• Title/Summary/Keyword: Risk Adjustment

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Local Scalar Trust Metrics with a Fuzzy Adjustment Method

  • Seo, Yang-Jin;Han, Sang-Yong
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.4 no.2
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    • pp.138-153
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    • 2010
  • The interactions between people who do not know each other have been greatly increased with the on-going increase of people's cyberspace activities. In this situation, there exist potential risk factors such as the possibility of fraud, so we need a method to reduce or eliminate those risk factors. Concerning this necessity, rating systems are widely used, and many trust metrics calculated from rate values that people give to each other are proposed to help them make decisions. However, the trust metrics decrease the accuracy, and this is caused by the different rating scales and ranges of each person. So, we propose a fuzzy adjustment method to solve this problem. It is possible to catch the exact meaning of the trust value that each person selects through applying fuzzy sets, which improve the accuracy of the trust metric calculated from the trust values. We have applied our fuzzy adjustment method to the TidalTrust algorithm, a representative algorithm for calculating the local scalar trust metric, and we performed an experimental evaluation with four data sets and three evaluation methods.

Association between assisted reproductive technology and autism spectrum disorders in Iran: a case-control study

  • Jenabi, Ensiyeh;Seyedi, Mahdieh;Hamzehei, Ronak;Bashirian, Saeid;Rezaei, Mohammad;Razjouyan, Katayoon;Khazaei, Salman
    • Clinical and Experimental Pediatrics
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    • v.63 no.9
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    • pp.368-372
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    • 2020
  • Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by impairments in social interaction and verbal and nonverbal communication. Purpose: Determine the association between use of assisted reproduction technology (ART) and the risk of ASD among children. Methods: This case-control study included 300 participants (100 cases, 200 controls). The control group included women with a child aged 2-10 years without ASD, while the cases were women with a child aged 2-10 years with ASD. We used a researcher-made questionnaire. Data were analyzed using Stata ver. 14 at the 0.05 significance level. Results: In the univariate analysis, there was significant association between child sex, delivery mode, history of preterm delivery, history of using ART, and maternal age at child's birth and the risk of ASD. After the adjustment for other variables, this association was significant for male sex (2.66; 95% confidence interval [CI], 1.11-4.31; P=0.001) and history of using ART (4.03; 95% CI, 1.76-9.21; P=0.001). Therefore, after the adjustment for confounder variables, there was no significant association between ART and the risk of ASD among children (4.98; 95% CI, 0.91-27.30; P=0.065). Conclusion: After the adjustment for other variables, risk factors for ASD were male sex and history preterm delivery. Thus, there was no significant association between ART and the risk of ASD among children.

Teachers' Perceptions of the Psychosocial Adjustment of Institutionalized and Home Reared Children (초·중·고교 교사가 지각한 시설아동과 일반아동의 사회심리적 적응차이)

  • Yi, Soon Hyung;Lee, Hae Seung
    • Korean Journal of Child Studies
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    • v.23 no.4
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    • pp.119-136
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    • 2002
  • This study examined teacher's perceptions of the psychosocial adjustment and problem behaviors of institutionalized children compared with home reared children. Data were collected from the teachers of institutionalized children in elementary and secondary schools. The majority of institutionalized children were regarded as not very much different from home reared children. Still, findings from this study lead to conclusions that institutionalization is likely to elevate children's risk for adjustment problems such as social withdrawal, peer violence, and academic failure. Findings that the ratio of institutionalized children attending school decreased with age lead to speculation that failure in psychosocial adjustment may lead to to dropping out of school. Finally, a practical framework for the optimal development of institutionalized children is provided, with emphasis on school-community based interventions.

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Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals (요양병원의 서비스 질 평가를 위한 요실금 결과 지표 개발)

  • Yoon, Ju-Young;Lee, Ji-Yun
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.110-118
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    • 2010
  • Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

A Longitudinal Study on Early School Adjustment and the Academic Performance of Children in Low-Income Families (저소득 아동의 초기 학교적응과 학업수행에 관한 종단적 연구)

  • Rhee, Un-Hai;Lee, Jeong-Rim;Kim, Myoung-Soon;Jun, Hey-Jung
    • Korean Journal of Child Studies
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    • v.31 no.1
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    • pp.65-82
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    • 2010
  • This study investigated the longitudinal effects of family risk factors, parent-child relationships, and language abilities of children in low-income families in terms of both school adjustment and academic performance. The subjects were 176 children aged 5 to 7 and their mothers. They participated in follow up studies over the next 3 years. The children were tested using the Wechsler Intelligence Scales and language tests; and classroom teachers rated their levels of both school adjustment and academic performance. Mothers reported parent-child relationships, maternal depression, and family economic resources. Data were analyzed using Pearson's correlation, and structural equation modeling (SEM). Our results indicated that there were direct effects of language abilities, and indirect effects of parent-child relationships and maternal depression upon children's school adjustment and academic performance. It was also revealed that language abilities had a mediating effect between parent-child relationship and school adjustment/ academic performance.

Suicide of The Psychiatric Patients during Social Adjustment Period (적응과정에서의 정신과 환자의 자살)

  • Nam, Jung-Hyun;Kwak, Sang-Kon
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.163-169
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    • 1996
  • The authors examined for risk factors for suicide among psychiatric patients who had committed suicide through the analysis of demographic, clinical and psychological characteristics of the patients. The total number of suicides committed during social adjustment period was 9. Male and female ratio was 5:4 and the highest incidence occurred in the age group of 21-29 years. Of the 9 cases, schizophrenia accounted for two-third of the suicides. Among the committed suicides, 4 were in hospitalization and rest were postdischarge state. We found that 4 of 5(80%) suicides occurred in the first year after discharge, and that three fifth(60%) occurred within three months of discharge. In this result, most of suicides occurred immediately or soon after discharge and some during inpatient care. The major precipitating factors the patients showed before committing suicide were realistic and psychological problems. Consquently, they become dejected, experience feelings of hopelessness, go on to a depressed mood, and, in that case, have suicidal ideas that are eventually acted on. We believe that the ability to recognize risk factors for suicide and develop appropriate interventions is key to suicide prevention.

