Kwon, Woo-Keun;Kim, Joo Han;Moon, Hong Joo;Park, Youn-Kwan
Journal of Korean Neurosurgical Society
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v.60
no.1
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pp.47-53
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2017
Objectives : The Korean Resource Based Relative Value Scale (K-RBRVS) was introduced in 2001 as an alternative of the previous medical fee schedule. Unfortunately, most neurosurgeons are unfamiliar with the details of the K-RBRVS and how it affects the reimbursement rates for the surgical procedures we perform. We summarize the K-RBRVS in brief, and discuss on how the relative value (RV) of the spinal neurosurgical procedures have changed since the introduction in 2001. Methods : We analyzed the change of spinal procedure RVs since 2001, and compared it with the change of values in the brain neurosurgical procedures. RVs of 88 neurospinal procedures on the list of K-RBRVS were analyzed, while 24 procedures added during annual revisions were excluded. Results : During the past 15 years, RVs for spinal procedures have increased 62.8%, which is not so different with the cumulative increase of consumer prices during this time period or the increase rate of 92.3% for brain surgeries. When comparing the change of RVs in more complex procedures between spinal and brain neurosurgery, the increase rate was 125.3% and 133%, respectively. Conclusion : More effort of the society of spinal surgeons seems to be needed to get adequate reimbursement, as there have been some discrimination compared to brain surgeons in the increase of RVs. And considering the relative underestimation of spinal neurosurgeons' labor, more objective measures of neurospinal surgeons' work and productivity should be developed for impartial reimbursement.
The authors investigated the effect of feedback and remediation after formative assessment (FRFA) by comparing the FRFA score and that of summative assessment (SA) in a course on clinical skills. In March 2015, 33 subjects underwent evaluation of their ability to perform a complex clinical skill using a real-time ready-made mobile assessment form tool, and through e-mail they were supplied with their feedback and final score (the pass group earned 2 points; the intermediate group earned 1 point; the nonpass group earned 0 points) followed by their self-reflection. The nonpass group underwent a re-test and e-mail feedback again until they passed the test, given the ease of performance. In December 2015, the 33 subjects took a 10-item SA, and one of the 10 items addressed a similar clinical skill. The difference between the first score on the FRFA and the score on the SA was evaluated statistically (p=0.05) through data analysis, variance distribution, correlation analysis, and linear regression analysis using SPSS software ver. 16. The increase from the score on the SA to that on the FRFA was statistically significant ($4.5{\pm}9.29$) in the pass group and the intermediate group, and was $29.7{\pm}11.49$ in the nonpass group of the formative evaluation (p<0.001). Using an FRFA could decrease the range in the standard deviation of the score and increase the minimum score among the subjects.
BACKGROUND/OBJECTIVES: Previous studies have shown an association between breastfeeding and higher fruit and vegetable consumption and the level of dietary variety in children. However, few studies have reported this association on the feeding characteristics. Therefore, this study examined the association of the feeding characteristics with the consumption of fruit and vegetable and dietary variety in children. SUBJECTS/METHODS: This study recruited 802 participants from their parents with information on their feeding, and 24-h dietary recall. The associations of the feeding characteristics with fruit and vegetable consumption and dietary variety score (DVS) were analyzed using a multiple logistic regression model. RESULTS: Compared to the feeding type of exclusive breastfed children, exclusive formula-fed children had a significant association with a lower DVS (odds ratio [OR], 0.42, 95% confidence interval [CI], 0.23-0.77). Fruit and vegetable consumption was classified into 6 groups: non-salted vegetables (NSV), salted vegetables (SV), fruit (F), total vegetables (TV), non-salted vegetables + fruit (NSVF), and total vegetables + fruit (TVF). According to the mean level of fruit and vegetable consumption, compared to the duration of total breastfeeding for 6 month or less, a greater duration of breastfeeding for 12 mon had a significant association with a higher intake of NSVF and TVF (OR, 1.85, 95% CI, 1.20-2.85 and OR, 1.89, 95% CI, 1.22-2.92). On the other hand, the early introduction of formula feeding for 4 mon had a significant association with a lower intake of F and NSVF (OR, 0.59, 95% CI, 0.38-0.91 and OR, 0.63, 95% CI, 0.40-0.99). CONCLUSIONS: These results confirm that breastfeeding is associated with higher fruit and vegetable consumption and dietary variety, whereas formula feeding is associated with lower fruit and vegetable consumption and dietary variety. Therefore, the feeding characteristics in infants may affect fruit and vegetable consumption and dietary variety in children.
