• Safety and Health at Work
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• v.6 no.3
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• pp.218-226
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• 2015

Background: The present study aimed to analyze the index value trends of injured employed persons (IEPs) covered in Pakistan Labour Force Surveys from 2001-02 to 2012-13. Methods: The index value method based on reference years and reference groups was used to analyze the IEP trends in terms of different criteria such as gender, area, employment status, industry types, occupational groups, types of injury, injured body parts, and treatment received. The Pearson correlation coefficient analysis was also performed to investigate the inter-relationship of different occupational variables. Results: The values of IEP increased at the end of the studied year in industry divisions such as agriculture, forestry, hunting, and fishing, followed by in manufacturing and construction industry divisions. People associated with major occupations (such as skilled agricultural and fishery workers) and elementary (unskilled) occupations were found to be at an increasing risk of occupational injuries/diseases with an increasing IEP trend. Types of occupational injuries such as sprain or strain, superficial injury, and dislocation increased during the studied years. Major injured parts of body such as upper limb and lower limb found with increasing trend. Types of treatment received, including hospitalization and no treatment, were found to decrease. Increased IEP can be justified due to inadequate health care facilities, especially in rural areas by increased IEP in terms of gender, areas, received treatment, occupational groups and employment status as results found after Pearson correlation coefficient analysis. Conclusion: The increasing trend in the IEP% of the total employed persons due to agrarian activities shows that there is a need to improve health care setups in rural areas of Pakistan.

• Journal of Korea Trade
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• v.25 no.3
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• pp.21-47
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• 2021

Purpose - Offshoring has emerged as one of the major trends in international trade and has become one of the strategies for achieving competitiveness in the global market. In spite of this, the expected gains of offshoring can be offset by hidden costs and risks, such as those associated with the COVID-19 pandemic, the trade war between the USA and China, and the ongoing trade dispute between Korea and Japan. To obviate such business failure and prevent critical business blunders, offshoring strategies that efficiently consider both risk elements and potential wealth creation are urgently need. The first purpose of this study is to contribute to the development of more advanced offshoring strategies to help host countries select the best locations to manage supply chain risks and create unique value. The second purpose is to specifically analyze the current status of Korea and provide Korean companies with implications to be considered when deciding whether to offshore or re-shore. Design/methodology - A Network DEA model was applied to measure the comparative location efficiency of national competencies for offshoring strategy from perspectives of wealth creation opportunities (profitability and marketability) and supply chain risk management. The location efficiencies are compared among a total 70 countries selected from the Global Competitiveness Index (GCI) and globally attractive locations outlined by Kearney (2017). For the secondary analysis of efficiency, a t-test examining the nature of competitive advantage and the level of sophistication in production processes was implemented in three divisions. We then analyzed differences in offshoring performance in terms of the identified national traits. Moreover, Tobit regression analysis is conducted to investigate the correlation between value-added business activities and each divisional efficiency, seeking to determine how each degree of value-added business activity influences the increase in offshoring productivity. Findings - Regarding overall location efficiency for offshoring performance, only the USA and Italy were identified as being efficient as host countries for offshoring, under circumstances of advanced development, such as productivity and risk management. Korea ranks 13th among 70 countries. The determinants of national competitiveness depend on national traits (the nature of competitive advantage and business sophistication). Countries with labor/resource advantages and labor-intensive industries are more competitive in terms of marketability than others. In contrast, countries with strong technology-intensive industries benefit offshoring companies, particularly in the technology sector, with the added advantage of supply chain risk management. As the perception of a value chain is broader in a country, it can achieve both production sophistication and competitive advantages such as marketability and SCRM. Originality/value - Existing studies focus on offshoring effectiveness from a company perspective. This paper contributes to comparing country efficiency in producing core competencies related to an offshoring strategy and also segments countries into three performance-based considerations associated with the global offshoring market. It also details Korea's position as an offshoring location according to national efficiency and competency.

• Journal of the Korean Dietetic Association
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• v.21 no.1
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• pp.25-36
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• 2015

In this study, we attempted to improve hospital food delivery service quality and customer satisfaction by using FMEA (Failure Mode and Effect Analysis), which is applied to the quality control of products in manufacturing plants. Subjective food delivery service quality improvement was judged based on a 5-point likert scale. Traditional FMEA uses an RPN (Risk priority number) to evaluate the risk level of a component or process. The RPN index was determined by calculating the product of severity, occurrence, and detection indexes. In our results, total RPN value (P<0.01) significantly decreased after FMEA introduction, whereas customer satisfaction (P<0.001) and food delivery service quality (P<0.001) significantly increased. Specifically, foodservice errors (P<0.01) and loss cost (P<0.01) were significantly improved by FMEA introduction. Taken together, we suggest that FMEA reduces critical activities and errors in foodservice delivery caused by simple priority selection.

