturable Airborne Bacteria and Fungi in Municipal Wastewater Treatment Plants (하수처리시설에서 배양 가능한 공기중 미생물의 분포 및 특성)

  • Park, Kyo-Nam;Koh, Ji-Yun;Jeong, Choon-Soo;Kim, Jong-Seol
    • Korean Journal of Microbiology
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    • v.47 no.1
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    • pp.38-49
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    • 2011
  • Bioaerosols generated from wastewater treatment plants may create health risks for plant workers and nearby residents. To determine the levels of culturable airborne bacteria and fungi in bioaerosols, samples were seasonally collected above and near the aeration tanks of one feces-urine and three sewage treatment plants in Ulsan, Korea with an impaction-type sampler. In the feces-urine treatment plant, concentrations of heterotrophic bacteria were between $1.3({\pm}0.2){\times}10^3$ and $2.6({\pm}1.2){\times}10^4$ MPN/$m^3$ above the aeration tank and between $1.7({\pm}1.0){\times}10^2$ and $7.2({\pm}2.2){\times}10^3$ MPN/$m^3$ near the aeration tank. Coliform bacteria were detected both above and near the aeration tank. In cases of sewage treatment plant, the numbers of heterotrophic bacteria ranged from $1.9({\pm}1.2){\times}10^1$ to $1.8({\pm}1.2){\times}10^4$ MPN/$m^3$ above the aeration tank and from $5.0({\pm}2.8){\times}10^0$ to $6.6({\pm}2.0){\times}10^3$ MPN/$m^3$ near the aeration tank. At reference sites, the concentrations of heterotrophs in ambient air were measured between $7.0{\times}10^0$ and $2.7{\times}10^1$ MPN/$m^3$. When we isolated and tentatively identified heterotrophic bacteria, Pseudomonas luteola was the most dominant species in bioaerosols from wastewater treatment plants, whereas the most abundant one in reference samples was Micrococcus sp. When we measured fungal concentrations in bioaerosols, they were rather similar regardless of sampling locations and seasons, and such genera as Cladosporium, Alternaria, and Penicillium were commonly identified.

Survey on utilization and demand for national food composition database (식품영양성분 데이터베이스 활용도 및 요구도 조사)

  • Lee, Hyun Sook;Chang, Moon-Jeong;Kim, Hye-Young;Shim, Jee-Seon;Lee, Jung Sug;Kim, Ki Nam
    • Journal of Nutrition and Health
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    • v.51 no.2
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    • pp.186-198
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    • 2018
  • Purpose: This study was performed to evaluate the utilization of a current national Food Composition Database (FCDB) and to investigate demand for nutrients that should be added or supplemented in order to expand the national FCDB. Methods: Surveys were constructed based on the utilization of FCDB, use of a food and nutrition analysis program, utilization and importance of nutritional ingredients, and nutritional ingredients desired to be supplemented in the national FCDB. Self-administered surveys were obtained from 349 food and nutrition specialists, including dietitians, nutrition teachers, food industry workers, professors, and researcher. Results: Exactly 73.6% of respondents used the FCDB, and 90.5% experienced using various food and nutrition analysis programs. Professors and researchers frequently utilized protein, carbohydrate, and lipid nutrients in the FCDB. Among vitamins, vitamin C, vitamin A, and vitamin D were frequently used. Among minerals, sodium and calcium were highly used. Among the subjects, 17.4% of subjects have used phytochemical DB. Carotenoids, anthocyanins, and isoflavones among phytochemicals were frequently used, in that order. Respondents desired an additional data on sugars, vitamin D, folic acid, selenium, iodine, dietary fiber, vitamin $B_{12}$, and carotenoids in the FCDB. Conclusion: The survey results indicate that the current FCDB is actively used for various purposes, although it is necessary to construct a national nutrition database with additional nutrients.

