Objectives : We wanted to evaluate the economic value of a pharmaceutical product, Kremezin, for treating patients with chronic renal failure (CRF) by estimating the amount of cost savings due to its effect for delaying the initiation of dialysis treatments. Methods : We defined a conventional treatment for CRF accompanied by Kremezin therapy as 'the treatment group' and only conventional treatment as 'the alternative group.' The types of costs included were direct medical and nonmedical costs and costs of productivity loss. The information on the effect of Kremezin was obtained from the results of earlier clinical studies. Cost information was derived from the administrative data for 20 hemodialysis and 20 peritoneal dialysis patients from one tertiary care hospital, and also from the administrative data of 10 hemodialysis patients from one free-standing dialysis center. Per-capita cost savings resulting from Kremezin therapy were separately estimated for the cases with delay for the onset of hemodialysis and the cases with immediate performance of peritoneal dialysis. By computing the weighted average for the cases of hemodialysis and peritoneal dialysis, the expected per-capita cost savings of a patient with CRF was obtained. Using a discount rate of 5%, future cost savings were converted to the present value. Results : The present value of cumulative cost savings per patient with CRF from the societal perspective would be $18,555,000{\sim}29,410,000$ Won or $72,104,000{\sim}112,523,000$ Won if Kremezin delays the initiation of dialysis by 1 or 4 years. Conclusions : The estimated amount of cost savings resulting from treating CRF patients with Kremezin confirms that its effect for delaying the onset of dialysis treatments has a considerable economic value.
Purpose: The Hospice Oriented Medical Record (HOMR) was developed for assessing the pain and symptoms of terminal cancer patients. Methods and Results: The HOMR consists of an instruction for users and 2 assessment pages which include the graph showing vital signs (temperature, blood pressure, pulse, respiration rate and pain score), current problem lists, performance status, laboratory data, pain characteristics and management, sedation score, associated symptoms and drug side effects, etc. Pilot study was performed in the inpatient Hospice Care Unit in Guro Hospital, Korea University Medical Center. Because an one-week progress data was recorded in HOMR as a flow sheet, the patient's condition and pain control status could be seen at a glance. Conclusion: The HOMR is useful for assessing the terminal cancer patients because it is simple and convenient to use. Further research is needed before it can be universally used in the clinical settings.
The purpose of this study was to investigate dietary behaviors, body image, hematological index and nutrient intake of female athletes in Incheon. The subjects were 112 female athletes (field and track: n=32, firing: n=27, fencing: n=29, swimming: n=14, badminton: n=10) from middle and high schools in Incheon. This cross-sectional study was conducted by a self-administered questionnaire. Fasting blood samples were obtained and analyzed for hemoglobin (Hb), hematocrit(Hct), ferritin, serum iron, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), unsaturated iron binding capacity (UBC), total iron binding capacity (TIBC) and transferrin saturation (TS). Nutrient intakes collected from 3 day-recalls were analyzed by the Computer Aided Nutritional Analysis Program. Statistical analysis was conducted using SPSS 10.0 program. The results are summarized as follows: Average age of field and track athletes, firing, fencer and swimmer was 14 years and that of badmintoner was 17 years. Most of female athletes had dietary problems such as unbalanced meals, skipping meals, and preference of processed foods. More than 60% of female athletes skipped breakfast. As for perception of body image, most of female athletes perceived themselves fatter compared to normal body image. Especially, field and track athletes were more significantly experienced weight control compared to the other athletes (p<0.05). As for physical burden during exercise, 56.3% of swimmer and 31.3% of field and track athletes answered “very hard”, which showed a significant difference (p<0.001) More than 80% of female athletes had experienced a vertigo during exercise (p<0.01). Also, more than 50% of female athletes except badmintoner had experienced an irregular menstruation (p<0.05). Average serum iron level (p<0.05) and TS (p<0.05) of field and track athletes were significantly lower compared to the other athletes. Serum ferritin of badmintoner, field and track athletes and fencer was significantly lower compared to firing and swimmer (p<0.05). Nutrient intakes of female athletes except vitamin B6, niacin and phosphorus were lower than the Korean RDA. Especially, calcium and iron intakes of female athletes were under the 50% of the Korean RDA. Therefore, proper nutrition education and supplementation are required for female athletes to encourage desirable food habits as well as to improve their nutritional status and exercise performance.
