Clinical Specialist in Oncology, Pharmacy Department, West Virginia University Medicine, Morgantown, West Virginia
A deduction may only be claimed on that portion of the bad debt that represents the amount reported as subject to tax blood pressure chart who purchase 75mg triamterene otc. In determining that amount hypertension jnc 8 summary purchase triamterene 75 mg otc, all payments and credits to the account may be applied ratably against the various charges that comprise the bad debt blood pressure 4080 75mg triamterene overnight delivery, except as provided by paragraph (3) of this subsection blood pressure medication given during pregnancy buy triamterene 75mg on-line. A person claiming a credit or refund under this subsection cannot add to the credit or refund amount: (i) the expense of collecting a bad debt; (ii) the expense of repossessing or selling a repossessed item; or (iii) the amount that a third party has retained or which has been paid to a third party for the service of collecting a bad debt or the service of repossessing or selling a repossessed item. If the retailer or private label credit provider claims a refund that includes accounts sold to a third party, the retailer or private label credit provider must provide the detailed collection amounts for sold accounts. If the person claiming the refund does not have the actual collection information, the comptroller will estimate the post-sale collections in calculating the amount eligible for a refund. Only the retailer who made the sale, or an affiliate or assignee of the retailer, is entitled to a credit or refund for local sales and use tax paid on a bad debt or the unpaid portion of the sales price of a taxable item repossessed under a conditional sales contract. A claim for a credit or a refund under this subsection must be submitted within four years from the date a bad debt is actually charged off for federal income tax purposes or the date the taxable item is repossessed, whichever is applicable. A person who later collects any payment on a bad debt or sells a repossessed item for which a credit or refund was claimed must report the total amount collected or received from the sale as a taxable sale in the reporting period in which the collection or sale occurs. A person who does not hold a valid Texas sales and use tax permit but is otherwise entitled the comptroller approves the procedures used; 46 TexReg 6386 September 24, 2021 Texas Register to a credit or refund under this subsection can only request a refund in writing from the comptroller for sales and use tax paid to the comptroller on the bad debt or the unpaid portion of the sales price of a taxable item repossessed. A person claiming a credit or requesting a refund for sales and use taxes paid on a bad debt or the unpaid portion of the sales price of a taxable item repossessed must maintain and make available to the comptroller: (i) date of original credit sale and name and Texas sales and use tax permit number of the retailer who collected and remitted the sales and use tax to the comptroller; (ii) (iii) amount that the purchaser contracted to pay; taxable and nontaxable charges; remitted to the comptroller with respect to the bad debt or unpaid sales price of a taxable item under a conditional sales contract. The new request should use a method that differs from the alternative method that the comptroller revoked. The approval does not extend to any other person, regardless of whether the requesting person and the other person are affiliates or file a consolidated federal income tax return. The deduction must not include any nontaxable charges that were a part of the original sales contract. Any payments that the purchaser made prior to repossession must be applied ratably against the various charges in the original sales contract. In addition to the requirements in subparagraph (C) of this paragraph, an assignee claiming a credit or requesting a refund for sales and use tax paid on a bad debt must maintain and make available to the comptroller the following additional information: (i) amount of bad debt acquired; (ii) name and taxpayer number of the original retailer who collected and remitted the sales or use tax; (iii) name and taxpayer number of the person from whom the assignee acquired the bad debt; and (iv) a written assignment with specific language transferring the right to a credit or refund of Texas sales or use tax paid on a bad debt executed by the person from whom the assignee acquired the bad debt. A person who is otherwise qualified to claim a credit or request a refund under this subsection, and whose volume and character of uncollectible accounts warrants an alternative method of substantiating the refund or credit, may request approval from the comptroller to use an alternative method of maintaining records, or an alternative method of calculating a credit or refund, by submitting a written request to the Audit Division, P. If the vendor, mortgagee, secured party, assignee, trustee, sheriff, or officer of the court does not collect the tax, the purchaser must remit the tax directly to the comptroller. Sellers who use [on] a cash basis of accounting and who sell taxable items by means of a credit sale [on credit] and charge interest on the amount of credit extended, including sales and use