Calculation of Derived Investigation Levels for Uranium Intake (우라늄 섭취의 유도조사준위 산출)

  • Lee, Na-Rae;Han, Seung-Jae;Cho, Kun-Woo;Jeong, Kyu-Hwan;Lee, Dong-Myung
    • Journal of Radiation Protection and Research
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    • v.38 no.2
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    • pp.68-77
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    • 2013
  • Derived Investigation levels(DILs) were calculated to protect the workers from the effects of both radiological hazard and chemical toxicity by uranium intake. Investigation Levels(ILs) of committed effective dose of 2 mSv $y^{-1}-6$ mSv $y^{-1}$ and uranium concentration of 0.3 ${\mu}g$ $g^{-1}$ in kidney, based on Korean Nuclaer Safety Act, Korean Occupational Safety and Health Act and current scientific studies of uranium intake were assumed. DILs of radiological hazard and chemical toxicity were then calculated based on the concentration of uranium in air of workplace, the lung monitoring and urine analysis, respectively. As a result, in case of the nuclear fuel fabrication plant where 3.5% enriched uranium is handled, derived investigation level(DIL) for the control of the concentration of uranium in the air of workplace assumed with 15-min acute inhalation was 0.6 mg $m^{-3}$ for all types of uranium. DILs for the control of the average concentration of uranium in air of workplace, assuming an 8-hour workday, were 15.21 ${\mu}g$ $m^{-3}$ of Type F uranium, 0.41-1.23 Bq $m^{-3}$ and 0.13-0.39 Bq $m^{-3}$ for Type M and Type S uranium, respectively. DILs for the lung monitoring assumed with a period of 6-month interval were 0.37-1.11 Bq and 0.39-1.17 Bq in acute and chronic inhalation for Type M, respectively and 0.30- 0.91 Bq and 0.19-0.57 Bq in acute and chronic inhalation for Type S, respectively. Since a detection limit of typical germanium detector for the measurement of 235U activity is 4 Bq, DILs calculated for the lung monitoring were not appropriate. DILs for urine analysis, for which an interval was assumed to be 1 month, were 14.57 ${\mu}g$ $L^{-1}$ based on chemical toxicity after acute inhalation. In addition, acute and chronic inhalation of Type M were calculated 2.85-8.58 ${\mu}g$ $L^{-1}$ and 1.09-3.27 ${\mu}g$ $L^{-1}$ based on the radiological hazard, respectively.

Research on the Actual Condition of the radiation Safety Management(RSM) for the Educated Training of the Dental Diagnostics X-ray Generators (교육용 치과 엑스선 발생장치에 대한 방사선 안전 관리 실태 조사)

  • Lee, Mihyeon;Yu, Yunsik;Lee, Jaeseung;Im, Inchul
    • Journal of the Korean Society of Radiology
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    • v.8 no.7
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    • pp.467-477
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    • 2014
  • The purpose of this study is to offer data base for establishment of dental training x-ray generator based safety usage through surveying real radiation safety management state of radiation worker's in plan of operations that have dental training x-ray generators and use it. For it, comprehensive references were surveyed referring reports of current state of regulation technique development and domestic radiation safety evaluation and nuclear related legislation regarding radiation safety management of dental training x-ray generators. On the basis of it, questionnaires were filled in about respondent's general characteristic radiation safety manager's status current state of radiation safety management and the level of knowledge & consciousness. For the study, the survey was conducted to 224 people of radiation safety managers and university graduates training assistants and full-time professors who can treat dental training x-ray generators in education center. through this survey 95 questionnaires were used as analysis materials except the insufficient and omitted responses. As a method of analysis, the frequency and percentage were figured out with the general characteristics and safety manager's status. Chi-square test for frequency and correlation per question analysis and Pearson correlation analysis for crosslevel correlation were done with current state of radiation safety management and knowledge & consciousness level. As a result, running dental training x-ray generators was dealt with by 20's to 40's who have high education level over post undergraduate degree and major in dental hygienic. In addition, female have higher consciousness level for radiation safety management than male. It shows significal linear relation statistically(${\chi}^2$ >5, 0.1${\chi}^2$ >5, 0.3${\chi}^2$ >5, 0.3