Kim, Young-Keun;Yang, Sook;Wang, Tae-uk;Kim, Eun-Hye
Journal of radiological science and technology
/
v.44
no.2
/
pp.101-107
/
2021
The purpose of this study was to evaluate optimal CT scan parameters to minimize patient dose to the irradiation and maintain satisfactory image quality in low-dose chest computed tomography (CT) scans. In a chest anthropomorphic phantom, chest CT scans were performed at different kVp and mA within reference of 3.4mGy in volume CT Dose Index (CTDIvol). The following quantitative parameters had been statistically evaluated: image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM). Nine radiographers conducted the blind test to select the optimal kVp-mA combination. Results indicated that the kVp-mA combination of 80kVp-90mA, 100kVp-50mA, 120kVp-30mA and 140kVp-30mA were obtained high SNR and CNR. The 120kVp-30mA combination offered good compromise in the FOM, which showed the quality and dose performance. In the blind test, an image of 80kVp-90mA obtained a high score with 4.7 points, and 120kVp-10mA or 140kVp-10mA with a low tube current were observed severe noise and poor image quality, thus resulting in decreased diagnostic accuracy. On the other hand, in the combination of high kVp and high mA(140kVp-90mA), the image quality was improved, but the radiation dose was also increased. the FOM value of 140kVp-90mA was lower than 120kVp-30mA. The application of appropriate scan parameters in low-dose chest CT scans produced satisfactory results in dose and image quality for the accuracy of the clinical diagnosis.
The present study analyzed movie consumption behavior from the perspective of transaction cost, taking into account the possible incurrence of additional costs in the process of consumers obtaining movie information to choose movies. Regression and multinomial logistic regression analyses were performed in the analysis by taking movie information and the individuals' social demographic characteristics as independent variables and the number and frequency of movies watched as dependent variables, using information from the "2015 movie consumer survey." The results showed that consumers considering elements such as "directors" and "online reviews" were found to be more active in movie consumption. The analysis of movie-watching frequency showed that the information considered when choosing a movie was different for high- and low-frequency movie viewers. Putting these factors together suggests that movie consumption can vary according to an individual's cultural capital, preferences, and their degree of movie information awareness. While existing studies have mostly analyzed the determinants of box office performance, the significance of the present study is its empirical analysis of individual movie information in terms of transaction cost. Based on the results above, it can be inferred that the cyclical structure of trading expenses influences movie consumption and, once preferences are formed through a certain level of consumption, the trading cost expenses decrease, which results in increasing consumption. Therefore, film makers need to establish and execute marketing strategies that appropriately use movie information so that consumers can reduce the trading costs necessary for movie watching.
With the development of IT technology, many changes are taking place in the health service environment over the past. However, even if medical technology is converged with IT technology, the problem of medical costs and management of health services are still one of the things that needs to be addressed. In this paper, we propose a model for hospitals that have established the IoT system to efficiently analyze and manage the personal information of users who receive medical services. The proposed model aims to efficiently check and manage users' medical information through an in-house IoT system. The proposed model can be used in a variety of heterogeneous cloud environments, and users' medical information can be managed efficiently and quickly without additional human and physical resources. In particular, because users' medical information collected in the proposed model is stored on servers through the IoT gateway, medical staff can analyze users' medical information accurately regardless of time and place. As a result of performance evaluation, the proposed model achieved 19.6% improvement in the efficiency of health care services for occupational health care staff over traditional medical system models that did not use the IoT system, and 22.1% improvement in post-health care for users who received medical services. In addition, the burden on medical staff was 17.6 percent lower on average than the existing medical system models.
The platelet count in clinical laboratories is essential for the diagnosis and treatment of hemostasis abnormalities, and accurate platelet counting in the low count range is of prime importance for deciding if a platelet transfusion is needed and for monitoring after chemotherapy. Quality control is designed to reduce and correct any deficiencies in the internal analytical process of a clinical laboratory prior to the release of patient results. Fragmented erythrocytes are the major confusing factors for platelet counting because of their similar size to platelets. The authors found that the low range QC values were out of 2SD with a Sysmex automatic analyzer in internal quality control process. Thus far, there has been little discussion on the relationship between hemolysis and the platelet parameters. Therefore, this study focused on the performance of automated platelet counts, including the PLT-F, the PLT-I, and PLT-O methods at the low platelet range using the low level QC materials and compared the 5 platelet parameters with the hemolyzed samples. The results showed that the CV was the smallest with PLT-F and P-LCR increased from 18.4 to 31.9% in the hemolysis samples. These results indicate that a more accurate estimation of the platelet counts can be achieved using the PLT-F method than the PLT-I method at the low platelet range. The use of the PLT-F system improves the confidence of results in low platelets samples in a routine hematology laboratory. The results suggest that P-LCR is a new parameter in assessing samples when the specimen is suspected of hemolysis and deterioration. Nevertheless, further studies will be needed to establish the relationship with P-LCR and hemolysis using human blood specimens.