tax, are required to remit to the comptroller a portion of the interest that has been collected on the state and local sales and use taxes. In determining the amount of interest to be remitted to the comptroller, a seller does not need to calculate the interest on each individual account. A formula for the calculation may be used if the formula correctly reflects the amount of interest collected. For example, sales and use tax will be due only on the difference between the amount allowed on an old piano taken in trade and the sales price of a new piano. The sales price of a taxable item does include the value of a trade-in that a seller takes as all or part of the consideration for the sale of a taxable item, if the trade-in is a different type from the type normally sold by the seller in the regular course of business. For example, a seller who sells only [of] pianos who takes a desk in trade as part of the sales price of a piano collects [would collect] sales and use tax on the retail sales price of the piano without any deduction for the value of the desk. However, if the [a] seller of pianos is also a seller of desks, the value of the desk is [would be] allowed as a trade-in. Sellers [Persons] who remove items from a tax-free inventory for use as a trade-in owe sales and use tax on their purchase [the cost] price of the items. If both parties to a transaction remove items from a tax-free inventory to trade for other items that each party will use, the transaction is [will be] regarded as bartering [barters] by both parties. Each party to the barter is [will be] required to collect sales and use tax on the retail sales price of the item being transferred. For example, a seller of drill pipe trades pipe to a seller of appliances in exchange for a refrigerator. The appliance seller must collect sales tax on the retail sales price of the refrigerator. Tax paid on an account that is later determined to be uncollectible and written off as a bad debt for federal tax purposes is not tax paid in error and does not accrue interest. The amendments were originally published for public comment in the October 16, 2020, issue of the Texas Register (45 TexReg 7404) but were not adopted until June 10, 2021. Kinsey has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. If the person in charge, the administrator, or the director of the operation is the perpetrator, we will notify the permit holder or other appropriate person; and (5) Notification to the reporter of the completion of the investigation within five calendar days after the investigation is closed. What actions regarding an abuse, neglect, or exploitation finding may we take at the conclusion of the administrative review Comments must be submitted by October 25, 2021, 31 days from publication in the Texas Register. The amendments will affect Texas Human Resources Code, Title 7, Chapter 112, Developmental Disabilities. Stalvey has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. Stalvey has also determined that for each year of the first five years the rule is in effect, the updates will further efforts to create change so that all people with disabilities are fully included in their communities and exercise control over their own lives. Beth Stalvey, Council Executive Director, has determined there is no fiscal implications to these amendments. Stalvey has also determined that for each year of the first five years the rules are in effect, the updates will further efforts to create change so that all people with disabilities are fully included in their communities and exercise control over their own lives. Comments must be submitted by October 25, 2021, 31 days after publication in the Texas Register. The Council shall reimburse the grantees for the reasonable cost of the required audit activities. Any indirect costs of a grantee above those amounts may be allowed as part of the required non-federal participant share. Selection criteria shall be designed to select applications that provide best overall value to the state and to the Council and meet the requirements and intent of the Council as provided in the request for applications [proposals]. Appeals may be submitted from applicants for grants who did not receive funding, or from grantees whose grants have not been awarded continuation funding. The appeals process adopted by the Council shall be included in the agency grants manual [grant application materials]. We continue to work on solutions to preserve the financial resources many of our hospitals depend on to provide access to quality care to Medicaid clients and the uninsured. State plan amendments to include various hospital ownership types may be submitted on individual timelines. The program will provide additional funding to hospitals to help offset the cost hospitals incur while providing Medicaid services. Calculations Comment: Multiple commenters shared concerns about using commercial rates to determine allocation of funds. The payments are calculated based on historical data and will be paid out twice a year based on the estimates using the historical data. Comment: A commenter suggested clarifying language related to data used in the definitions of Average Commercial Reimbursement gap and Medicare payment gap. Per our most recent licensing records, this hospital does not meet the definition of a non-state government-owned and operated hospital. The methodology was updated as a result of comments to remove the Average Commercial Reimbursement gap. For Texas Medicaid purposes, fee-for-service excludes any service rendered under a managed care program through a managed care organization. As a condition of participation, all hospitals participating in the program must allow for the following.