A Study on Relationship between Physical Elements and Tennis/Golf Elbow

  • Choi, Jungmin;Park, Jungwoo;Kim, Hyunseung
    • Journal of the Ergonomics Society of Korea
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    • v.36 no.3
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    • pp.183-196
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    • 2017
  • Objective: The purpose of this research was to assess the agreement between job physical risk factor analysis by ergonomists using ergonomic methods and physical examinations made by occupational physicians on the presence of musculoskeletal disorders of the upper extremities. Background: Ergonomics is the systematic application of principles concerned with the design of devices and working conditions for enhancing human capabilities and optimizing working and living conditions. Proper ergonomic design is necessary to prevent injuries and physical and emotional stress. The major types of ergonomic injuries and incidents are cumulative trauma disorders (CTDs), acute strains, sprains, and system failures. Minimization of use of excessive force and awkward postures can help to prevent such injuries Method: Initial data were collected as part of a larger study by the University of Utah Ergonomics and Safety program field data collection teams and medical data collection teams from the Rocky Mountain Center for Occupational and Environmental Health (RMCOEH). Subjects included 173 male and female workers, 83 at Beehive Clothing (a clothing plant), 74 at Autoliv (a plant making air bags for vehicles), and 16 at Deseret Meat (a meat-processing plant). Posture and effort levels were analyzed using a software program developed at the University of Utah (Utah Ergonomic Analysis Tool). The Ergonomic Epicondylitis Model (EEM) was developed to assess the risk of epicondylitis from observable job physical factors. The model considers five job risk factors: (1) intensity of exertion, (2) forearm rotation, (3) wrist posture, (4) elbow compression, and (5) speed of work. Qualitative ratings of these physical factors were determined during video analysis. Personal variables were also investigated to study their relationship with epicondylitis. Logistic regression models were used to determine the association between risk factors and symptoms of epicondyle pain. Results: Results of this study indicate that gender, smoking status, and BMI do have an effect on the risk of epicondylitis but there is not a statistically significant relationship between EEM and epicondylitis. Conclusion: This research studied the relationship between an Ergonomic Epicondylitis Model (EEM) and the occurrence of epicondylitis. The model was not predictive for epicondylitis. However, it is clear that epicondylitis was associated with some individual risk factors such as smoking status, gender, and BMI. Based on the results, future research may discover risk factors that seem to increase the risk of epicondylitis. Application: Although this research used a combination of questionnaire, ergonomic job analysis, and medical job analysis to specifically verify risk factors related to epicondylitis, there are limitations. This research did not have a very large sample size because only 173 subjects were available for this study. Also, it was conducted in only 3 facilities, a plant making air bags for vehicles, a meat-processing plant, and a clothing plant in Utah. If working conditions in other kinds of facilities are considered, results may improve. Therefore, future research should perform analysis with additional subjects in different kinds of facilities. Repetition and duration of a task were not considered as risk factors in this research. These two factors could be associated with epicondylitis so it could be important to include these factors in future research. Psychosocial data and workplace conditions (e.g., low temperature) were also noted during data collection, and could be used to further study the prevalence of epicondylitis. Univariate analysis methods could be used for each variable of EEM. This research was performed using multivariate analysis. Therefore, it was difficult to recognize the different effect of each variable. Basically, the difference between univariate and multivariate analysis is that univariate analysis deals with one predictor variable at a time, whereas multivariate analysis deals with multiple predictor variables combined in a predetermined manner. The univariate analysis could show how each variable is associated with epicondyle pain. This may allow more appropriate weighting factors to be determined and therefore improve the performance of the EEM.

