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Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

  • Ma, I Chun;Chen, Kao Chin;Chen, Wei Tseng;Tsai, Hsin Chun;Su, Chien-Chou;Lu, Ru-Band;Chen, Po See;Chang, Wei Hung;Yang, Yen Kuang
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.398-406
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    • 2018
  • Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

A Comparative Study on the Consistency between Domestic Implementation of Sustainable Development Goals and Development Cooperation in the Area of Climate Change (지속가능발전목표의 국내이행과 개발협력 간 일관성에 관한 국별 비교와 시사점 - 기후변화 분야 -)

  • Lim, Soyoung
    • International Area Studies Review
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    • v.22 no.4
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    • pp.209-227
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    • 2018
  • The issue of climate change, which calls for urgent and improved action by countries around the world, requires cooperation from the international community. Therefore, consistency among various policies on climate change is particularly important. This study analyzes the relationship between the implementation of SDGs and the scale of assistance in the field of climate change in order to see if there is consistency between domestic policy and aid policy to address climate change issues. An analysis of the correlation between the indices related to the domestic implementation of SDGs and ODA amounts in the field of climate change by OECD countries was conducted. As a result, there is a significant negative correlation between imported CO2 emissions and the portion of climate change ODA. On the other hand, the amount of CO2 emissions embodied in fossil fuel export is significantly positively correlated with the portion of ODA for climate change. Consistency between domestic and aid policies of OECD countries in the field of climate change is not sufficiently ensured, and climate change, the cross-cutting issue, is not being pursued in a consistent direction across national policy.

A Study on Critical Understanding of Family Ideologies in Geun Hyung Park's Plays (박근형 연극에 나타난 가족 이데올로기에 대한 비판적 인식)

  • Kim, Sukkyung
    • Journal of Korean Theatre Studies Association
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    • no.48
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    • pp.85-125
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    • 2012
  • Geun Hyung Park is one of the playwrights who consistently pursues his unique world of play. One of the characteristics that is constantly discovered in Park's plays is the motif of 'family.' Park chooses family as the motif in most of his work. Park particularly emphasizes 'family life' rather than 'individual life' to focus on the internal problems of families. Therefore, the motif of family in Park's plays takes a very important position in the content and theme. The Korean society imposes unique value on families and possesses a strictly obstinate family ideology. Park observes distorted family relations or individuals who cannot be happy within their families to identify the problems related to the family ideology that is deeply rooted in the Korean society. This is one of the important backgrounds for which Park is constantly dealing with 'family life.' This study selected five of Park's most famous plays to specifically examine Park's critical understanding of family ideology. First, his criticizes extreme family egoism by depicting a family that cannibalizes people to keep the family full. Park chooses 'absurd time and space' and the extreme subject of 'human flesh' to warn his audiences about the awful consequences of family egoism. His , which is the only piece that deals with family history among the five pieces selected, criticizes Korea's unique family-centered ideology by humorously depicting the history of the Cho family that is all about maintaining and worshipping the its clan. He reveals the unethical and hypocritical attitudes of the Cho family for the audiences to reconsider the family-centered ideology of the Korean society. In , he talks about the son and the father who lose his ethical authority and fail to perform his paternal responsibilities to criticize the traditional family ideology of patriarchism and suggests the pessimistic future of patriarchism. contrasts a blood-related family with an irresponsible father and a quasi-family to criticize the identity of blood-related families. In , Park depicts a 'smelly house' of a family in agonizing relations to deny the family myth and the maternal myth. He clearly shows how the ideals of family myth and maternal myth are distant from the reality. In result of this study, Park's criticism of family ideology appears in various forms. He comprehensively criticizes both the general family problems and the unique family issues of Korea. The family ideology of Korea is currently undergoing a radical change. It has been long since the traditional family ideologies have exposed problems to show the signs of crisis. Also, there have emerged various forms of families, including single-parent families, one-person families, adoption families, and multi-cultural families. In this respect, Park's critical understanding of family ideologies allows you to see the obvious family forms from a new perspective and greatly contributes to awakening the essential questions about families. Park's work is noticeable among the various artistic and literature pieces that deal with family issues because of his extraordinary skills to capture the key issues inherent in the problems of family ideologies.

