• Title/Summary/Keyword: Risk Adjustment

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Acceptable work limits for the upper extremities with the psychophysical approach (누적외상병 예방을 위한 심생리학적 접근법을 이용한 상체작업의 안전한 작업기준의 설정에 관한 연구)

  • Kim, Chol-Hong;Marley, Robert J.;Fernandez, Jeffrey E.;Klein, Mary G.
    • Journal of the Ergonomics Society of Korea
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    • v.13 no.2
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    • pp.57-63
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    • 1994
  • This paper summarizes recent research in the use of the psychophysical method of adjustment to establish acceptable parameters for upper extremity work activities. Results from these studies show that this psychophysical approach can provide reliable guidelines based upon realistic job conditions which involve one or more risk factors for cumulative trauma. It is also shown that this method provides advantages over other psychophysical methods as well as current biomechanical and physioligical criteria.

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Family History of Cancer and Head and Neck Cancer Risk in a Chinese Population

  • Huang, Yu-Hui Jenny;Lee, Yuan-Chin Amy;Li, Qian;Chen, Chien-Jen;Hsu, Wan-Lun;Lou, Pen-Jen;Zhu, Cairong;Pan, Jian;Shen, Hongbing;Ma, Hongxia;Cai, Lin;He, Baochang;Wang, Yu;Zhou, Xiaoyan;Ji, Qinghai;Zhou, Baosen;Wu, Wei;Ma, Jie;Boffetta, Paolo;Zhang, Zuo-Feng;Dai, Min;Hashibe, Mia
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.8003-8008
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    • 2015
  • Background: The aim of this study was to investigate whether family history of cancer is associated with head and neck cancer risk in a Chinese population. Materials and Methods: This case-control study included 921 cases and 806 controls. Recruitment was from December 2010 to January 2015 in eight centers in East Asia. Controls were matched to cases with reference to sex, 5-year age group, ethnicity, and residence area at each of the centers. Results: We observed an increased risk of head and neck cancer due to first degree family history of head and neck cancer, but after adjustment for tobacco smoking, alcohol drinking and betel quid chewing the association was no longer apparent. The adjusted OR were 1.10 (95% CI=0.80-1.50) for family history of tobacco-related cancer and 0.96 (95%CI=0.75-1.24) for family history of any cancer with adjustment for tobacco, betel quid and alcohol habits. The ORs for having a first-degree relative with HNC were higher in all tobacco/alcohol subgroups. Conclusions: We did not observe a strong association between family history of head and neck cancer and head and neck cancer risk after taking into account lifestyle factors. Our study suggests that an increased risk due to family history of head and neck cancer may be due to shared risk factors. Further studies may be needed to assess the lifestyle factors of the relatives.

Mechanical versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 to 70 Years

  • Youngkwan Song;Ki Tae Kim;Soo Jin Park;Hong Rae Kim;Jae Suk Yoo;Pil Je Kang;Sung-Ho Jung;Cheol Hyun Chung;Joon Bum Kim;Ho Jin Kim
    • Journal of Chest Surgery
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    • v.57 no.3
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    • pp.242-251
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    • 2024
  • Background: This study compared the outcomes of surgical aortic valve replacement (AVR) in patients aged 50 to 70 years based on the type of prosthetic valve used. Methods: We compared patients who underwent mechanical AVR to those who underwent bioprosthetic AVR at our institution between January 2000 and March 2019. Competing risk analysis and the inverse probability of treatment weighting (IPTW) method based on propensity score were employed for comparisons. Results: A total of 1,580 patients (984 patients with mechanical AVR; 596 patients with bioprosthetic AVR) were enrolled. There was no significant difference in early mortality between the mechanical AVR and bioprosthetic AVR groups (0.9% vs. 1.7%, p=0.177). After IPTW adjustment, the risk of all-cause mortality was significantly higher in the bioprosthetic AVR group than in the mechanical AVR group (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.07-1.80; p=0.014). Competing risk analysis revealed lower risks of stroke (sub-distributional hazard ratio [sHR], 0.44; 95% CI, 0.28-0.67; p<0.001) and anticoagulation-related bleeding (sHR, 0.35; 95% CI, 0.23-0.53; p<0.001) in the bioprosthetic AVR group. Conversely, the risk of aortic valve (AV) reintervention was higher in the bioprosthetic AVR group (sHR, 6.14; 95% CI, 3.17-11.93; p<0.001). Conclusion: Among patients aged 50 to 70 years who underwent surgical AVR, those receiving mechanical valves showed better survival than those with bioprosthetic valves. The mechanical AVR group exhibited a higher risk of stroke and anticoagulation-related bleeding, while the bioprosthetic AVR group showed a higher risk of AV reintervention.

