• 제목/요약/키워드: Risk Adjustment

검색결과 389건 처리시간 0.026초

미국표준연구원 체크리스트 Z-365의 자가보고형 설문개발 및 타당도 평가 (Development of Self Administered Questionnaire and Validity Evaluation for American National Standards Z-365 Checklist)

  • 박경식;강동묵;이용환;우지훈;신용철
    • 한국산업보건학회지
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    • 제16권2호
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    • pp.172-182
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    • 2006
  • Self administered checklist is needed to be developed to evaluate ergonomic risk factors. This study was conducted to develop self administered form of American National Standards Institute (ANSI) Z-365 checklist which represents comprehensive ergonomic risk factors, and to evaluate validity of this checklist. This study had been conducted from May 2004 to July 2005, of which subjects were 147 workers from 4 workplaces. Response rates for every items of self administered form of ANSI Z-365 were evaluated. To estimate the validity of checklist, relationship between the checklist grade that ANSI recommended and work-related musculoskeletal disorders (WMSDs) symptom were calculated with and without adjustment of related variables. To evaluate the utility of checklist, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Because response rates of almost items were over 90 %, item development was successful. Because the checklist was related with WMSDs symptom after adjusting related variables, the checklist might represents ergonomic risk well. Because of low sensitivity and NPV, high specificity and PPV, the checklist is not suitable for screening tool. The checklist has better relationship with more severe symptom. Because of high specificity of the checklist, using it with high sensitive tool would enhance it's utility. Further study to develop high sensitive and comprehensive self administered ergonomic checklist is needed.

관상동맥우회술 수술환자의 수술 후 사망률 예측모형의 개발 (Severity-Adjusted Mortality Rates : The Case of CABG Surgery)

  • 박형근;권영대;신유철;이진석;김해준;손문준;안형식
    • Journal of Preventive Medicine and Public Health
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    • 제34권1호
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    • pp.21-27
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    • 2001
  • Objectives : To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the perfermance of hospitals. Methods : Data from 564 CABGs peformed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic repression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, $R^2$, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. Results : The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission. acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and $R^2$ were 0.791 and 0.001, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were net significantly different. Conclusion : Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may He an indicator for evaluating hospital performance in Korea.

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Association between fish and shellfish, and omega-3 PUFAs intake and CVD risk factors in middle-aged female patients with type 2 diabetes

  • Kim, Hyesook;Park, Seokyung;Yang, Hyesu;Choi, Young Ju;Huh, Kap Bum;Chang, Namsoo
    • Nutrition Research and Practice
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    • 제9권5호
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    • pp.496-502
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    • 2015
  • BACKGROUND/OBJECTIVES: This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS: A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS: In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS: These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D.

Association of Thigh Muscle Mass with Insulin Resistance and Incident Type 2 Diabetes Mellitus in Japanese Americans

  • Han, Seung Jin;Boyko, Edward J.;Kim, Soo-Kyung;Fujimoto, Wilfred Y.;Kahn, Steven E.;Leonetti, Donna L.
    • Diabetes and Metabolism Journal
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    • 제42권6호
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    • pp.488-495
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    • 2018
  • Background: Skeletal muscle plays a major role in glucose metabolism. We investigated the association between thigh muscle mass, insulin resistance, and incident type 2 diabetes mellitus (T2DM) risk. In addition, we examined the role of body mass index (BMI) as a potential effect modifier in this association. Methods: This prospective study included 399 Japanese Americans without diabetes (mean age 51.6 years) who at baseline had an estimation of thigh muscle mass by computed tomography and at baseline and after 10 years of follow-up a 75-g oral glucose tolerance test and determination of homeostasis model assessment of insulin resistance (HOMA-IR). We fit regression models to examine the association between thigh muscle area and incidence of T2DM and change in HOMA-IR, both measured over 10 years. Results: Thigh muscle area was inversely associated with future HOMA-IR after adjustment for age, sex, BMI, HOMA-IR, fasting plasma glucose, total abdominal fat area, and thigh subcutaneous fat area at baseline (P=0.033). The 10-year cumulative incidence of T2DM was 22.1%. A statistically significant interaction between thigh muscle area and BMI was observed, i.e., greater thigh muscle area was associated with lower risk of incident T2DM for subjects at lower levels of BMI, but this association diminished at higher BMI levels. Conclusion: Thigh muscle mass area was inversely associated with future insulin resistance. Greater thigh muscle area predicts a lower risk of incident T2DM for leaner Japanese Americans.

