• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.1-11
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• 2022

The Act on Decisions on Life-Sustaining Treatment has been in effect since 2018 for end-of-life patients. However, only 20~25% of deaths of terminally ill patients comply with the law, while the remaining 75~80% do not. There is significant confusion in how the law distinguishes between those in the terminal stage and those in the dying process. These 2 stages can be hard to distinguish, and they should be understood as a single unified "terminal stage." The number of medical institutions eligible for life-sustaining treatment decisions should be legally expanded to properly reflect patients' wishes. To prevent unnecessary suffering resulting from futile life-sustaining treatment, life-sustaining treatment decisions for terminal patients without the needed familial relationships should be permitted and made by hospital ethics committees. Adult patients should be permitted to assign a legal representative appointed in advance to represent them. Medical records can be substituted for a patient's judgment letter (No. 9) and an implementation letter (No. 13) for the decision to suspend life-sustaining treatment. Forms 1, 10, 11, and 12 should be combined into a single form. The purpose of the Life-sustaining Medical Decisions Act is to respect patients' right to self-determination and protect their best interests. Issues related to the act that have emerged in the 3 years since its implementation must be analyzed, and a plan should be devised to improve upon its shortcomings.

• Journal of Biomedical Engineering Research
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• v.44 no.4
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• pp.225-241
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• 2023

The study empirically analyzed the differences in industry distribution and innovation activity performance in the metropolitan and non-metropolitan areas of Korea's bio companies, which are highlighted as future growth engines. The main innovation activities of the bio industry, which are focused on science and technology and expressed with high uncertainty, were analyzed, centering on human resources, technology cooperation, and investment promotion. As a result of the analysis, the biomedical industry in the metropolitan area was found to have a high proportion, and bio foods, bio-based chemicals, and energy industries in the non-metropolitan area, respectively. Moreover, the innovation activity performances differed between the two regions. In particular, the notable characteristics included human resources, investment promotion, and technical cooperation with medical institutions in the metropolitan area with a high proportion of biomedical industries, and technology personnel exchange and cooperation with private research institutions in the non-metropolitan area, which has a high proportion of bio foods, bio-based chemicals, and energy industries. This study is significant in that it is the first study to compare and analyze the performance of innovative activities based on the distribution of industries in the bio-industry, focusing on human resources, technology cooperation, and investment promotion. In addition, after investigating the distribution status and competitiveness of the domestic bio-industry by region, it will analyze the status and characteristics of the domestic bio-industry and present policy implications to implement relevant promotion policy more efficiently.

• Journal of radiological science and technology
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• v.47 no.2
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• pp.107-116
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• 2024

In this study, we analyzed the use of general radiography imaging and effective dose in inpatients. Our aim is to help reduce national medical radiation exposure doses and develop rational health-care financial policies. The effective dose for each general radiography was calculated using the ALARA-GR program for 53 types (total: 260 codes) general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2018 inpatient patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was analyzed. 89.00% of inpatients undergo general radiography imaging at least once, with an average of 12.63 scans per person and an effective dose of 1.00 mSv. Those who received support from Medical Aid showed a higher value compared to those who were insured by National Health Insurance, with 17.39 cases and 1.43 mSv (p<.001). Chest had the highest usage rate at 23.12% for general radiography imaging, while L-spine had the highest effective dose at 24.53%. It is estimated that 420 inpatients patients undergo 121 to 820 general radiography imaging procedures per year, and 233 inpatients are estimated to have an annual effective dose of >20.00~58.25 mSv. Rational use of health-care finances and the practice of medical radiation safety management are essential for the well-being of individuals, the enhancement of quality of life, and the improvement of health-care quality.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.23.1-23.14
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• 2023