The relationships of body mass index, waist-to-height ratio, and body fat percentage with blood pressure and its hemodynamic determinants in Korean adolescents: a school-based study

  • Kim, Na Young;Hong, Young Mi;Jung, Jo Won;Kim, Nam Su;Noh, Chung Il;Song, Young-Hwan
    • Clinical and Experimental Pediatrics
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    • v.56 no.12
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    • pp.526-533
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    • 2013
  • Purpose: Obesity is an important risk factor for hypertension in adolescents. We investigated the relationship of obesity-related indices (body mass index [BMI], waist-to-height ratio [WHR], and body fat percentage [%BF]) with blood pressure and the hemodynamic determinants of blood pressure in Korean adolescents. Methods: In 2008, 565 adolescents, aged 12-16 years, were examined. The %BF of the participants was measured by bioelectrical impedance analysis. Echocardiography and brachial artery pulse tracing were used to estimate the stroke volume (SV), cardiac output (CO), total vascular resistance (TVR), and total arterial compliance (TAC). Results: We noted that BMI, WHR, and %BF were positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP). The positive correlation between BMI and blood pressure (SBP and DBP) persisted after adjustment for WHR and %BF. However, after adjustment for BMI, the positive associations between blood pressure (SBP and DBP) and WHR as well as %BF, were not noted. With regard to the hemodynamic factors, BMI, but not WHR and %BF, was an independent positive factor correlated with SV and CO. TVR had an independent negative association with BMI; however, it was not associated with WHR or %BF. Moreover, we noted that BMI, WHR, and %BF did not affect TAC. Conclusion: In Korean adolescents, BMI had an independent positive correlation with SBP and DBP, possibly because of its effects on SV, CO, and TVR. WHR and %BF are believed to indirectly affect SBP and DBP through changes in BMI.

North Koreans' Lives in the United States (미국으로 간 탈북자들의 정착과 적응에 관한 질적 연구)

  • Jun, Myung Hee
    • Korean Journal of Social Welfare
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    • v.64 no.4
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    • pp.89-111
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    • 2012
  • Since the U.S. government officially accepted North Korean(NK) as refugees starting in 2006, about 120 North Koreans have come to and been living in the United States. However, little is known in regard to what the North Korean refugees need for a qualify life. This study aims to explore the essential experiences of North Korean defectors who have settled in the United States after escaping North Korea. Research inquiries are why North Korean refugees have chosen the United States for their settlement, and how they are living in the United States. Data were collected from in-depth interviews with eight NK refugees. For data analysis, grounded theory approach by Strauss and Corbin(1998) was employed. The data analysis identified the central phenomenon, protective and risk factors, and core actions and consequences of NK refugees' adjustment in the U.S. The central phenomenon was "voluntary choose to come to the U.S." The core action and consequences in the process of their adjustment were 'searching for the meaning of life,' and 'achieving acculturation.' The findings may provide deeper understanding on the situation of North Korean refugees in the U.S. and implications for how to help them adjust well in the society.

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Abdominal Obesity and Associated Factors in the Elderly with a Focus on Health Habits, Mental Health, Chronic Diseases, and the Nutrient Intake Status: Data from the 2014 Korea National Health and Nutrition Examination Survey (우리나라 노인의 복부비만과 관련 요인 - 생활습관, 정신건강, 질환 및 영양소섭취 상태 중심으로: 2014 국민건강영양조사 자료 -)

  • Lee, Hye-Sang
    • Journal of the Korean Dietetic Association
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    • v.26 no.1
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    • pp.42-53
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    • 2020
  • The relationship of abdominal obesity ("AO") with co-morbidity and mortality is well established. This study assessed the factors associated with AO, which was defined as a waist circumference ≥90 cm for men and ≥85 cm for women, in the group aged over 65 years. A total of 1,435 subjects were analyzed among the participants of the 2014 Korean National Health and Nutrition Examination Survey. Statistical methods for a complex sample were applied by using a SPSS program (ver. 25.0). AO was more frequently found in females. The results of the logistic regression analysis showed that heavy drinking (OR: 1.53), no weight training (OR: 0.68), stressful mental status (OR: 0.61), bad health-related quality of life (by EQ_5D, OR: 1.45), hypertension (OR: 2.18), prediabetes (OR: 1.94), diabetes (OR: 1.63), low HDL-cholesterol (OR: 1.86), anemia (OR: 0.55), and heavy energy intake (OR: 1.41) were significantly related with the prevalence of AO after adjustment for gender. Heavy drinking (OR: 1.89), bad self-rating of health status (OR: 1.72), low HDL-cholesterol (OR: 1.85), heavy energy intake (OR: 1.79), low intake of riboflavin (OR: 1.60) were still significantly related with the prevalence of AO after adjustment for gender and body mass index (BMI), this study suggests that certain characteristics of health habits, mental health status, and chronic diseases may be associated with AO. This study did not establish the existence of relationship between nutrient intakes, except for riboflavin, and risk of AO, but this study suggests that prospective research is needed to establish causal connections among those factors.