A Survey on the Status of Noisy Working Environment in Manufacturing Industries (제조업 산업장의 소음 작업환경 실태에 관한 조사 연구)

  • Kim, Joon-Youn;Kim, Byung-Soo;Lee, Chae-Un;Jun, Jin-Ho;Lee, Jong-Tae;Kim, Jin-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.16-30
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    • 1986
  • In order to prepare the fundamental data for the improvement of noisy working environments and the effective hearing conservation program on workers exposed to industrial noise, the authors surveyed the working processes and evaluated the noise levels on 56 manufacturing industries in Pusan area from April to July in 1985. The results were summarized as follows : 1. The noise level was the highest in shipbuilding and repairing(95.6 dBA), and followed by steel rolling(94.0 dBA), manufacture of motor vehicles(93.1 dBA), manufacture of fishing nets(92.9 dBA), manufacture of testiles(92.5 dBA), iron and steel foundries(89.3 dBA), manufacture of metal products(89.1 dBA), preserving and processing of marine foods(87.0 dBA), manufacture of rubber products(85.3 dBA), manufacture of plywood(84.9 dBA) and manufacture of paints(84.5 dBA). 2. Among fifty surveyed working processes, the noise level of twenty-one processes (42%) exceeded the threshold limit value for 8 hours per day. 3. As the allowable exposure times by governmental threshold limit values to industrial noise level(dBA), cocking of shipbuilding and repairing and plating(CGL) of steel rolling were the shortest(30 minutes), and followed by assembling(rivet) of manufacture of motor vehicles(1 hour) weaving of manufacture of textiles and shot, machine, pipe laying of shipbuilding and repairing(2 hours). 4. By the result of octave band analysis on noisy working processes in excess of 90 dBA, the sound level was the highest at 2,000 Hz or 4,000 Hz. 5. It was recognized that the measurement of overall sound pressure level was also effective as octave band analysis in evaluating the industrial noise.

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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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A Study on The Content of Liver Protein, Nucleic Acids, and Guanine Deaminase Activity of Mouse During Acute Starvation (급성(急性) 기아(饑餓)마우스의 간단백질(肝蛋白質), 핵산(核酸) 및 Guanine Deaminase 활성(活性)에 관(關)한 연구(硏究))

  • Park, Seung-Hee;Kim, Seung-Won
    • Journal of Nutrition and Health
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    • v.1 no.2
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    • pp.107-115
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    • 1968
  • Number of aspects, not only nutritional but social as well as political involved in human starvation pose nowadays global problems. In order to help establish the minimum nutritional requirements in the daily life of a man and to free people as well from either undernourishment, malnutrition or even starvation many workers have devoted themselves so far on the research programs to know what and how number of metabolic events take place in animals in vivo. It is the purpose of the present paper to examine in effect to what extent both of the protein and nucleic acids (DNA & RNA) together with an enzyme, guanine deaminase, which converts guanine into xanthine and in turn ends up to uric acid as an end product, undergo changes, quantitatively during acute starvation, using the mouse as an experimental animal. The mouse was strictly inhibited from taking foods except drinking water ad libitum and was sacriflced 24, 48, and 72 hours following starvation thus acutely induced. The animals consisted of two experimental groups, one control and another starvation groups, each being consisted of 6-24 mice of whose body weights ranged in the vicinity of 10 g. The animals were sacriflced by a blow on the head, followed by immediate excision of their livers into ice-cold distilled water, washing adherent blood and other contaminant tissues. The liver was minced foramin, by an all-glass homogenizer immersing it in an ice-bath, followed by subsequent fractionatin of the homogenate (10% W/V in 0.25M sucrose solution made up with 0.05M phosphate buffer of pH 7.4). For the liver protein and guanine deaminase assay, the 10% homogenate was centrifuged at 600 x g for 10 minutes to eliminate the nuclear fraction; and for the estimation of DNA and RNA, the homogenate was prepared by the addition of 10% trichloroacetic acid in order to free the homogenate from the acid-soluble fraction, the remaining residue being delipidate by the addition of alcohol and dried in vacuo for later KOH (IN) hydrolysis. The changes in body and liver wegihts during acute starvation were checked gravimetrically. Protein contents in the liver were monitored by the method of Lowry et al; and guanine deaminase activities were followed by the assay of liberated ammonia from the substrate utilizing the Caraway's colorimetry. The extraction of both DNA and RNA was performed by the Schmidt-Thannhauser's method, which was followed by Marmur's method of purification for DNA and by Chargaff's method of purification for RNA. The determinations of both DNA and RNA were carried out by the diphenylamine reaction for the former and by the orcinol reaction for the latter. The following resume was the results of the present work. 1. It was observed that the body as well as liver weights fall abruptly during starvation, and that the loss of body weight showed no statistical correlation with the decreases in the content of liver protein. 2. The content of liver protein and activity of liver guanine deaminase activity as well decline dramatically, and the specific activities of the enzyme (activity/protein), however, decreased gradually as starvation proceeded. 3. Both of the nucleic acids, DNA and RNA, showed decrements in the liver of mouse during acute starvation; the latter, however, being more striking in the decline as compared to the former. 4. The decreases in the liver protein content as resulted from the acute starvation had no statistically significant correlation with the decrements of DNA in the same tissue, but had regressed with a significant statistical correlation with the fall of RNA in the tissue. 5. The decrease in the activity of guanine deaminase in the liver of mouse during acute starvation was functionally more proportional to the decrease in RNA than DNA, and moreover correlated with the changes in the content of the liver protein. 6. The possible mechanisms involved during in this acute starvation as bring the decreases in the contents of DNA, protein, and guanine deaminase were discussed briefly.

