• Quality Improvement in Health Care
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• v.22 no.1
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• pp.11-26
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• 2016

The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.

• Safety and Health at Work
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• v.2 no.4
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• pp.301-312
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• 2011

Firefighters and police officers have the third highest prevalence of obesity among 41 male occupational groups in the United States (US). However, few studies have examined the relationship of firefighter working conditions and health behaviors with obesity. This paper presents a theoretical framework describing the relationship between working conditions, health behaviors, and obesity in firefighters. In addition, the paper describes a detailed study plan for exploring the role of occupational and behavioral risk factors in the development of obesity in firefighters enrolled in the Orange County Fire Authority Wellness Fitness Program. The study plan will be described with emphasis on its methodological merits: adopting a participatory action research approach, developing a firefighter-specific work and health questionnaire, conducting both a cross-sectional epidemiological study using the questionnaire and a sub-study to assess the validity of the questionnaire with dietary intake and physical activity measures, and evaluating the strengths and weaknesses of the body mass index as an obesity measure in comparison to skinfold-based percent body fat. The study plan based on a theoretical framework can be an essential first step for establishing effective intervention programs for obesity among professional and voluntary firefighters.

• Radiation Oncology Journal
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• v.35 no.2
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• pp.137-143
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• 2017

Purpose: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer. Materials and Methods: Data was analyzed on men diagnosed with localized prostate cancer between 2004-2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States. Results: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was $725cGy{\times}5fractions$ (49.6%) followed by $700cGy{\times}5fractions$ (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently $700-725cGy{\times}5fractions$ appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.

• Proceedings of the Korea Society for Energy Engineering kosee Conference
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• 1998.05a
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• pp.235-242
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• 1998

Aiming at one of decisive alternatives for long term aspect of nuclear power concerns, an integral and closed nuclear system, AMBIDEXTER (Advanced Molten-salt Break-even Inherently-safe Dual-mission Experimental and TEst Reactor) concept is under development. The AMBIDEXTER complex essentially comprises two mutually independent loops of the radiation/material transport and the heat/energy conversion, centered at the integrated reactor assembly, which enables one to utilize maximum benefits of nuclear energy under minimum risks of nuclear radiation. And it provides precious radioisotopes and radiation sources from its waste stream. Also the reactor operates at very low level of fission products inventory throughout its lifetime. The nuclear and thermalhydraulic characteristics of the molten TH/$^{233}$ U fuel salt extend the capability of the self-sustaining AMBIDEXTER fuel cycle to enhance resource security and safeguard transparency. The reactor system is consisted of a single component module of the core, heat exchangers and recirculation pumps with neither pipe connections nor active valves in between, which will significantly improve inherent features of nuclear safety. States of the core technologies associated with designing and developing the AMBIDEXTER concept are mostly available in commercialized form and thus demonstration of integral aspects of the concept should be the prime area in future R＆D programs.

• Transactions of the Korean Society of Automotive Engineers
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• v.18 no.3
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• pp.53-59
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• 2010

The Developing & Producing of Eco-Friendly vehicle have been more incremented, as People appreciate the importance of Earth Environment Conservation. The needs of Neighborhood Electric Vehicle(NEV) that suits Current people's short drive distance is incremented. In this Paper, we define Neighborhood Electric Vehicle through out National Highway Traffic Safety Administration of United States of America's regulation and explain motor and battery of primary constituents of that. We used MATLAB and ADVISOR 200 programs for Simulation, and propsed NEV's Model that tow people can be got in. In this Model, the battery is Lead-acid battery(72V, 85Ah) and the motor is 8kW permanent magnet synchronous motor(PM motor). We compared change of driving range of NEV through out non-changing speed Driving(10km/h, 20km/h, 30km/h, 40km/h) and Manhattan driving schedule.

• Tuberculosis and Respiratory Diseases
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• v.69 no.1
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• pp.1-15
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• 2010

Lung cancer remains the most common cause of cancer death in the United States and worldwide. About 80~90% of cases are smoking-related and smoking cessation programs are of great importance in reducing lung cancer risk. However, the lifetime risk for lung cancer remains elevated even in ex-smokers. Chemoprevention holds the promise to further reduce this risk and thus to decrease lung cancer incidence and mortality. Over the last decades, most chemoprevention trials for lung cancer have yielded negative outcomes. Population-based studies suggest that high intake of certain foods such as soy, red wine or green vegetables may be associated with decreased cancer risk. Because of these observations and their general safety, a plethora of natural compounds is currently being studied for the chemoprevention of cancer. In this review we discuss promising in vitro and in vivo data of novel natural compounds, their interference with molecular mechanisms responsible for lung cancer development and potential implications for their further preclinical and clinical investigation.