Insufficient Rest Breaks at Workplace and Musculoskeletal Disorders Among Korean Kitchen Workers

  • Park, Sungjin;Lee, Jongin;Lee, June-Hee
    • Safety and Health at Work
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    • 제12권2호
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    • pp.225-229
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    • 2021
  • Background: The socioeconomic burden of musculoskeletal disorders (MSDs) is significant, and kitchen work is a high-risk occupation for MSDs due to the intensive manual workload and repetitive movements that are involved. However, there are very few studies on MSDs and rest breaks as a workplace intervention among kitchen workers. This study examined the relationship between insufficient rest breaks and increased MSD risk among Korean kitchen workers. Methods: Sociodemographic and occupational factors of 1,909 kitchen workers were collected from the 3rd-4th Korean Working Conditions Survey data. Five items on rest breaks at work were categorized into two groups, "sufficient" and "insufficient." The number of MSDs and work-related MSDs (WMSDs), an outcome variable, was obtained from the sum of MSDs/WMSDs in three anatomical sites (back, neck, and upper limb, lower limb). The association between rest breaks and MSDs was estimated using zeroinflated negative binomial analyses, with adjustments for age, education level, and weekly working hours, and the analyses were stratified by sex. Results: After adjustment, significant associations were found between insufficient rest breaks and an increased risk of MSDs (odds ratio [OR] 1.68 95% confidence interval [CI] 1.11-2.54) and WMSDs (OR 1.40 95% CI 1.01-1.96) among female kitchen workers. Insufficient rest breaks were significantly associated with MSDs in female kitchen workers in all three anatomical sites. Conclusion: This study emphasizes the need for rest breaks as a workplace intervention for preventing MSDs in kitchen workers. Further studies to reveal the causality of this relationship are required.

여성노인의 대사증후군과 모유수유, 골밀도와의 연관성 분석 (An Analysis of The Correlation between Breast-feeding, Bone Mineral Density and Metabolic Syndrome in Elderly Women)

  • 황정희
    • 문화기술의 융합
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    • 제7권3호
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    • pp.51-58
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    • 2021
  • 여성은 폐경이후에 대사증후군의 위험이 더욱 증가한다고 보고되고 있지만, 출산으로 인한 모유수유, 골밀도와 대사증후군의 융합적 연관성에 대한 연구는 부족하다. 본 연구에서는 2010년과 2011년의 제 5기 국민건강영양조사의 원시자료를 이용하여 여성노인 939명을 대상으로, 모유 수유한 자녀수 기준의 세 그룹으로 분류하여 모유 수유한 자녀수, 골밀도와 대사증후군과의 연관성을 분석하였다. 분석 결과에서 변수 보정 후 모유수유 자녀수의 증가에 따른 대사증후군의 위험요인과 골밀도와의 유의한 연관성은 나타나지 않았지만, 모유 수유한 자녀수가 많은 여성노인은 더 많은 대사증후군 위험 요소들과 유의한 연관성을 보였다. 이러한 연구결과는 여성노인의 대사증후군 예방과 진단 그리고 건강관리를 위한 기초 자료로 활용될 수 있다.

