• Title/Summary/Keyword: standard of review

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The Demands on Parish Nursing Services by Pastors in Busan (부산지역 목회자의 교구간호사업 요구조사)

  • Sohn, Sue-Kyung;Kang, Kyung-Ja;Lee, Jj-Hyun;Lee, Young-Eun;Park, Choon-Hwa
    • Research in Community and Public Health Nursing
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    • v.13 no.1
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    • pp.182-196
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    • 2002
  • The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

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Classification of Landscape Type on Land and Evaluation of Site-suitability Based on It (토지의 경관유형분류와 이에 기초한 입지타당성 평가)

  • Ra, Jung-Hwa;Ku, Ji-Na;Lee, Hyun-Taek;Cho, Hyun-Ju
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.5
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    • pp.57-75
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    • 2011
  • The purpose of this study is to find ways of evaluating the suitability of sites being considered for development of different types of parks in the vicinity of yangmock-myun kyoung buk, where a large project(as large as about14.0$km^2$) has been planned. The results are as follows. Three surveys for selecting the assessment indicators were performed. ${\cdot}$ The first survey analyzed the importance of 23 selected assessment indicators based on a review of existing literature review and an on-the-spot research. ${\cdot}$ The second survey selected assessment indicators for each park type. ${\cdot}$ The third survey computed additive values of selected assessment indicators by the park types. It used a method of standardizing the average importance of indicators by making their sum equal to 10. These additive values were then multiplied by each grade of indicators to make a final evaluation. An evaluation of the site-suitability of park types was performed twice. The purpose of the first evaluation was to figure out how much each type met the minimum requirements targeted for all landscape types. The minimum requirements were derived by using a relative comparison between the standard of value rating of the assessment indicators, which was over the medium magnitude on the importance analysis, and the result of field research. A second evaluation estimated the targeted sites that met the minimum requirements. Value ratings of second assessment indicators were quantitatively divided as 1 to 3 grade and the evaluation scores were added, giving an additive value for each assessment indicator. The evaluation score on each park type was rated on a scale of 1 to 3 according to their averages, (from lowest to highest). Since this evaluation model of the site suitability on park types only focused on the 'face' of space in this study, additional analysis is necessary for setting the evaluation model and incorporating the overall impact of space, network connection and other factors, considering 'spot', 'line' and 'face' aspects of space.

Improvement of Personal Information Protection Laws in the era of the 4th industrial revolution (4차 산업혁명 시대의 개인정보보호법제 개선방안)

  • Choi, Kyoung-jin
    • Journal of Legislation Research
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    • no.53
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    • pp.177-211
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    • 2017
  • In the course of the emergence and development of new ICT technologies and services such as Big Data, Internet of Things and Artificial Intelligence, the future will change by these new innovations in the Fourth Industrial Revolution. The future of this fourth industrial revolution will change and our future will be data-based society or economy. Since there is personal information at the center of it, the development of the economy through the utilization of personal information will depend on how to make the personal information protection laws. In Korea, which is trying to lead the 4th industrial revolution, it is a legal interest that can not give up the use of personal information, and also it is an important legal benefit that can not give up the personal interests of individuals who want to protect from personal information. Therefore, it is necessary to change the law on personal information protection in a rational way to harmonize the two. In this regard, this article discusses the problems of duplication and incompatibility of the personal information protection law, the scope of application of the personal information protection law and the uncertainty of the judgment standard, the lack of flexibility responding to the demand for the use of reasonable personal information, And there is a problem of reverse discrimination against domestic area compared to the regulated blind spot in foreign countries. In order to solve these problems and to improve the legislation of personal information protection in the era of the fourth industrial revolution, we proposed to consider both personal information protection and safe use by improving the purpose and regulation direction of the personal information protection law. The balance and harmony between the systematical maintenance of the personal information protection legislation and laws and regulations were also set as important directions. It is pointed out that the establishment of rational judgment criteria and the legislative review to clarify it are necessary for the constantly controversial personal information definition regulation and the method of allowing anonymization information as the intermediate domain. In addition to the legislative review for the legitimate and non-invasive use of personal information, there is a need to improve the collective consent system for collecting personal information to differentiate the subject and to improve the legislation to ensure the effectiveness of the regulation on the movement of personal information between countries. In addition to the issues discussed in this article, there may be a number of challenges, but overall, the protection and use of personal information should be harmonized while maintaining the direction indicated above.

Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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Function and Use Evaluation of 'Classification & Disposal Schedule Management' in the Standard Records Management System (표준 기록관리시스템의 '기준관리' 기능 및 이용 평가)

  • Chung, Sang-hee
    • The Korean Journal of Archival Studies
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    • no.37
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    • pp.189-237
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    • 2013
  • Since central governments began to establish and use the Standard Records Management System(RMS) in 2007, more and more local governments and other public organizations have constructed RMS. RMS is the essential tool for records management in electronic environments, but it is not known how well the functions of RMS reflect standards and practice related records management or how many records managers use RMS in performing their works. This paper deals with analyzing the evaluation of 'classification & disposal schedule management' function in RMS. 'Classification & disposal schedule management' function has 4 subfunctions of review of classification & preservation period, management of the schedule items, assignment of classification scheme and reclassification. Classification and disposal schedule is at the heart of intellectual control of records and core area of records management. So it is important to analyze whether this function plays well a role in RMS or not. This research carried out evaluation of function and use about classification & disposal schedule management in RMS. Functional evaluation is to compare and analyze how well RMS meets the functional requirements which home and foreign standards give. Use evaluation is to investigate how records managers use RMS in accomplishing their task of managing classification & disposal schedule and to look into what is the problem with the use. This paper could get the implications through the survey of records managers who are working at central governments, regional local governments and basic local governments. And these implications are considered in institutional, functional, use and administrative aspect. It is important to communicate with stakeholders so that 'classification & disposal schedule management' function, further, all functions of the RMS in practice of records management could be used smoothly. Users of RMS have to raise demands or call for technical solutions of the problems which come up in use, while RMS developers and administrators must make more of an effort to satisfy their demands, reflect them on the RMS and enhance the system.

LI-RADS Treatment Response versus Modified RECIST for Diagnosing Viable Hepatocellular Carcinoma after Locoregional Therapy: A Systematic Review and Meta-Analysis of Comparative Studies (국소 치료 후 잔존 간세포암의 진단을 위한 LI-RADS 치료 반응 알고리즘과 Modified RECIST 기준 간 비교: 비교 연구를 대상으로 한 체계적 문헌고찰과 메타분석)

  • Dong Hwan Kim;Bohyun Kim;Joon-Il Choi;Soon Nam Oh;Sung Eun Rha
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.331-343
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    • 2022
  • Purpose To systematically compare the performance of liver imaging reporting and data system treatment response (LR-TR) with the modified Response Evaluation Criteria in Solid Tumors (mRECIST) for diagnosing viable hepatocellular carcinoma (HCC) treated with locoregional therapy (LRT). Materials and Methods Original studies of intra-individual comparisons between the diagnostic performance of LR-TR and mRECIST using dynamic contrast-enhanced CT or MRI were searched in MEDLINE and EMBASE, up to August 25, 2021. The reference standard for tumor viability was surgical pathology. The meta-analytic pooled sensitivity and specificity of the viable category using each criterion were calculated using a bivariate random-effects model and compared using bivariate meta-regression. Results For five eligible studies (430 patients with 631 treated observations), the pooled per-lesion sensitivities and specificities were 58% (95% confidence interval [CI], 45%-70%) and 93% (95% CI, 88%-96%) for the LR-TR viable category and 56% (95% CI, 42%-69%) and 86% (95% CI, 72%-94%) for the mRECIST viable category, respectively. The LR-TR viable category provided significantly higher pooled specificity (p < 0.01) than the mRECIST but comparable pooled sensitivity (p = 0.53). Conclusion The LR-TR algorithm demonstrated better specificity than mRECIST, without a significant difference in sensitivity for the diagnosis of pathologically viable HCC after LRT.

Radiotherapic Valuation of Paraffin Wax for Patients with Oral Cancer (구강암 환자 치료시 치과용 기초상 왁스(Paraffin Wax)의 유용성 평가)

  • Na, Kyoung-Su;Seo, Seuk-Jin;Lee, Je-Hee;Yoo, Sook-Heun
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.41-49
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    • 2011
  • Purpose: This study is designed to investigate radiotherapic valuation of Paraffin Wax, which is newly formed for this study and generally utilized in dentistry, and Mouth Piece and Putty impression, which are commonly used in radiotherapy, for oral cavity as a compensator. Materials and Methods: Each compensator was formed by $10{\times}10{\times}1cm$ and measured radiation dose attenuation ratio with reference of water phantom which is made of tissue-equivalent materials. Two patients with oral cancer underwent DRR (Digitally Reconstructed Radiogrph) of Offline Review Program of Aria System and Portal vision for 5 times for each material to evaluate reproducibility by each filling materials. Moreover, MU (monitor unit) changes by dose absorption were considered in the case of inevitable implication of an filling materials in the range for radiotherapy. Results: Radiation dose attenuation ratios were shown -0.7~+3.7% for Mouth Piece, +0.21~+0.39% for Paraffin Wax and -2.71~-1.76% for Putty impression. Error ranges of reproducibility of positions were measured ${\pm}3mm$ for Mouth Piece, ${\pm}2mm$ for Paraffin Wax and ${\pm}2mm$ mm for Putty impression. Difference of prescription MU from dose absorption with an filling material increased +7.8% (250 MU) in Putty impression and -0.9% (230 MU) in Paraffin Wax as converted into a percentage from the standard phantom, Water 232 MU. Conclusion: Dose reduction of boundary between cavity and tissue was observed for Mouth Piece. Mouth Piece also had low reproducibility of positions as it had no reflection of anatomy of oral cavity even though it was a proper material to separate Maxilla and Mandible during therapy. On the other hand, Putty impression was a suitable material to correctly re-position oral cavity as before. However, it risked normal tissues getting unnecessary over irradiation and it caused radiation dose decrease by -2.5% for 1cm volume in comparison of it of water phantom. Dose reduction in Paraffin Wax, Fat Tissue-Equivalent Material, was smaller than other impressions and position reproducibility of it was remarkable as it was possible to make an anatomy reflected impression. It was also well fitted to oral cavity to transfer radiation dose planned in radiotherapy. Thus, Paraffin Wax will be an ideal material in radiotherapy for patients with oral cancer.