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A Study on the Children's Eating Habits and Food Preference according to Their Parents' Economic Status (I) - Seoul & Gyeonggi (Incheon) Area - (부모의 경제수준에 따른 자녀의 식습관과 식품기호도에 관한 연구 (I) -서울.경기 (인천)지역을 중심으로-)

  • Chung, Hea-Jung;Eum, Yun-Ho;Kim, Jung-Yoon
    • Journal of Nutrition and Health
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    • v.41 no.1
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    • pp.77-88
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    • 2008
  • This research was carried out a to investigate the food habit and preference of parents' social and economic level with 681 children (145 of Kindergarten, 300 of Children, 236 of Adolescences) in Seoul and Gyeonggi area using question naires. The parents' income level divided into 2 groups, less than 4 million won and equal or greater than 4 million won. Most of the middle years were over-weighing but kindergarten and adolescences had standard weights. The majority of parents had Bachelor degrees, most of father were office workers, majority of mothers of kindergarten with parents' income level less than 4 million won were professional women and mothers of the rest of the groups were mostly house wives. The middle years with parents income level less than 4 million son were skipping meals most frequently, but other groups didn't show much differences in their eating habits. All age groups showed that they like meats the most and dislike vegetables the worst. All age groups also showed that they mostly eat out 1-2 times a week and the next was 3-4 times a week. All age groups preferred ice creams, fruits, juices and snacks for their desserts. The middle years with parents' income equal or greater than 4 million won also showed high preference on strawberry and chocolate flavored milk, burgers and pizzas. The food s that preferred to eat when dining out were Chinese foods (Ja-jang-myeon and sweet and sour pork) for kindergarten group, Korean foods (kalbi and bulgogi) for the middle years with parents' income level less than 4 million won, family restaurant food (steak and rib) for the middle years with parents' income level equal or greater than 4 million won and Korean foods (kalbi and bulgogi) for the adolescences. The preferred cooking methods were roast (fish and sea weeds) for the kindergarten, roasted meat for the middle years, Kimchi and bean paste pot stew for the adolescences with parents' income level less than 4 million won and roasted meats for the adolescences with parents' income level equal or greater than 4 million won. The results showed that the adolescences with higher parental income lever preferred meats.