In medium and small firm, the management system which is simple and where there is a practicality is required Ill)re than the management system which is complicated and minute of the centered around large company so that the introduction of the standard costs can be activated and it can be usefully used as a tool of management decisions. A difference between the standard costs introduction plan proposed in this paper and the preexistance study literature are as follows. In this paper, by breaking from the whole cost accounting aiming at all item, that is the traditional introduction method, and presenting the product cost accounting method by group the standards setting object was minimized and simplified. In this way, if the standards setting object is simplified, it is quick at the perimeter environment change as the little man power and flexibly it corresponds to and the cost information calculation which is exact with the setting up and maintenance of the efficient cost standard becomes available. As a result of applying for real through S corp., the usability of the method that the standard costs introduction method proposed in this paper produced the standard costs relatively short within period, it manages was verified. And the standard costs introduction method proposed in this paper went by the various cost information for each products, the management class did the management will decision which was objective and reasonable in the putting first.
Purpose: This research was done to compare obstetric pain, anxiety and cervical dilatation between an epidural analgesia group and a control group. Methods: Participants were assigned to the experimental or control group depending on their decisions for pain relief. Subjective / objective obstetric pain, anxiety level and cervical dilatation were measured and ANOVA was used for comparison of groups and paired t-test to make pre-post comparisons. Results: Homogeneity of pain, anxiety and cervical dilatation were assessed at the latent phase. Cervical dilatation was larger in the control group than the experimental group, at both the active and the transitional phase (F=22.9, p<.001; F=39.9, p<.001 respectively). The degree of pain and anxiety were not significantly different between the groups. Within the experimental group, subjective / objective pain and anxiety level were significantly lower post-analgesia compared to pre-analgesia in the active phase. All variables, except for sweating in the objective pain measurement, changed significantly at the transient phase. Conclusion: The results of this evidence-based research indicate that epidural analgesia while effective in relieving pain and anxiety may have an adverse effect on the cervix during labor stage I. Epidural analgesia should be used carefully during cervical dilatation in labor stage I.
Kim, Chang-Keun;Callaway, Zak;Park, Jin-Sung;Nishimori, Hisashi;Ogino, Tikatoshi;Nagao, Mizuho;Fujisawa, Takao
Allergy, Asthma & Immunology Research
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제10권6호
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pp.686-697
/
2018
Purpose: Several markers for eosinophilic inflammation have been proposed to predict response to asthma treatment. However, definitive criteria for treatment decisions have not yet been established. We investigate a potentially useful relatively non-invasive biomarker, eosinophil-derived neurotoxin (EDN), to predict favorable responses to budesonide or montelukast, common treatment for children with asthma. Methods: Young children (1 to 6 years old) were enrolled in this randomized, parallel, 2-group, open-label trial. Criteria for eligibility included: 1) being symptomatic during the run-in period; and 2) having a serum EDN (sEDN) level ${\geq}53ng/mL$, with positive specific immunoglobulin E to house dust mite. Eligible patients were randomly placed into 2 groups: the BIS group received budesonide inhalation suspension (BIS) 0.5 mg once daily; the MONT group received montelukast 4 mg once daily. Ineligible patients were invited to receive montelukast 4 mg once daily (OBS group). Treatment period was 12 weeks. Results: Asthma control days increased significantly in the BIS and MONT groups (P < 0.000) over the 12-week study period. There was no significant change in sEDN in the BIS group but there was a significant decrease in the MONT group (P < 0.000). Patients in the OBS group with high EDN levels (> 53 ng/mL) showed a significant decrease due to MONT treatment (P = 0.023). Rescue medication usage significantly decreased in the BIS and MONT groups (P < 0.000). Conclusions: EDN is a useful relatively non-invasive biomarker for predicting responses to montelukast and budesonide treatment of preschool children with beta2-agonist responsive recurrent wheeze and multiple-trigger wheeze (Trial registry at UMIN Clinical Trials Registry, UMIN000008335).
Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.