주유소 내 연료전지설비에 대한 사고피해예측 연구 (A Study on Damage Assessment for Fuel Cell Facilities in Gas Stations)

  • 임성윤;이장춘;이재훈;최승호
    • 한국방재안전학회논문집
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    • 제16권1호
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    • pp.71-80
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    • 2023
  • 연료전지는 저탄소 발전원으로 주유소 내 연료전지를 설치 시 분산에너지와 전기차 충전인프라를 확충할 수 있다. 주유소 내 연료전지 설치 시 안전성 확보를 위하여 국‧내외 주유소 및 연료전지의 사고데이터를 기반으로 사고시나리오를 도출하고 사고피해예측을 위한 정량적 위험성평가를 실시하였다. 최악의 사고시나리오가 아닌 현실적으로 발생 가능한 화재 및 폭발사고의 피해범위를 산출하고, 피해영향을 분석한 결과 주유기로부터 9.0 m, 주유 중 차량으로부터 15.5 m, 통기관으로부터 4.1 m, 연료전지의 정압기 등 가스조정장치로부터 1.1 m 이상 이격 시 사고로 인한 심각한 피해 위험을 낮출 수 있는 것으로 나타났다. 이러한 연구 결과는 주유소 내 연료전지 배치 및 사고피해를 경감할 수 있는 안전대책 수립에 활용할 수 있을 것으로 기대된다.

호스피스.완화의료에서의 사별 돌봄 (Bereavement Care in Hospice and Palliative Care)

  • 김창곤
    • Journal of Hospice and Palliative Care
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    • 제10권3호
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    • pp.120-127
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    • 2007
  • Bereavement is the state of loss resulting from death. Grief is the emotional response associated with loss, intense and acute sorrow resulting from loss. Complicated grief represent a pathological outcome involving social, physical, emotional, cognitive, spiritual morbidity. The common psychiatric disorders associated complicated grief or abnormal grief responses include clinical depression, anxiety disorders, alcohol abuse or other substance abuse, and dependence, psychotic disorders, and post-traumatic stress disorder (PTSD). Grief tasks involve a series of stage or phases following an important loss that gradually permit adjustment and recovery. Three phases of grief involve phase 1 (walking the edges), phase 2 (entering the depths), and phase 3 (reconnecting the world). For intervention to be effective they need to be individually tailored to abnormal grief reaction or unresolved grief reaction. Clear understandings of complicated grief, abnormal responses, factors increasing risk after bereavement will often enable us to prevent psychiatric disorders in bereaved patients.

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초저속 후방 추돌시 BioRID-II를 이용한 목 상해 지수 측정에 관한 연구 (A Study on the Neck Injury Criteria Using BioRID-II during Very Low Speed Rear-end Collision)

  • 홍승준;유한규;김영은
    • 한국자동차공학회논문집
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    • 제21권4호
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    • pp.54-61
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    • 2013
  • Although typically classified as AIS 1, whiplash injuries continue to represent a substantial social problem with associated costs estimated at over $1 billion annually. The primary objective of this study was to determine the effects of seat positions(seatback angle, headrest height) on risk for whiplash injury in very low speed(${\Delta}V$=4~10km/h) rear-end impact. To accomplish this, rear impact seat carriage tests and simulations were conducted using the BioRID-II dummy seated in a mass production seat, which allowed for the adjustment of seatback angle and headrest height. Neck injury criteria(NIC, Nkm) were then compared for different ${\Delta}V$ and seat positions.

The Multiethnic Cohort Study of Diet and Cancer: Design and Early Findings

  • Kolonel, Laurence N.
    • Nutritional Sciences
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    • 제7권1호
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    • pp.53-58
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    • 2004
  • The Multiethnic Cohort Study was designed to study prospectively the relationship of diet and other lifestyle factors to the risk of cancer. The cohort was established in 1993-1996 in Hawaii and California (primarily Los Angeles) and included a representative sample of more than 215,000 men and women primarily from five different ethnic groups: Japanese, whites, Native Hawaiians, Latinos, and African- Americans. Because of the emphasis on diet, great attention was paid to developing and pre-testing a self-administered quantitative food frequency questionnaire that would adequately assess food and nutrient intakes in these groups. An extensive food composition database was also created for the study. In addition, during data collection, a calibration study was conducted that makes possible adjustment for measurement error in nutrient intakes and valid comparison of intakes across the several ethnic groups. At the present time, blood and urine specimens are being collected from cohort participants and should yield a biorepository of more than 80,000 subjects. Baseline data indicate that the cohort is well representative of the general population of Hawaii and California, so that results can be generalized. These data also show a wide range in dietary intakes and in other lifestyle variables that should facilitate the testing of etiologic hypotheses.