Introduction: In Oriental medicine, the status of tongue is the important indicator to diagnose one's health, because it represents physiological and clinicopathological changes of inner parts of the body. The method of tongue diagnosis is not only convenient but also non-invasive, so tongue diagnosis is most widely used in Oriental medicine. By the way, since tongue diagnosis is affected by examination circumstances a lot, its performance depends on a light source, degrees of an angle, a medical doctor's condition etc. Therefore, it is not easy to make an objective and standardized tongue diagnosis. In order to solve this problem, in this study, we tried to design a discriminant function for thick and thin coating with color vectors of preprocessed image. Method: 52 subjects, who were diagnosed as white-coated tongue, were involved. Among them, 45 subjects diagnosed as thin coating and 7 subjects diagnosed as thick coating by oriental medical doctors, and then their tongue images were obtained from a digital tongue diagnosis system. Using those acquired tongue images, we implemented two steps: Preprocessing and image analyzing. The preprocessing part of this method includes histogram equalization and histogram stretching at each color component, especially, intensity and saturation. It makes the difference between tongue substance and tongue coating was more visible, so that we can separate tongue coating easily. Next part, we analyzed the characteristic of color values and found the threshold to divide tongue area into coating area. Then, from tongue coating image, it is possible to extract the variables that were important to classify thick and thin coating. Result : By statistical analysis, two significant vectors, associated with G, were found, which were able to describe the difference between thick and thin coating very well. Using these two variables, we designed the discriminant function for coating classification and examined its performance. As a result, the overall accuracy of thick and thin coating classification was 92.3%. Discussion : From the result, we can expect that the discriminant function is applicable to other coatings in a similar way. Also, it can be used to make an objective and standardized diagnosis.
The Journal of Korean Orthopaedic Ultrasound Society
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v.1
no.1
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pp.31-39
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2008
After the introduction of ultrasound enabling a detailed view of both neonatal hip instability and morphology, two different streams have developed: one arguing that neonatal hip instability is the major pathology warranting treatment, the other including acetabular dysplasia as an important feature. Graf's method including the acetabular dysplasia led to higher treatment and follow-up rate than that based upon neonatal hip instability only. Recent report suggested that improved examination techniques and a better understanding of the findings have enabled a more tailored approach, and no differences in treatment rates exist due to different ultrasound techniques. I'd like to emphasize that enough experiences and the understanding enabling standardized examination and high repeatbility is more important than the choice of different techniques. Here the mothods and meanings of different techniques of ultrasound and its usefulness in the diagnosis and treatment of DDH is discussed.
Andersson, Ing-Marie;Gunnarsson, Kristina;Rosen, Gunnar;Aberg, Marie Mostrom
Safety and Health at Work
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v.5
no.3
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pp.140-146
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2014
Background: Young male and female workers are over-represented in statistics concerning negative outcomes of poor work environment and risky work. Young workers often have low awareness of risk, a lack of safety training, and inadequate introduction to the work. The aim of this study was to identify the knowledge and experiences of pupils of vocational schools concerning potential work environment risks in their future work. Methods: The study design was a dual one, and included a questionnaire and focus group interviews. The study group consisted of 239 pupils from 10 upper secondary schools, who were graduating pupils in four vocational programs: the Industrial Technology Programme, the Restaurant Management and Food Programme, the Transport Programme, and the Handicraft Programme (in which students specialize in wood products). The upper secondary schools were located in the central region of Sweden. Results: The pupils had limited knowledge that employers must, by law, conduct risk analyses and prevent risks. Many felt that they themselves are mainly responsible for performing their tasks safely. Pupils in all programs mentioned acute risk as the greatest risk at work. The theoretical education about safety at work was provided in the $1^{st}$ year of the 3-year vocational programs. Conclusion: A systematic approach to pupils' training in work environment, which is a basis for a safe and healthy workplace, is lacking. The study findings indicate that pupils are offered knowledge far from that intended by laws and by state-of-the-art occupational health risk research.