This study aims to examine eligibilities, services and delivery of services for the current end-of-life care and analyze the quality control of services for end-of-life care. We analyzed the literature and laws on end-of-life systems in Korean and the United States. Current end-of-life care, hospice and palliative care in Korea is being provided mainly in hospital setting. Quality control for the services focuses on setting the criteria for structures in hospitals (i.e. staffing, facilities and equipment). Whereas American end-of-life care system has much broader eligibility for service beneficiaries and provides care mostly at home. Also quality control for services includes process (delivering service) and outcomes, such as monitoring performance indicators and consumer's satisfaction. This is linked to annual payment. The comparative analysis findings contributed to give the next direction of current Korean end-of-life care system. It is nessary to establish the better and extensive end-of-life care system in Korea in considering other countries' end-of-life care systems based on more future research.
Objective: The purpose of this study was to investigate the muscle activity ratio of the lower limb according to changes in straight leg raise (SLR) test angles on hamstring muscle shortening during squat exercises. Design: Randomized controlled trial. Methods: The subjects were 14 healthy adults who were informed of and agreed to the method and purpose of the study. The participants were classified into SLR groups according to two angles (over $80^{\circ}$ or under $80^{\circ}$) assessed using the SLR tests. After training and practicing the wall squat posture to be applied to the experiment, electromyography (EMG) was used to measure changes in muscle activity during the performance of a wall squat. After stretching, a sequence of pre-stretch tests were performed again, and the active and passive SLR tests were also reconducted; thereafter, a wall squat was performed again by attaching EMG electrodes. The EMG results before and after stretching were compared. Results: The muscle activity of the vastus lateralis oblique muscle increased in both groups. The muscle activity of the vastus medialis oblique muscle decreased in over both group. Rectus femorus activity increased in the under 80-degree groups but decreased in the over 80-degree group. The muscle activity of the biceps femoris muscle decreased after stretching in the over 80-degree group and increased in the under 80-degree group, and the semitendinosus muscle activity after stretching was decreased. The quadriceps-to-hamstring muscle (Q:H) ratio before and after stretching between groups showed that the hamstring muscle ratio decreased after stretching in both groups. Conclusions: The results of this study showed that the Q:H ratio before and after stretching between groups was not significantly different.
This study is descriptive research to investigate the effects of COVID-19 stress, interpersonal (caregiver-patient) stress, and emotional labor on burnout in emergency room (ER) nurses during the COVID-19 pandemic. The data collection of this study was conducted from December 9 to 23, 2021 with ER nurses working at five tertiary general hospitals and general hospitals of Medical Center H. The data was collected with a questionnaire using tools measuring the subjects' general & job-related characteristics, COVID-19 stress, interpersonal(caregiver-patient) stress, emotional labor and burnout. The collected data was analyzed using the SPSS/WIN 25.0 statistical program for frequency analysis, descriptive statistical analysis, independent sample t-test, one-way ANOVA, Scheffé test, correlation analysis, and multiple regression analysis. The average score of COVID-19 stress in ER nurses was 3.64, interpersonal(caregiver-patient) stress 4.35, emotional labor 3.38, and burnout 3.44. As a result of analyzing differences according to general & job-related characteristics, burnout showed a significant difference according to gender, marital status, total clinical experience, and working organization. And burnout showed a significant positive correlation with COVID-19 stress, interpersonal stress and emotional labor. As a result of multiple linear regression analysis, regional emergency medical centers and local emergency medical centers among the work organization types, interpersonal stress, COVID-19 stress, and gender and the explanatory power was 28.6%. Through these results, we intend to provide basic data for the development of an intervention program to prevent burnout of emergency room nurses and improve nursing performance at the time of a new infectious disease pandemic.
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