Background: Exposure to heavy metals is a public health concern worldwide. Previous studies on the association between heavy metal exposure and neurobehavioral functions in children have focused on single exposures and clinical manifestations. However, the present study evaluated the effects of heavy metal complex exposure on subclinical neurobehavioral function using a Korean Computerized Neurobehavior Test (KCNT). Methods: Urinary mercury, lead, cadmium analyses as well as symbol digit substitution (SDS) and choice reaction time (CRT) tests of the KCNT were conducted in children aged between 10 and 12 years. Reaction time and urinary heavy metal levels were analyzed using partial correlation, linear regression, Bayesian kernel machine regression (BKMR), the weighted quantile sum (WQS) regression and quantile G-computation analysis. Results: Participants of 203 SDS tests and 198 CRT tests were analyzed, excluding poor cooperation and inappropriate urine sample. Partial correlation analysis revealed no association between neurobehavioral function and exposure to individual heavy metals. The result of multiple linear regression shows significant positive association between urinary lead, mercury, and CRT. BMKR, WQS regression and quantile G-computation analysis showed a statistically significant positive association between complex urinary heavy metal concentrations, especially lead and mercury, and reaction time. Conclusions: Assuming complex exposures, urinary heavy metal concentrations showed a statistically significant positive association with CRT. These results suggest that heavy metal complex exposure during childhood should be evaluated and managed strictly.

• Safety and Health at Work
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• v.14 no.4
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• pp.358-367
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• 2023

Background: This study aimed to develop and assess the psychometric features of the Physical Activity at Workplace Questionnaire (PAWPQ) based on the Social Cognitive Theory (SCT) to evaluate employees' physical activity (PA) behaviors at the workplace. Methods: This psychometric cross-sectional study was conducted on 455 employees working in one of the gas refineries in Iran. The participants were selected using the proportional stratified sampling method in 2019. The data collection tools were a demographic information questionnaire, the short form of the International Physical Activity Questionnaire (IPAQ), and a questionnaire developed based on the SCT, whose psychometric features were confirmed in terms of validity and reliability. Data were analyzed using SPSS₂₂ and AMOS₂₀ software. Results: The first version of PAWPQ-SCT had 74 items. After evaluating content and face validity, nine items were removed. The results of the content validity index (0.98), content validity ratio (0.86), and impact score (3.62) were acceptable for the whole instrument. In exploratory factor analysis, after removing seven items-58-item final version of the scale-six factors could explain 73.54% of the total variance. The results of structural equation modeling showed the acceptable fit of the model into the data (RMSEA = 0.052, CFI = 0.917, NFI = 0.878, TLI = 0.905, IFI = 0.917, CMIN/DF = 2.818). Cronbach's alpha coefficient and Intraclass Correlation were 0.90 and 0.86, respectively. Conclusion: This study confirmed that the psychometric features of the 58-item final version of PAWPQSCT constructs were acceptable in a sample of Iranian employees. This questionnaire can be used as a valid and reliable tool to evaluate Iranian employees' PA behaviors and develop effective educational interventions for workers and managers.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.25 no.1
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• pp.27-35
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• 2015

Objectives: To investigate safety and health management, conditions in factories or facilities handling radiation-generating devices and radioactive isotopes were reviewed in terms of regulations of radiation safety control in Korea. Radiation exposure levels generated at those facilities were directly measured and evaluated for establishing an effective safety and health management plan. Methods: Government organizations with laws and systems of radiation safety and health were investigated and compared. There are three laws governing radiation-related employment such as occupational safety and health acts, nuclear safety acts, and medical service acts. We inspected 12 workplaces as research objects:four workplaces that manufacture and assemble semiconductor devices, three non-destructive inspection workplaces that perform inspections on radiation penetration, and five workplaces in textile and tire manufacturing. Monitoring of radiation exposure was performed through two methods. Spatial and surface monitoring using real-time radiation instruments was performed on each site handling radiation generating devices and radioactive isotopes in order to identify radiation leakage. Results: According to the occupational safety and health act, there is no legal obligation to measure ionizing radiation and set dose limits. This can cause confusion in the application of the laws, because the scopes and contents are different from each other. Surface dose rates in radiation generating devices such as implanters, thickness gages and accelerators, which were registered according to nuclear safety acts, using surveymeters, and seven of 36 facilities(19.4%) exceeded the international standards for surface radiation dose of $10{\mu}Sv/hr$. Conclusions: The results showed that occupational health and safety acts require a separate provision for measuring and assessing the radiation exposure of workers performing radiation work. Like noise, ionizing radiation will also periodically be controlled by including it in the object factors of work-environment measurement.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.26 no.4
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• pp.389-395
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• 2016