Objective: To investigate the physical appearance and therapeutic changes that occur with the performance of Schroth exercise in patients with scoliosis. Design: Randomized controlled trial. Methods: Fifteen subjects with maximum curvature of the lumbar who were diagnosed with idiopathic scoliosis had volunteered to participate in the study. Eight subjects were included in the experimental group where they performed the Schroth Therapeutic Exercise and the other seven were included in the control group. The experimental group underwent 2 hours of weekly treatment for 12 weeks, while the control group did not during the same period based on the decisions of patients or guardians. The Mann-Whitney rank test was carried out to compare the treatment results of the two groups, and the comparison within the group was done by Wilcoxon signed-rank test. The vertebral rotation angle (VRA) was by Scoliometer, and difference of rotated and curved portion volume (DV) between both sides on the major curvature portion measured by 3D human body scanning system. Results: In the experimental group, 12 weeks of Schroth exercise therapy has significant improved in correction rate (CR) in Cobb's angle (CA), VRA, and DV between both sides on the major curvature portion (p<0.05), while significant differences were not found between the groups regarding weight bearing difference in both feet (WD) and DV (p<0.05). Conclusions: Schroth exercise performance showed significant changes in the patient's therapeutic changes (CA, VRA), but the physical appearance (DV, WD) was not significant, indicating that external changes in the treatment goal setting are more difficult goals to achieve.
Purpose - This study aims to identify the effects of communication cues, anonymity, and social presence on group polarization in computer-mediated communication (CMC) settings. Extant literature has introduced some theoretical backgrounds of social presence and SIDE (Social Identity model of Deindividuation Effects) to explain the effects of communication cues and anonymity. The concept of social presence emphasized the mediating role on communication cues and anonymity. However, most literature did not measure social presence and compare group polarization of all condition groups. This does not sufficiently explain the result of group polarization. Research design, data, and methodology - We believe that the direct impact of anonymity on group polarization can provide a more admissible and clearer explanation for the results. In addition, this study categorizes anonymity into two levels, as anonymity of group and anonymity of self. To justify the anonymity view, a laboratory experiment was conducted. The experiment was conducted in communication cues settings (visual cue; without visual cue) and anonymity settings (identified; anonymous). Each of the four settings has 10 groups consisting of five subjects each (total 200 subjects). The subjects are undergraduates from a large university, majoring in business. All experimental procedures and calculations of choice shift and preference change follow the literature. Results - First, the removal of visual cues does not produce a significant impact on group polarization, which cannot be explained by the social presence view. Second, the anonymous condition does not significantly affect group polarization, which also cannot be explained by the social presence view. However, the anonymous condition directly affects group polarization. Specifically, anonymity of self has a stronger effect on group polarization than anonymity of group. The result explains about the leading factor affecting group polarization. This study examines another view of how computer-mediated communication may be associated with group polarization. The process and outcome data from the experiment reveal that group polarization is not affected by level of social presence, but by level of anonymity. Group discussions conducted with visual cue CMC setting and identified CMC setting result in weaker group polarization. Conversely, group discussions conducted without visual cue CMC setting and anonymous CMC setting lead to stronger group polarization. The results of the study have the following implications. First, they provide clues for business organizations to design the most appropriate media conditions and preemptive social conditions to implement when making group decisions through CMC, to maximize achievements, generate amicable agreements, or actively share information. Second, this study can be useful in analyzing different adverse effects generated through Internet use. Conclusions - This research can help explain discussions and decision-making actions on Internet forums, which have recently increased, as well as providing a foundational basis in newly establishing policies for the forums. Finally, it should be noted that many other factors such as group size, topics, and group history may affect group polarization. These should be examined in future studies.
Korean Government had performed three pilot programs to introduce the long term care insurance system. Persons aged 65 or older who are dependent on others for daily living could use long term care services in the pilot program. The long-term care insurance covered nursing home services, home care services and cash benefits. The cash benefits are included that for elderly at home and for patients in geriatric hospital. This study investigated whether there had been any change in the medical care utilization according to cash benefits for geriatric hospitalization. This study used National Health Insurance claims and Long term Care Insurance claims 2003 through 2006. Data were composed of subjects who undertook both insurance coverage. The subjects was divided into two groups. Case group included participants with the cash benefits of geriatric hospitalization. Control group included persons without the cash benefits selected by random sampling according to the distribution of case group. This study showed that the amount of medical care utilization of the case group is more significantly increased than the control group after adjusted their health condition and functional condition. This result will be helpful for making decisions on whether the cash benefit of geriatric hospitalization can be introduced into long term care insurance system.