As the cuff pressure is released arteria y arteriola order 75 mg triamterene with visa, the pressure at which the sound muffles (K4) and the pressure at which the sound disappears (K5) should also be recorded hypertension orthostatic order 75 mg triamterene with amex. These oscillometric methods uses a machine that automatically inflates and deflates the cuff while monitoring pulse-related air pressure fluctuations within the cuff prehypertension 125 triamterene 75 mg mastercard. Deflation is performed in a stepwise fashion arrhythmia icd 9 discount triamterene 75mg without a prescription, and at each step the machine pauses for 2 seconds or less while the cuff pressure oscillations are recorded. The amplitude of these pulsatile oscillations begins to increase as the cuff pressure falls to the level of the systolic blood pressure, reaches a maximum amplitude at a cuff pressure equal to mean blood pressure, and diminishes as cuff pressure falls to diastolic levels. Because the method depends on measurement of faint pulsatile pressure oscillations, irregular heart rhythm. Leg blood pressure should also be taken with an appropriate-sized cuff, usually larger than the cuff used for measurement of the arm blood pressure in the same patient. Since the same-sized cuff is frequently used at both sites, the pressure values obtained may be higher in the legs than in the arms. Coarctation of the aorta is suspected when the systolic pressure is 20 mmHg lower in the legs than in the arms. When using automated methods requiring nonsimultaneous measurement, recording the heart rate measured with each 12 Pediatric cardiology pressure reading may be helpful, since wide rate variations may give a clue to varying states of anxiety and may help in the interpretation of differing pressure values. Pulse pressure (the difference between the systolic and diastolic pressures) normally should be approximately one-third of the systolic pressure. Pulse pressure widens in conditions with an elevated cardiac output or with abnormal runoff of blood from the aorta during diastole. Adapted from National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Coarctation of the aorta, for example, can be considered by comparing the femoral with the upper-extremity arterial pulses. Mistakes have been made, however, in interpreting the quality of femoral arterial pulses. Palpation alone is not sufficient either to diagnose or to rule out coarctation of the aorta. Respiratory rate and effort the respiratory rate and respiratory effort should be noted. Although the upper limit of normal respiratory rate for an infant is frequently given as 40 breaths per minute, observed rates can be as high as 60 breaths per minute in a normal infant; the respiratory effort in such infants is easy. Difficulty with breathing is indicated by intercostal or suprasternal retractions or by flaring of the alae nasae. Premature infants or neonates may show periodic breathing, so the rate should be counted for a full minute. Cardiac examination Inspection Cardiac examination begins with inspection of the thorax. A precordial bulge may be found along the left sternal border in children with cardiomegaly. The upper sternum may bulge in children with a large left-to-right shunt and pulmonary hypertension or with elevated pulmonary venous pressure. Depth of respirations and effort expended by the patient are equally or more important than the rate itself. In infants and children under 4 years of age, the apex impulse, which is the most lateral place that the cardiac impulse can be palpated, should be located in the fourth intercostal space at the mid-clavicular line. In older children, it is located in the fifth intercostal space at the midclavicular line. These are best identified by palpation of the precordium with the palmar surfaces of the metacarpophalangeal and proximal interphalangeal joints. Thrills are coarse, low-frequency vibrations occurring with a loud murmur, and are located in the same area as the maximum intensity of the murmur. In any patient suspected of congenital heart disease, the suprasternal notch also should be palpated but with a fingertip. A thrill at this site indicates a murmur originating from the base of the heart, most commonly aortic stenosis, less commonly pulmonary stenosis. Forceful, outward movements of the precordium (heaves) indicate ventricular hypertrophy. Right ventricular heaves are located along the right sternal border, and left ventricular heaves are located at the cardiac apex. Percussion Percussion of the heart can substantiate estimation of cardiac size in addition to that obtained by inspection and palpation. Auscultation of the heart Auscultation of the heart provides perhaps the most useful diagnostic information and should be performed in a systematic way to obtain optimum information. It should have short, thick tubing, snug-fitting earpieces, and