The difference of the effects of private tutoring expenditure on the change of consumption structure of households depending on income bracket (소득계층별 사교육비 증가에 따른 가구의 소비지출 변화)

  • Baek, Hakyoung;Ahn, Seo Yeon
    • 한국사회정책
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    • v.19 no.3
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    • pp.9-47
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    • 2012
  • The purpose of this study is to analyse the change of consumption structure of households due to spending on private tutoring, then analyse the difference of change depending on income bracket. The results of the study show that the proportion of private tutoring spending of poor households is relatively higher than high or middle income households although the amount is smaller than them. The consumption items adjusted by the change of private tutoring spending are different depending on income level, and adjustment possibility of them of poor households is very lower than other classes. These show their risk of insufficient consumption of food, clothing, and shelter is high. The burden of private tutoring spending of the poor increase the economic insecurity, therefore various supportive approaches such as improvement of the quality of public education, economic support the poor suffering from the burden of private tutoring spending are necessary to prevent the latent problems of the poor and their children.

Cognitive Impairment and Decreased Quality of Life in Elderly Patients with Subsyndromal Depression (노인 아증후군적 우울증 환자의 인지기능 및 삶의 질 저하)

  • Ryu, Jae Sung;Kim, Moon Doo;Lee, Chang In;Park, Joon Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.20 no.2
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    • pp.45-53
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    • 2013
  • Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

Clinical data analysis in retrospective study through equality adjustment between groups (후향적연구의 집단 간 동등성확보를 통한 임상자료분석)

  • Kwak, Sang Gyu;Shin, Im Hee
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.6
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    • pp.1317-1325
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    • 2015
  • There are two types of clinical research to figure out risk factor for disease using collected data. One is prospective study to approach the subjects from the present time and the other is retrospective study to find the risk factor using the subject's information in the past. Both approached and study design are different but the purpose of the two studies is to identify a significant difference between two groups and to find out what the variables to influence groups. Especially when comparing the two groups in clinical research, we have to look at the difference between the impact clinical variables by group while controlling the influence of the baseline characteristics variables such as age and sex. However, in the retrospective study, the difference of baseline characteristic variables can occur more frequently because the past records did not randomly assign subjects into two groups. In clinical data analysis use covariates to solve this problem. Typically, the analysis method using the analysis of covariance of variance, adjusted model, and propensity score matching method. This study is introduce the way of equality adjustment between groups data analysis using covariates in retrospective clinical studies and apply it to the recurrence of gastric cancer data.

Risk Assessment on the Water BOT Business Participation in China : Domestic EPC Contractor's View (해외기업의 중국 수처리 BOT시장 참여 저해 위험요인 분석 : 국내 EPC 건설기업의 관점)

  • Choi, Jae-ho;Li, Shoushuang;Lee, Seungho
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.28 no.5D
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    • pp.695-703
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    • 2008
  • China water market has huge potential for increased use of BOT mode and one of the most attractive markets of doing business. However, the current China water BOT market shows that many foreign companies are retreating from the market while Chinese water companies fast growing. From the view no domestic companies have track records in China BOT water market, the research identified twenty market access barriers in terms of construction laws, regulations, BOT-related policy and the recent market situation. These are evaluated based on interview results with 10 professionals direct or indirect having a China water BOT experience. All the factors are found to be highly influential to foreign company's decision on the market participation. Among those, no fixed return policy and low water price, difficulty in water price adjustment and approval, and no government guarantees, all directly related to the project viability and under the control of government, were the most critical factors, implying government's role is the key in increasing the market competition by attracting more foreign participation on the market. In addition, new construction law regulating foreign EPC contractor's construction work, namely Decree 113, and requirement of applying competitive bidding in selecting EPC contractor in a BOT project are also considered signigicant barriers on foreign participation, which contradicts international norm and therefore necessitates an adjustment on current decision process in domestic companies.