• Clinical Endoscopy
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• v.55 no.4
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• pp.489-495
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• 2022

An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition, the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, and patient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major international guidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommended risk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or no surveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previous guidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopy screening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratified post-polectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-up after the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines, are warranted.

• The Journal of the Korea Contents Association
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• v.22 no.6
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• pp.596-605
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• 2022

This study aimed to introduce research on coerced debt victimization and interventions in the context of domestic violence. To achieve the aim, this study reviewed existing studies on coerced debt conducted in the US. This study discussed the followings: First, coerced debt was theorized by coerced control theory of domestic violence and control mechanisms of economic abuse and conceptualized as fraud and force. Second, the effects of coerced debt included credit damage, economic dependence, and barriers to housing, employment, and safety. Third, to intervene the victimization, service providers should endure uncertainty and its time consuming process of recovering, provide an intense and personalized advocacy, and overcome the problems of absence of policies to support the victims. Finally, service providers should have educations and training programs on the assessment and intervention skills of coerced debt acknowledging empowerment and safety of the victims as the most important.

• Journal of the Korea Institute of Building Construction
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• v.23 no.6
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• pp.841-849
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• 2023

The rising number of accidents during building demolition work has significantly heightened interest in this field. This study undertakes a comprehensive analysis of the essential capabilities required for building demolition experts, drawing on both domestic and international examples. This includes an examination of training courses for building demolition inspectors and the competencies mandated for structural demolition roles as per Korea's National Competency Standards(NCS). Furthermore, the study reviews the qualification tests and training programs for building demolition professionals in the United States, Japan, and England. The research concludes that the expertise needed for demolition construction professionals should be categorized into seven key domains: legal, structural, safety, planning, operational, constructional, and environmental aspects. These competencies are further divided across three professional tiers: technician, engineer, and manager.

• The Korean Journal of Air & Space Law and Policy
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• v.23 no.2
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• pp.137-172
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• 2008

The earliest safety data programs, the FDR and CVR, were electronic reporting systems that generate data "automatically." The FDR program, originally instituted in 1958, had no publicly available restrictions for protections against sanctions by the FAA or an airline, although there are agreements and union contracts forbidding the use of FDR data for FAA enforcement actions. This FDR program still has the least formalized protections. With the advent of the CVR program in 1966, the precursor to the current FAR 91.25 was already in place, having been promulgated in 1964. It stated that the FAA would not use CVR data for enforcement actions. In 1982, Congress began restricting the disclosure of the CVR tape and transcripts. Congress added further clarification of the availability of discovery in civil litigation in 1994. Thus, the CVR data have more definitive protections in place than do FDR data. The ASRS was the first non-automatic reporting system; and built into its original design in 1975 was a promise of limited protection from enforcement sanctions. That promise was further codified in an FAR in 1979. As with the CVR, from its inception, the ASRS had some protections built in for the person who might have had a safety problem. However, the program did not (and to this day does not) explicitly deal with issues of use by airlines, litigants, or the public media, although it appears that airlines will either take a non-punitive stance if an ASRS report is filed, or the airline may ignore the fact that it has been filed at all. The FAA worked with several U.S. airlines in the early 1990s on developing ASAP programs, and the FAA issued an Advisory Circular about the program in 1997. From its inception, the ASAP program contained some FAA enforcement protections and company discipline protections, although some protection against litigation disclosure and public disclosure was not added until 2003, when FAA Order 8000.82 was promulgated, placing the program under the protections of FAR 193, which had been added in 2001. The FOQA program, when it was first instituted through a demonstration program in 1995, did not contain protections against sanctions. Now, however, the FAA cannot take enforcement action based on FOQA safety data, and an airline is limited to "corrective action" under the program. Union contracts can exclude FOQA from the realm of disciplinary action, although airline practice may be for airlines to require retraining if there is no contract in place forbidding it. The data is protected against disclosure for litigation and public media purposes by FAA Order 8000.81, issued in 2003, which placed FOQA under the protections of FAR 193. The figure on the next page shows when each program began, and when each statute, regulation, or order became effective for that program.