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The Characteristic of Research Regulation in Recent Japanese Medical World (최근 일본의 의학계 연구규율의 특색)

  • Song, Young-mi
    • The Korean Society of Law and Medicine
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    • v.20 no.2
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    • pp.173-206
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    • 2019
  • This research examines the characteristic of regulation on Japanese clinical research in recent years. First, Japan has had a severe punishment policy on research misconduct like Korea, but, in recent days, Japan has changed the direction of research ethics policy from restriction to research publicness securement by educational training, in addition, Act of Clinical Research, effected April 2018, has recruited excellent researchers, and then integrated clinical research and medicine clinical trial through raising transparency of funding and integrating ethics screening by mandating announcement on funding information of clinical research. Second, Japan has integrated and organized ethics guideline from dual system that consists of ethics guideline on dynamic research(here after, referred to as 「dynamic guideline」) and ethics guideline on clinical research(here after, referred to as 「clinical guideline」) to ethics guideline on medical research aimed at human(here after, referred to as 「integrated guideline」), thus, it complements repetition and deficit of ethics guideline needed in clinical research and dynamic research, and it has risk evaluation system for protecting human subjects, and also it clarifies the concept of 「invasiveness」, a preliminary consideration of evaluation. 「Evaluation issue of risk and profit」, common contents of international regulation related clinical research, is the method to check whether the research is designed appropriately or not, this is the method for Institutional Review Board to decide whether the risk on human subjects could be justified, and also this is the important standard for future human subjects to participate in clinical trial. Therefore, it is meaningful to define 「invasiveness」 concept, a preliminary consideration of risk evaluation for human subjects. This research examines Japanese clinical trial focusing on change of awareness on prevention of research misconduct, efficiency improvement of research through research screening and integration of human subjects, and clarification and extension of range of 「invasiveness」 concept, a preliminary of risk evaluation to protect human subjects.

A Comparison of Segmental Gastrectomy and Distal Gastrectomy with Billroth I Reconstruction for Early Gastric Cancer That's Developed on the Gastric Body (위체부에 발생한 조기위암에서 위구획절제술과 Billroth I 재건술식의 비교)

  • Song, Min-Sang;Lee, Sang-Il;Sul, Ji-Young;Noh, Seung-Moo
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.207-214
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    • 2009
  • Purpose: Subtotal distal gastrectomy has been accepted as the standard treatment for early gastric cancer that's developed on the gastric body. EMR and ESD have been introduced to minimize the incidence of postgastrectomy syndrome, but these procedures can not detect lymph node metastasis and they have a risk for gastric perforation. Segmental gastrectomy has recently been applied for treating early gastric cancer, but its usefulness has not been clarified. The aim of this study was to compare segmental gastrectomy and distal gastrectomy with Billroth I reconstruction for treating early gastric cancer that's developed on the gastric body. Materials and Methods: We performed a retrospective review of all the patients who were diagnosed as having early gastric cancer that developed on the gastric body at Chungnam National University Hospital from January 2004 through July 2007. During this period, 41 patients received segmental gastrectomy and 40 patients underwent subtotal distal gastrectomy. All the patients were studied via a biannual review of the body systems, a physical examination, endoscopy, computed tomography and the laboratory findings. Results: There were no significantly differences of the clinicopathologic characteristics between the two groups. The changes of the nutritional status (Hb, TP, Alb and TC) and the body weight change were not significantly different between the 2 groups. There were significantly more residual food in the SG group than that in the SDG group (RGB classification, Residual>Grade 2), but there were no differences for epigastric discomfort (P>0.05). Esophagitis developed at a similar rate for both two groups (LA classification, >Grade A), and bile reflux was found in only one patient of each group. Conclusion: We expected the reduction of esophagitis and gastritis and the improvement of nutritional status according to the type of procedure. Yet the results of our study showed no significant differences between the two study groups. More patients and a longer follow up time are needed for determining the advantage sand disadvantages of segmental gastrectomy.

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CT Examinations for COVID-19: A Systematic Review of Protocols, Radiation Dose, and Numbers Needed to Diagnose and Predict (COVID-19 진단을 위한 CT 검사: 프로토콜, 방사선량에 대한 체계적 문헌고찰 및 진단을 위한 CT 검사량)

  • Jong Hyuk Lee;Hyunsook Hong;Hyungjin Kim;Chang Hyun Lee;Jin Mo Goo;Soon Ho Yoon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1505-1523
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    • 2021
  • Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.