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Role of Intraoperative Angiography in the Surgical Treatment of Cerebral Aneurysms (뇌동맥류의 수술 중 뇌혈관 조영술의 역할)

  • Sim, Jae Hong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.4
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    • pp.491-499
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    • 2000
  • Objective : In the cerebral aneurysm surgery, the goal is complete circulatory exclusion of the aneurysm without compromise of normal vessels. In an operating room, an operator should confirm the completeness and precision of the surgical result, before closing the wound. Object of this study was to determine which cases require intraoperative angiography. Methods : We reported our experience with 48 intraoperative angiographic studies performed during the surgical treatment of cerebral aneurysm of these 48 cases. There were 5 giant(10.4%), 15 globular(1.5-2.5cm)(31.25%) and 28 saccular(58.3%) aneurysm. We recorded the incidence of unexpected findings, such as residual aneurysms, major vessel occlusions. Using Fischer's exact test, we assessed whether unexpected angiographic findings showed any correlation with aneurysm site, size and clinical findings. Results : In 5 cases(10.4%), we detected unexpected angiographic findings which resulted in clip adjustment. By means of clip adjustment, an operator could restore the flow of two major arterial occlusion(4.2%) and also obliterate three persistent filling aneurysms(6.3%). Globular aneurysm was the only factor to predict unexpected angiographic findings(p<0.05). The subgroup of globular and giant aneurysm has a high risk of occlusion of the parent artery and its branches and/or residual aneurysm. There were two minor complications related to this procedure. Conclusion : Intraoperative assessment makes it possible to recognize and correct the technical defect. Particularly in globular aneurysm, we were able to prevent both the chance for another operation and the risk of postoperative complications.

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A Study on Prevalence and Risk Factors for Varicose Veins in Nurses at a University Hospital

  • Yun, Myeong-Ja;Kim, Young-Ki;Kang, Dong-Mug;Kim, Jong-Eun;Ha, Won-Choon;Jung, Kap-yeol;Choi, Hyun-Woo
    • Safety and Health at Work
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    • v.9 no.1
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    • pp.79-83
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    • 2018
  • Background: Lower-limb varicose veins (VVs) are common and known to have a higher prevalence among people who work in occupations requiring prolonged standing. In the Republic of Korea, however, VV-related occupational factors have seldom been examined. This study was conducted to assess the prevalence of VVs among nurses, an occupational group considered to be at high risk of VVs, and determine the occupational risk factors of prolonged standing. Methods: Between March and August 2014, a questionnaire survey coupled with Doppler ultrasonography was conducted on the nurses working at a university hospital. Results: A total of 414 nurses participated in the survey and diagnostic testing. From the survey analysis and test results, the prevalence of VVs in nurses was estimated to be 16.18%. Significant factors for venous reflux were age [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.03-1.10], pregnancy (OR = 2.15, 95% CI = 1.17-3.94), and delivery (OR = 2.02, 95% CI = 1.08-3.78). The statistical significance of these factors was verified after risk adjustment for sociodemographic factors (OR = 3.40, 95% CI = 1.27-9.09). Conclusion: Factors significantly associated with venous reflux were increasing age and prolonged working hours (${\geq}4hours$) in a standing position (OR = 2.80, 95% CI = 1.08-7.25), even after risk adjustment for sociodemographic factors. This study is significant in that an objective diagnosis of VVs preceded the analysis of the risk factors for VV incidence, thus verifying objectively that VVs are associated with occupations requiring prolonged hours of working in a standing position.

The association of blood pressure with body mass index and waist circumference in normal weight and overweight adolescents

  • Song, Young-Hwan
    • Clinical and Experimental Pediatrics
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    • v.57 no.2
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    • pp.79-84
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    • 2014
  • Purpose: Overweight can be defined by the body mass index (BMI) and is likely associated with an increased cardiovascular disease risk. However, waist circumference (WC), a central adiposity index, may be a better indicator of cardiovascular disease risk. Studies comparing the effects of BMI and WC on cardiovascular risk factors, such as high blood pressure (BP), are rare in adolescents. Methods: We analyzed the correlations of BMI and WC with BP in 3,363 Korean adolescents (aged 10-19 years), using data from the Korean National Health and Nutrition Examination Surveys (2009-2011). Results: Systolic BP (SBP) in both sexes and diastolic BP (DBP) in boys were higher in the high BMI (>85th percentile) and high WC (>90th percentile) groups. High BMI and high WC were positively correlated with high SBP (>90th percentile) in both sexes, and high DBP (>90th percentile), in boys. BMI maintained its positive associations with SBP, DBP, high SBP, and high DBP in the normal weight ($BMI{\leq}85th$ percentile) and overweight (BMI>85th percentile) groups in both boys and girls, as well as in all subjects of both sexes, even after adjustment for WC. However, WC did not correlate with SBP, DBP, high SBP, or high DBP after adjustment for BMI in any group in either sex. Conclusion: In Korean adolescents, BMI correlated better with BP and high BP levels than WC. Further, BMI was positively associated with BP and high BP in the normal weight group as well as in the overweight group.