The Limitations of Holocaust Narratives and the Possibility of Healing Narratives Suggested by Smith's Fires in the Mirror ('홀로코스트' 서사의 한계와 스미스의 『거울 속에 반영된 분노』에 제시된 치유 서사의 가능성)

  • Jung, Sun-kug
    • Cross-Cultural Studies
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    • v.43
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    • pp.377-404
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    • 2016
  • In this paper, I intend to focus on the 1991 racial tension and violence portrayed in Anna Devear Smith's book Fires in the Mirror, which was published in book form in 1993. I make use of a series of interviews with many of those involved in the conflicts, which were based on the Jewish Holocaust and the history of African American enslavement. In Crown Heights, the black community and the Jewish community have each suffered terrible losses, but individuals and communities become rhetorically attached to foundational historical traumas that lie at the center of each group's cultural identity rather than try to understand each other's pain. Smith lets this rhetoric dominate Fires in the Mirror by putting contradictory monologues side by side in order to show how discourses on 'slavery' and 'the Holocaust' still have control over specific ethnic communities. My intention is not to delve into the conflict between the Jewish and black communities exclusively. Rather, I attempt to form an understanding of the problems of the critical/theoretical tenets proposed by 'the rhetoric of holocaust,' including the Jewish Holocaust and the black experience of enslavement. Such an understanding will help us see the failure in the theories, illuminating the ways that such rhetoric should have recognized its own violence and helped to forge a new relationship between racism and anti-Semitism. Fires in the Mirror mirrors back to us the ways that 'the Holocaust' betrays the possibility of error to indicate its own susceptibility to blindness. The cracks brought forth by conflicting narratives enable readers to observe wounds being healed and the possibility of new narrative looming up.

Chronotope and Feeling: Gangnam Blues (시공간과 감정- 『강남1970』)

  • Kim, Miehyeon
    • Cross-Cultural Studies
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    • v.53
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    • pp.193-218
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    • 2018
  • In this essay, I examine the interactions of chronotopes in the narrative of Gangnam Blues, a film written and directed by Yu Ha and released in 2015. Bakhtin's chronotope, the connectedness of temporal and spatial relationships in literary narratives, provides the background for the representability of events and becomes the organizing center for the events. Each chronotope offers a different way of acting, interacting and understanding experience, and chronotopes can interact with each other in a single text or between the reader and the represented world. Gangnam Blues is a gangster movie, first of all, showing an individual's illusion of an unlimited possibility for achieving wealth and power. At the same time, the film describes the government's project to transform Gangam, a rural area in the south of the Han, into a new downtown and residential area for Seoul. As the world in the narrative and the world of the author or the reader are all chronotopic, we can see the interactions of chronotopes between the narrative of an individual and the historical narrative, as well as between the narrative about the beginning of Gangnam and the audience's perception of the present Gangnam. In this film, the main character's ambition is shown as part of the social desire for rapid economic achievements in the 1970s, along with high social mobility. The social desire can be explained as envy, as it is fueled by social comparisons and competitions. The main character's pursuit of money and power through the possession of Gangnam land overlaps with the envious desire for the present Gangnam shared by many. The individual's exceptional ambition and violence are not fully examined in this text. Moreover, the film's dependence on the feelings of envy to represent the individual's choice and violence can be a symptom of the lack of critical distance from social desire and envy.

Development of a Hydrogen Peroxide Sensor Based on Palladium and Copper Electroplated Laser Induced Graphene Electrode (PdCu를 전기 도금한 레이저 유도 그래핀 전극 기반의 과산화수소 측정 센서 개발)

  • Park, Daehan;Han, Ji-Hoon;Kim, Taeheon;Pak, Jungho
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.67 no.12
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    • pp.1626-1632
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    • 2018
  • In this paper, we describe the fabrication and characterization of a hydrogen peroxide ($H_2O_2$) sensor based on palladium and copper (PdCu) electroplated laser induced graphene (LIG) electrodes. $CO_2$ laser was used to form LIG electrodes on a PI film. This fabrication method allows simple control of the LIG electrode size and shape. The PdCu was electrochemically deposited on the LIG electrodes to improve the electrocatalytic reaction with $H_2O_2$. The electrochemical performance of this sensor was evaluated in terms of selectivity, sensitivity, and linearity. The physical characterization of this sensor was conducted using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS), which confirmed that PdCu was formed on the laser induced graphene electrode. In order to increase the sensor sensitivity, the Pd:Cu ratio of the electroplated PdCu was varied to five different values and the condition of highest amperometric current at an identical of $H_2O_2$ concentration was chosen among them. The resulting amperometric current was highest when the ratio of Pd:Cu was 7:3 and this Pd;Cu ratio was employed in the sensor fabrication. The fabricated PdCu/LIG electrode based $H_2O_2$ sensor exhibited a sensitivity of $139.4{\mu}A/mM{\cdot}cm^2$, a broad linear range between 0 mM and 16 mM of $H_2O_2$ concentrations at applied potential of -0.15 V, and high reproducibility (RSD = 2.6%). The selectivity of the fabricated sensors was also evaluated by applying ascorbic acid, glucose, and lactose separately onto the sensor in order to see if the sensor ourput is affected by one of them and the sensor output was not affected. In conclusion, the proposed PdCu/LIG electrode based $H_2O_2$ sensor seems to be suitable $H_2O_2$ sensor in various applications.