Background: This study aims to conduct curriculum analysis on health management schools focusing on relationship with licence and certification in Republic of Korea. Methods: Possible employment field, licence and certification as well as curriculum were collected from the home page of 30 health management schools. The subjects and credits of curriculum were analyzed using descriptive statistics. Main subjects by areas were drew using categorization and ranking within qualitative methods. Comparative analysis was conducted for checking relationship between main subject and possible employment field, licence and certification. Results: First, major employment fields after graduation were public health officer, general hospital and clinic, and National Health Insurance Service. Possible licence and certificate were hospital administrator, medical recorder, health education specialist, and medical insurance specialist. Second, total graduate credits were 133.9 including 79.0 for major education, 30.5 for of general education, and 30.5 for elective courses. Third, main subjects were reviewed by areas including basic medicine, health management, hospital business & management, medical records & information, insurance billing & assessment, healthcare marketing & tourism, and health education. There were highest number of subjects on health education area among 8 categories. By subjects, many health management schools open health law, medical terminology, introduction to public health, and biostatistics. Relationship between main subjects and possible employment field, licence and certification in health management schools was strong. Conclusion: It is necessary to review curriculum and for improving educational quality in health management schools. Also, development of curriculum standards for courses in health administration and introduction of accreditation system can be considered.
Choi, Hee Jae;Hur, Jun Wook;Cho, Jae Bum;Park, Kwan Ha;Jung, Hye Jin;Kang, Yue Jai
Fisheries and Aquatic Sciences
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v.22
no.2
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pp.5.1-5.9
/
2019
Background: Live fish import may lead to the unintended introduction of pathogens. We examined the monthly distribution of microbial pathogens in ornamental finfish imported into South Korea over a 6-month period. Results: Vibrio alginolyticus was detected in one lemon damsel in June and July; V. vulnificus was detected in one lemon damsel, one caerulean damsel, and one pearl-spot chromis and one ocellaris clownfish in July, April, and May, respectively; Photobacterium damselae was detected in one ocellaris clownfish and one caerulean damsel in June and July, respectively; V. anguillarum was detected in one pearl-spot chromis in February; V. harveyi was detected in one ocellaris clownfish and two mandarin fish in February and April, respectively; Yersinia ruckeri was detected in a pearlscale goldfish group in June and July and in two colored carp groups in July; and Lactococcus garvieae was detected in a lemon damsel group and a sutchi catfish group in July and May, respectively. European catfish virus, the only viral pathogen detected, was found in two sutchi catfish groups in May. Conclusion: This study is the first to identify pathogenic species and the presence or absence of pathogens (non-quarantine diseases) in imported ornamental finfish. These results demonstrate that various pathogens with the potential to harm indigenous fish populations can accompany ornamental finfish imported into South Korea.
Nursing is a discipline that helps to understand human being, to mitigate pains in life by promoting and recovering health, and to study the basic principles in sustaining and preserving life. To understand man and thus to nurse, it is essential to take the way of life of the specific person, his/her ideas, and natural environment into consideration. This means, the temperament, geography, environment and society peculiar to Korea have formed its own culture distinguished from those of other people. Thoughts and philosophy develop as a products of the specific culture and society. Therefore, accurate understanding of the concepts of nursing in the traditional thoughts and philosophy is indispensible to define Korean nursing. Modern Korean nursing at first rooted in the westernized nursing and western nursing intervention has been applied ever since its introduction in the late 19th century under the paradigm of western natural science. However, Koreans in the past made use of alternative therapy which put its emphasis on the organic and holistic view of life as well as a means for traditional medicine and nursing. This alternative therapy has been largely ignored since the introduction of western medical science, and was considered something used only by the aged or the uneducated. Moreover, Health concerned practices and customary traditional therapy have been discarded in the clinical medicine as "unscientific" or "unsystematic". As described above, it is true that Korean nursing has developed in the quantitative aspect only adhering to western nursing intervention. Now it is the time to stop to hold ourself and to look back our past. To find and develop the originality of Korean nursing to cope with the globalization, it is necessary to rediscover nursing (alternative) therapy in Korean culture ignored so far. For this purpose, this study examines the oriental philosophy to explore alternative nursing theory now under development. Also it aims to present ways to apply alternative therapy to nursing education, research and clinical practices and ultimately to show the desirable direction of the nursing to go in the future. Yangsaeng theory of Taoism and Yin-yang, Oh-hang(five elements) and khi theory in Dongeuibogam which gave enormous influences on Korean medical culture and treatment together with Sahsang(four temperaments) emphasized in Dongeuisusebowon will be examined as conceptual framework. Concepts of nursing are categorized into views on each the universe, the human being and nursing. Views on human being is classified into subcategories of body, life, health, and disease. Also it emphasizes the necessity of including alternative therapy in nursing intervention. Views on the universe is classified into yin-yang, khi, and temperament. Nursing will be available anywhere and easily accessible with this new nursing intervention. Trying to give a new thoughts to all those traditional concepts and alternative therapy, this article suggests the necessity of developing original Korean nursing theory and nursing intervention.
Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.
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