both a bell and a diaphragm. Low-pitched sounds and murmurs are heard best with the bell, and high-pitched sounds with the diaphragm. For most children, a 34-inch bell and a 1-inch diaphragm are suitable for auscultation, although an adult-sized bell and diaphragm are preferable if adequate contact can be made with the chest wall. A diaphragm 1 inch in diameter can be used in children of all ages, since only part of the diaphragm need be in 24 Pediatric cardiology contact with the chest wall to transmit sound. In infants, initially auscultate through the clothing despite the often-quoted admonition that auscultation should never be performed in such a manner. Sometimes removing the clothes disturbs the child and results in a fussy state that precludes adequate auscultation. After the initial period of listening, the clothing can be removed to listen further. In older children, they can sit on the examination table and the examination can proceed as in adults. Both the anterior and posterior thorax are auscultated with the patient in the upright position. Each of the five major areas (aorta, pulmonary, tricuspid, mitral, and back) is carefully explored. High-pitched murmurs and the first and second heart sounds are heard better with the diaphragm; low-pitched murmurs and the third heart sound are most evident with the bell. The diaphragm should be applied with moderate pressure; the bell must be applied with only enough pressure for uniform contact and not enough force to stretch the underlying skin into a "diaphragm," which alters the sensitivity to low frequencies. When auscultating the heart, attention is directed not only to cardiac murmurs but also to the quality and characteristics of the heart sounds. As the ventricles begin to contract, the papillary muscles close the mitral and tricuspid valves. The pressure in the ventricles soon exceeds the atrial 1 Tools to diagnose cardiac conditions in children 25 pressure and continues to rise until it reaches the diastolic pressure in the great vessel, at which point the semilunar valves open. During the next period, the ejection period, blood leaves the ventricles, and the ventricular pressure slightly exceeds the pressure in the corresponding great artery. As blood flow decreases, eventually the pressure in the ventricle falls below that in the great vessel, and the semilunar valve closes. Diastole Diastole is divided into three consecutive phases: Early Early diastole is defined as the portion of ventricular diastole comprising the isovolumetric relaxation period, a time when ventricular pressures are falling but the volume is not changing because all cardiac valves are closed. The rapid filling phase comprises approximately the first 20% of diastole, during which about 60% of blood flow into the ventricle occurs. When a third heart sound (S3) is present, it occurs at the transition between the rapid and slow filling phases (see Figure 1. Late Late-diastole begins with atrial contraction and the remaining 20% of ventricular filling occurs. The timing and meaning of cardiac sounds and murmurs are easily understood by considering their location within the cardiac cycle and the corresponding cardiac events. Although the origin of heart sounds remains controversial, we will discuss them as originating from valvar events.
The hepatic metabolism of lidocaine can be reduced by administration of lipophilic beta blockers arteria jugular purchase triamterene 75 mg on line, such as propranolol blood pressure 6030 75mg triamterene with amex. The term use dependence arteriogenesis buy triamterene 75mg lowest price, you may recall heart attack the song order triamterene 75mg with visa, refers to the time-related effect of Class I drugs on the sodium channel; as a result of binding kinetics, the degree of sodium-channel blockade increases as the heart rate increases. Reverse use dependence means that at slower heart rates, the prolongation of the action potential is most pronounced; at faster heart rates, the effect diminishes. Drugs that preferentially bind to closed potassium channels, for instance, display significant reverse use dependence because phase 4 of the action potential is longer (and thus potassium channels spend more time in the closed state) when the heart rate is slow. The low magnitude of reverse use dependence seen with amiodarone may explain not only its remarkable efficacy against tachyarrhythmias but also its low incidence of producing torsades de pointes. Amiodarone Amiodarone was synthesized in Belgium in the 1960s as a vasodilator, mainly for the purpose of treating angina. Electrophysiologic effects Amiodarone displays activity from all four antiarrhythmic classes. When therapy with amiodarone is first initiated, prolongation of refractoriness is not seen immediately. Instead, refractory periods gradually increase during the prolonged loading period (see below). Clinical pharmacology the clinical pharmacology of amiodarone can be fairly described as being bizarre, complex, and incompletely understood. Once absorbed, amiodarone displays a complex pattern of distribution that is usually described as (at least) a three-compartment model. The first, or central, compartment is thought to consist of the intravascular space. With aggressive loading regimens, the central compartment can be