Objectives : Clinical data in traditional medicine, such as Korean medicine, traditional Chinese medicine have a long history of accumulating evidence and these rich data are recorded in classic literature. We have conducted a study of developing an algorithm that support clinical diagnosis with composing both users knowledge and data obtained from literature. In order to define necessary information and required steps in diagnosis procedure, we have established a clinical diagnostic procedure including a step of collecting patients symptoms, a step of determining candidates, a step of diagnostic decisions, a step of deciding of treatment and a step of adjusting medicinal treatment. Methods : Our study have been based on the following premises. 1. Using data obtained from literature contributes to accurate diagnosis 2. Displaying the data before users request contributes to accurate conclusion. Displaying before users request enable users to recognize their overlooking a fact on purpose or not. 3. Checking symptoms that are commonly accompanied with a group of diseases that accompany symptoms appealed by a patient contributes to accurate conclusion. These symptoms are worthy of checking. 4. Comparing more than two candidates contributes to accurate conclusion. Users can compare their accompanied symptoms with patients symptoms and this helps users to make a decision. Results : Based on the above premises, we have developed an literature based algorithm to provide various functions, such as recommending symptoms to check, comparing groups of symptoms, differential diagnosis, recommending medicinal materials to prescribe, and more. Conclusions : By the results of simulation with virtual diagnostic scenario, we concluded this algorithm is useful helping clinician in diagnosis procedure.
An organization must restructure itself once it makes outsourcing decisions. Outsourcing is a strategy that a company adopts to direct internal efforts into strengthening its core business processes while contracting other companies for strategically less critical tasks thereby improving organizational production efficiency, and the strategy inevitably involves organizational restructuring. While public service organizations have increasingly embraced outsourcing as well, only a handful of studies analyze the change in efficiency from organizational restructuring. Therefore, this study uses Stochastic Frontier Analysis (SFA) to test whether efficiency improved in Korea Expressway Corporation's restructured branch offices. Korea Expressway Corporation evaluated and grouped its branches based on road extensions management, traffic volume, the number of snow days, road deterioration, and the number of junctions to differentially allocate its personnel and budget. The extent of efficiency improvement in each group was compared, and results show that inefficiency did not exist in any of the groups. The efficiency index among the three group categories was similar across the board; 9 offices in the A-group with its expanded personnel and budget had an efficiency index of 0.954, 12 offices in the B-group with unchanged personnel and budget conditions had an index of 0.950, and 12 offices in the C-group with reduced personnel and budget had an index of 0.937. SFA facilitates efficiency analyses because it does not require pre-restructuring data. This study is easy to apply in practice and empirically tests efficiency improvement in organizational restructuring based on data collected from all the branch offices in Korea Expressway Corporation.
Gurol, Gonul;Ciftci, Ihsan Hakki;Terzi, Huseyin Agah;Atasoy, Ali Riza;Ozbek, Ahmet;Koroglu, Mehmet
Journal of Microbiology and Biotechnology
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제25권4호
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pp.521-525
/
2015
Bacteremia and sepsis are common causes of morbidity and mortality worldwide, with incorrect or delayed diagnoses being associated with increased mortality. New tests or markers that allow a more rapid and less costly detection of bacteremia and sepsis have been investigated. The aim of this study was to clarify the cutoff value of the neutrophillymphocyte ratio (NLR) according to procalcitonin (PCT) level in the decision-making processes for bacteremia and sepsis. In addition, other white blood cell subgroup parameters, which are assessed in all hospitals, for bacteremia and sepsis were explored. This retrospective study included 1,468 patients with suspected bacteremia and sepsis. Patients were grouped according to the following PCT criteria: levels <0.05 ng/ml (healthy group), 0.05-0.5 ng/ml (local infection group), 0.5-2 ng/ml (systemic infection group), 2-10 ng/ml (sepsis group), and >10 ng/ml (sepsis shock group). One important finding of this study, which will serve as a baseline to measure future progress, is the presence of many gaps in the information on pathogens that constitute a major health risk. In addition, clinical decisions are generally not coordinated, compromising the ability to assess and monitor a situation. This report represents the first study to determine the limits of the use of NLR in the diagnosis of infection or sepsis using a cutoff value of <5 when sufficient exclusion criteria are used.
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