A Study on the Effects of the Policy Funding Program Provided to the Small and Medium Sized Enterprises in Gangwon-Do (강원도 중소기업 정책자금지원제도의 성과분석)

  • Shim, Sangpil;Jang, Woon Wook
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.4
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    • pp.179-190
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    • 2019
  • To alleviate financing difficulties of small and medium sized enterprises (SMEs), the government and municipal governments are providing a variety of SME policy funding programs. This study introduced the policy funding program of Gangwon-do and quantitatively analyzed the financial performance of companies supported by the Gangwon-do SME policy fund in the year 2014. Specifically, we compared the financial ratios for three years, from 2013 to 2015, between funded firms and non-funded firms. In addition, we applied a regression analysis to see if the policy funding program contributed to profitability (the operating profit growth and return on equity), stability (the interest coverage ratio and debt-to-equity ratio), and growth (the asset growth and sales growth) of the funded firms. The empirical results show that the firms that received the policy funds did not show any improvement compared to non-funded firms in terms of profitability, stability, and growth. This suggests that Gangwon-do should improve the policy funding program, that currently provides only an interest amount of 2-4% of the corporate loan principal, without any strategic selection criteria for the target funded firms, and without any follow-up management system, after support.

A Study on the Measures for Detection Error from the Displacement Distortion of the RADAR Waveform (레이더 전파의 왜곡현상에서 오는 탐지 오류 저감 방안 연구)

  • Kim, Jin Hieu;Kim, ChangEun;Lee, Yong-Soo
    • Journal of the Korea Institute of Construction Safety
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    • v.2 no.1
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    • pp.36-44
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    • 2019
  • $21^{st}$ century is digitally civilized era. Technologies such as AI, Iot, Big Data, Mobile and etc makes this era digitally advanced. These advancement of the technology greatly impacted detection range of the radar. Human's eye sight can see about 20Km and hear 20 ~ 20000 Hz. These limitations can be overcome using radar. This radar technology is used in military, aircraft, ship, vehicle and etc. to replace human eye. However, radar technology is capable of making False Alarm Rate. This document will propose the fix of these problems. Radar's distortion includes beam refraction, diffraction and reflection. These inaccurate data result in deterioration of human judgements and my cause various casualties and damages. Radar goes through annual testing to test how many false alarm is being produced. Normal radar usually makes 10 to 20 False alarms. In emergency situation, if operator were to follow this false alarm, this might result in following false object or take 12 more seconds to follow the right object. This problem can be overcome by using different radar data from different places and angles. This helps reduces False Alarm rate and track the object twice as fast.

A Study on Determining Archiving Priorities of Primary and Secondary Educational Resources (초·중등 교육자원 아카이브 구축을 위한 자원의 우선순위 선정에 관한 연구)

  • Kim, Seonghun;Do, Suelki;Oh, Sam G.
    • Journal of the Korean Society for information Management
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    • v.36 no.2
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    • pp.153-174
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    • 2019
  • This study was conducted to find out basic facts on educational resources in Korea and see how educators have managed their tasks without educational resource archives. The research had the following steps: 1) finding out how the current state of primary and secondary education resources is managed and type of educational resources via Web search and literature review, 2) conducting a survey to determine archiving priorities according to the value of resources to the users, and 3) engaging in a discussion with experts on merits of establishing an educational resource archive system. Due to sporadic management and restricted use of educational resources produced in Korea, the primary and secondary education resources are not easily available to the public even though the public and private sectors produce significant amount of resources. The survey result on preferred educational resource types for archiving showed the following top three: 1) actual case studies conducted in the field, 2) curriculum related resources, and 3) various textbooks adopted. Considering the value of educational resources and the necessity of archiving agencies, the experts recommended to set up a national archiving system of educational resources. This study hopes to raise awareness of the need to set up educational resource archives as a start.

A Study on Chatbot Profile Images Depending on the Purpose of Use (사용 목적에 따른 챗봇의 프로필 이미지 연구)

  • Kang, Minjeong
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.118-129
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    • 2018
  • In AI chatbot service via a messenger, a profile image of the chatbot is the first thing that users see to communicate with the chatbot. This profile image not only manages an impression about the profile owner in SNS on followers, but also makes an important impression about chatbot services on users. Thus motivated, this study investigates proper profile images tailored for the types of chatbot services and users. Specifically, I reviewed the preferred images and expressions of chatbots for each purpose of chatbot service. Then, in a case study, I collected and analyzed the representative chatbot profile images for the purpose of fun and counseling. The profile images are categorized as robot, human, animal, and abstract images. Based on these categories, I surveyed the preferred profile image of the chatbot service in either the text type or image type alternatives. For the purpose of fun, in the text version, I found that both men and women preferred a human image to others. However, in the image version, men preferred woman and robot images while women preferred cute animation character and robot images. For counseling services, both men and women preferred woman and animal images most, which is similar to the results of the text version of questionnaires as well. While both genders consistently preferred real photo images, women tend to like abstract images more than men do. I expect that the results of this study would be useful to develop the proper profile images of AI chatbot for each service purpose.