largely saturated within 24 hours. It takes many weeks or months for the third compartment to become saturated, and it may never actually become completely saturated. Tissue concentrations of amiodarone vary markedly from organ to organ and are the highest in organs with high-fat content, such as the liver and the lungs. If the drug is discontinued, the concentration of amiodarone in the central compartment (the serum) falls quickly to low levels, but the low serum levels persist for weeks or months because of the slow leaching of the drug from the peripheral and deep compartments. Its chief means of elimination may actually be the gradual and natural sloughing of amiodaronepacked epithelial cells. The half-life of the drug has been reported as being between 2 weeks and 3 months in duration. This extraordinarily long half-life is reflected in the low daily dosage requirement after loading has been achieved. This sort of loading regimen was derived empirically, but it is a logical approach. By giving large doses for days to weeks, one can achieve relatively rapid saturation of the central and peripheral compartments. Achieving a steady state, however, requires filling the deep compartment, which takes many weeks. When treating non-life-threatening arrhythmias or when using amiodarone as prophylaxis against arrhythmias that are not manifest, a much gentler loading regimen is often used. Less aggressive loading schedules may avoid some toxicities associated with administering higher doses of the drug but require significantly more time to achieve both an antiarrhythmic effect and a steady state. The use of intravenous amiodarone is generally reserved for the treatment of recurrent life-threatening ventricular tachyarrhythmias that have not responded to other therapies. Accordingly, the most prominent electrophysiologic effect is prolongation of the Table 5. When amiodarone is loaded intravenously, 1 g is delivered during the first 24 hours as follows: 150 mg is infused during the first 10 minutes (15 mg/min), followed by 360 mg during the next 6 hours (1 mg/min), and then followed by 540 mg during the next 18 hours (0. If intravenous therapy is still desired after the first 24 hours, the infusion can continue at 0. Amiodarone is the most effective drug yet developed for recurrent ventricular fibrillation or hemodynamically unstable ventricular tachycardia. Early studies with amiodarone generally limited its use to patients whose ventricular tachyarrhythmias had proven refractory (most often, as documented during electrophysiologic testing) to other antiarrhythmic therapy. Even in this difficult-to-treat population, amiodarone reduced the risk of sudden death to about half that seen with more conventional drugs. In subsequent randomized trials, however, amiodarone proved to be significantly inferior to the implantable defibrillator in reducing mortality. The main indications for oral amiodarone today in the treatment of ventricular arrhythmias are to either reduce the frequency of shocks in patients who have implantable defibrillators or offer at least partially effective therapy to patients deemed not to be candidates for an implantable defibrillator. Amiodarone is moderately effective in maintaining sinus rhythm in patients with atrial tachyarrhythmias, including atrial fibrillation and atrial flutter. In patients with heart failure, amiodarone is probably the drug of choice after cardioversion for atrial fibrillation, since it has few adverse hemodynamic effects, and often results in a wellcontrolled ventricular response should the arrhythmia recur. Adverse effects and interactions Amiodarone causes a high incidence of side effects, ranging from merely annoying to life threatening. Many side effects of amiodarone appear to be related to the total lifetime cumulative dose of the drug (rather than to the daily dosage). Even when low daily dosages are used, therefore, significant side effects are seen, and the risk of developing new side effects continues to increase as therapy continues over time. Side effects occur in approximately 15% of patients during the first year but increase to over 50% with chronic therapy. Adverse effects require discontinuation of the drug in approximately 20% of patients. It has been widely speculated that much of the unique organ toxicity seen with amiodarone is related to the iodine atoms contained in the drug, a feature not shared by any other antiarrhythmic drug. Nausea, vomiting, or anorexia have an incidence of approximately 25% during the high-dose loading phase, but these symptoms often improve with lowering of the daily dosage. Esophageal reflux caused by an amiodarone-induced paralysis of the lower esophageal sphincter is an uncommon but potentially devastating side effect. Elevation of hepatic transaminases of up to twice normal values is seen in about 25% of patients treated with amiodarone. In most cases, these elevations return toward normal after a few months, although amiodarone-induced hepatitis has been reported in approximately 3% of patients. When hepatic transaminases remain chronically elevated, the consequences are unclear. Pulmonary complications are generally considered the most dangerous side effect seen with amiodarone and are the form of toxicity most likely to prove fatal. Acute adult