Objectives: Acute methanol poisonings known to be typical occupational diseases occurring in developing countries broke out in sub-contract manufacturers in the early 2016. The present paper attempted to identify underlying causes which hide under apparent findings, and suggest alternative policies to prevent recurrence of similar intoxication Methods: We evaluated occupational health and safety characteristics of workers in micro-enterprises similar to workplaces with methanol poisoning by in depth-interview of employers, workers, and labor inspectors, and literature review. Results: The common findings of workplaces with methanol poisoning were addressed; First, the victims were illegal agency workers. Second, the workplaces were sub-contract micro-manufacturers with less than 5 employees. Investigators found that local ventilations did not work, while most of workers did not wear any proper personal respiratory protective equipment in the workplace. In addition, periodic environmental monitoring and medical check-ups were not done. However, these apparent findings do not appear to be root causes of methanol poisoning. Our in depth-analysis clarified a root cause; micro-enterprises with less than 5 employees are exempted with essential regulations of OSH Act, and employers do not know about OSH Act. Conclusions: We suggest occupational health policies to prevent recurrence of similar intoxication; First, government should introduce programs so that all employers should know about employers' responsibilities in OSH Act from the start of business. Second, even manufacturers with less than 5 employees should not be exempted with essential regulations of OSH Act. Finally, employers should take responsibilities for health and safety of all the workers including agency workers working in workplaces.

• Health Policy and Management
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• v.16 no.1
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• pp.17-40
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• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

• Safety and Health at Work
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• v.4 no.2
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• pp.117-121
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• 2013

This paper describes progress on formulating a national asbestos profile for the country of Vietnam. The Center of Asbestos Resource, Vietnam, formulated a National Profile on Asbestos-related Occupational Health, with due reference to the International Labor Organization/World Health Organization National Asbestos Profile. The Center of Asbestos Resource was established by the Vietnamese Health Environment Management Agency and the National Institute of Labor Protection, with the support of the Australian Agency for International Development, as a coordinating point for asbestos-related issues in Vietnam. Under the National Profile on Asbestos-related Occupational Health framework, the Center of Asbestos Resource succeeded in compiling relevant information for 15 of the 18 designated items outlined in the International Labor Organization/World Health Organization National Asbestos Profile, some overlaps of the information items notwithstanding. Today, Vietnam continues to import and use an average of more than 60,000 metric tons of raw asbestos per year. Information on asbestos-related diseases is limited, but the country has begun to diagnose mesothelioma cases, with the technical cooperation of Japan. As it stands, the National Profile on Asbestos-related Occupational Health needs further work and updating. However, we envisage that the National Profile on Asbestos-related Occupational Health will ultimately facilitate the smooth transition to an asbestos-free Vietnam.

• Informatization Policy
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• v.29 no.4
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• pp.43-66
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• 2022

With the development of artificial intelligence technology, competition for artificial intelligence technology patents around the world is intensifying. During the period 2000 ~ 2021, artificial intelligence technology patent applications at the US Patent and Trademark Office have been steadily increasing, and the growth rate has been steeper since the 2010s. As a result of analyzing Korea's artificial intelligence technology competitiveness through patent indices, it is evaluated that patent activity, impact, and marketability are superior in areas such as auditory intelligence and visual intelligence. However, compared to other countries, overall Korea's artificial intelligence technology patents are good in terms of activity and marketability, but somewhat inferior in technological impact. While noise canceling and voice recognition have recently decreased as topics for artificial intelligence, growth is expected in areas such as model learning optimization, smart sensors, and autonomous driving. In the case of Korea, efforts are required as there is a slight lack of patent applications in areas such as fraud detection/security and medical vision learning.