respiratory distress syndrome from amiodarone-induced pneumonitis can be seen at any time during therapy, but the time of highest risk is probably immediately after surgery, especially cardiac surgery. A chronic interstitial fibrosis can also be seen with amiodarone; the 94 Chapter 5 incidence of this problem is unclear. Therefore, routine pulmonary function tests do not appear to help in predicting which patients will eventually develop lung toxicity. Approximately 10% of patients treated with amiodarone eventually develop true hypothyroidism (a low serum T4 level is always significant in patients taking this drug), and a smaller proportion develop hyperthyroidism. Although hypothyroidism can be treated relatively easily with thyroid-replacement medication, hyperthyroidism represents a difficult clinical problem because of its presentation and its treatment. Further, because amiodarone itself contains a significant amount of iodine, patients receiving amiodarone have highiodine stores, which thus precludes the use of radioactive iodine for thyroid ablation. To make matters worse, treating amiodaroneinduced hyperthyroidism with antithyroid drugs can be difficult or even impossible.
The collected e-waste is recycled using responsible methods blood pressure medication cialis discount 75 mg triamterene mastercard, and recovered materials are reused as resources to reduce virgin feedstocks arteria communicans anterior triamterene 75 mg mastercard. Of these arteria umbilical purchase 75 mg triamterene free shipping, mobile phone batteries are processed through the four steps of drilling prehypertension warsaw 2014 safe triamterene 75mg, dipping in salt-water, drying, and crushing to extract rare metals such as cobalt and nickel, to increase resource recycling. In 2019, the Asan Recycling Centre, our recycling facility in South Korea, collected 24,524 tonnes of valuable resources including copper, aluminum, steel and plastic. Some 1,882 tonnes of recycled plastics collected from e-waste were used in product manufacturing. Through these efforts, we continue to reduce the plastic waste and the use of petrochemical raw materials needed to manufacture new products. Earth Day Campaign - Take-back and Recycling of E-waste Starting from 2015, our employees have celebrated Earth Day on April 22 with consumers to promote a range of sustainability campaigns. In South Korea, we have collected unused mobile phones to extract and reuse materials such as metals and plastic, or to upcycle some of the units. In 2019, we expanded this program to other countries including the United States, Spain, and Russia. In addition, we gave away plant pots, eco-conscious souvenirs, and brochures on environmental awareness to customers at 25 our service centers around the world. Kvadrat Phone Case - Plastic Waste Turned into Smartphone Case Cover Under a partnership with premium Danish textile brand Kvadrat, we developed a special Galaxy S20+ case cover, made up of recycled plastic waste. Two phone cases can be created from the yarns made from just one 500ml plastic bottle. Through this, we minimize environmental impacts by reducing plastic bottle waste, and encourage upcycling by creating new products. Galaxy Clean-up Partnership - Used Mobile Phone Collection and Recycling in Africa In emerging countries, including many African nations, mobile phone recycling infrastructure is scarce, so most of the wasted phones are often discarded in landfills. To minimize the environmental impact, we launched the Galaxy Clean-up program in the Netherlands in partnership with T-Mobile and social enterprise Closing the Loop. Under this program, together with our partners, we buy, collect and recycle two scrap phones from Africa for every Galaxy S10e sold to a consumer through T-Mobile. As of end of 2019, more than 10,000 used mobile phones were collected and recycled through this partnership. Galaxy Upcycling - Used Mobile Phone Turned to IoT Device Galaxy Upcycling is a program that transforms Samsung Galaxy phones that are no longer in use into Internet of Things (IoT) devices that can contribute to the environment and society. Since 2017, we have supported the development of a medical device that can screen for eye diseases, which resulted in the production of a medical device which costs only 10% of the price of the commercial device. In 2019, a total of 90 devices were distributed in Vietnam, enabling preemptive eye checkups for more than 14,000 people. We ensure equal opportunities for all employees and job applicants, and do not tolerate discrimination of any kind. Furthermore, we embed and integrate the respect for human rights throughout our business to protect and promote the rights of employees of our company and of people in our supply chain. To protect labor and human rights, we have established various policies and regularly evaluate our compliance status and explore ways to enhance our policies. In addition, we strive to protect the human rights of vulnerable groups, such as children and juvenile workers, migrant workers, and apprentices. In 2019, 96% of employees at overseas production subsidiaries and 100% of employees in South Korea completed training programs. In cooperation with external stakeholders, we provided special training on protecting vulnerable groups such as migrant workers. Through this, we were able to raise awareness on protecting the rights of migrant workers and share the importance of eradicating forced labor. Any important matters are escalated to the Sustainability Council, which consists of key executives, and then reported to top management. Worksite Monitoring System Our worksite monitoring system supports the enforcement of labor and human rights and compliance management in areas such as working environment, workplace culture, operation of representative bodies, and management of suppliers. Footnote: 1) Communication, Organization Management, Employee Relationship Capacity, Employee Committees, Training, Compliance, Supplier Management Listening to Employee Opinions We listen to our employees and understand their needs and concerns about labor and human rights through a variety of communication channels. Attendants were informed of business updates and participated in a question and answer session with the management on various agenda including work environment and benefits. Outside of South Korea, heads of subsidiaries hosted 236 similar sessions, where 77,329 employees attended. In addition, we encourage our department heads to meet frequently with team members to discuss matters related to their work relationships and career development. Footnote: 1) Including duplicate attendees Listening to External Stakeholders To identify labor and human rights risk factors that could impact our worksites around the world, it is also important to engage with our external stakeholders. To do this, we engage in regular dialogue with governments, academia and civil society. Labor and Human Rights Impact & Risk Assessment and Audit We periodically evaluate the level of labor and human rights compliance and monitor improvement activities. Samsung Electronics Internal Risk Assessment Every year we use our workplace monitoring system to identify those worksites which are considered high-risk and then conduct a detailed analysis of each of them. In 2019, we performed assessments in six locations, including two in Southeast Asia and one in Europe. As a result, a total of 99 tasks that required improvements were identified, of which 82 tasks (82. We also engage in continuous dialogue to seek mutual solutions and detect and prevent potential risk factors. Our Business Global Crisis Priority Areas Sustainability Pillars Sustainability Foundation Appendix 037 Multistakeholder Forum Since 2018, we have hosted multistakeholder forums in Vietnam. Works Council A total of 42 worksites around the world operate works councils in accordance with the laws of the respective countries and the requirements of each site. Employees elect their own representatives under the principle of direct and anonymous voting. The results of consultations are disclosed to all employees through internal communications channels. In addition, worksites employing migrant workers provide information on grievance resolution channels in their native languages to enhance employee accessibility and grievance channel effectiveness. Footnotes: 1) 300 channels at 29 worksites, as of March 2020 2) /sec-audit. In particular, the number of grievances regarding working environment decreased by 1,462 (33%) from 4,403 in 2017 to 2,941 in 2019. In addition, grievances relating to workers right have resulted in improvements of policies, internal processes and increased capacity building efforts throughout the entire organization. Grievance Reports and Types Types of Grievance Work conditions Work environment Interpersonal relationships Health and safety Work change Organizational change Harassment Discrimination Total 2017 3,894 4,403 2,414 1,755 550 139 64 36 13,255 2018 4,467 4,165 2,362 1,184 440 115 63 18 12,814 Unit: No. Anyone can raise their concerns, free from any discrimination and retributions, and can expect the procedure to be fully transparent and protect the human rights of the involved throughout the entire process. If we decide that discipline is deemed necessary after a thorough review of the reported grievance, we provide fair chances for the accused to appeal against the findings. Our disciplinary actions comply with the laws and regulations of the respective countries and also with the policies of each worksite. In 2019, one of our employees was dissatisfied with the security screening process required for entering the worksite and spoke abusively to a security company employee. Moreover, we are consistently providing training to our employees through our Data Protection Handbook, Privacy Policy on Data Sharing with Third Parties, and other personal data protection guidelines. We will continue to support our employees to recognize the importance of personal data protection and to apply related polices and regulations to their practices. Therefore, we let users decide on whether to allow us to collect, use, and share their data with third parties when using our products and services. For instance, we designed and applied the fingerprint and face recognition technology on our mobile phones so that customers can use their phones and access their personal data safely. In addition, we provide a specialized offline training curriculum for employees who handle personal data during their daily tasks.
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