• Korean Journal of Community Nutrition
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• v.8 no.1
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• pp.3-14
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• 2003

The purpose of this study was to estimate the nutrient intake, dietary habits, and body indices among preschool children. The study subjects were 166 kindergarten children, aged 4 to 6 years. A measurement of the weight, height, chest circumference, and head circumference of the children was conducted. The general home environment and factors related to the eating habits of children were collected using a questionnaire that included information about physical activity, outdoor playing time, television watching, family income, and parents education and occupations. Underweight, overweight were defined based on a value of less than 110 and more than 140 on the Rohrer Index, or less than 90 and more than 120 on the weight-length index (WLI). The average Rohrer and WLI for the preschool children were 14.3 $\pm$ 23.2% and 104 $\pm$ 13.5%. Using the WLI, 12.7% of the preschool children were underweight 62.6% were normal, and 24.7% were overweight or obese. On the Rohrer Index, 32.0% of the preschool children were underweight, 34.7% were normal, and 34.1% were overweight or obese. With regard to frequency of regularity of eating breakfast, 2.5% of preschool children skipped breakfast every morning. The risk of being overweight increased in preschool children who had faster eating times. The Rohrer and WLI were negatively related to faster eating times. The average daily energy intake was 1272 Kcal, which corresponded to 79.5% of the Korean RDA. In particular, the average intakes of calcium, iron, and vitamin B$_2$ were much lower than the Korean RDAs for each of those nutrients. Children whose mothers had occupations were at greater risk of decreased nutrient intake than those whose mothers were at home. The data presented in this study confirm that, in preschool children, undernutrition remains the nutritional problem of great concern in Korea, even though Koreans are starting to have worrisome rates of overweight. Therefore, during the early years of life, focus should remain on sustaining Proper growth and development.

• Acute and Critical Care
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• v.33 no.4
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• pp.222-229
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• 2018

Background: The diagnosis of pediatric acute respiratory distress syndrome (PARDS) is a pragmatic decision based on the degree of hypoxia at the time of onset. We aimed to determine whether reclassification using oxygenation metrics 24 hours after diagnosis could provide prognostic ability for outcomes in PARDS. Methods: Two hundred and eighty-eight pediatric patients admitted between January 1, 2010 and January 30, 2017, who met the inclusion criteria for PARDS were retrospectively analyzed. Reclassification based on data measured 24 hours after diagnosis was compared with the initial classification, and changes in pressure parameters and oxygenation were investigated for their prognostic value with respect to mortality. Results: PARDS severity varied widely in the first 24 hours; 52.4% of patients showed an improvement, 35.4% showed no change, and 12.2% either showed progression of PARDS or died. Multivariate analysis revealed that mortality risk significantly increased for the severe group, based on classification using metrics collected 24 hours after diagnosis (adjusted odds ratio, 26.84; 95% confidence interval [CI], 3.43 to 209.89; P=0.002). Compared to changes in pressure variables (peak inspiratory pressure and driving pressure), changes in oxygenation (arterial partial pressure of oxygen to fraction of inspired oxygen) over the first 24 hours showed statistically better discriminative power for mortality (area under the receiver operating characteristic curve, 0.701; 95% CI, 0.636 to 0.766; P<0.001). Conclusions: Implementation of reclassification based on oxygenation metrics 24 hours after diagnosis effectively stratified outcomes in PARDS. Progress within the first 24 hours was significantly associated with outcomes in PARDS, and oxygenation response was the most discernable surrogate metric for mortality.

• Korean Journal of Community Nutrition
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• v.23 no.4
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• pp.277-288
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• 2018

Objectives: This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women. Methods: A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value <0.05 was considered to be statistically significant. Results: The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p<0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p<0.001). Conclusions: This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

• Journal of Food Hygiene and Safety
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• v.35 no.6
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• pp.587-601
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• 2020

Exposure to hazardous substances occurs through multiple pathways. Aggregated risk assessment, which includes all potential exposure pathways to a single toxicant, is necessary to prevent exposure to harmful substances. We aimed to estimate cadmium and lead exposure through various media, such as food, water, air, smoking, cosmetics, and female hygiene products. This study covered 10,733 subjects from the Seventh Korea National Health and Nutrition Examination Survey(2016, 2017). Dietary exposure was estimated using 24-hour recall data. For water and inhalational exposure, regional variations were considered. Water was classified as tap, bottled, and public water. Inhalational exposure was estimated using the '2014 Time Use Survey' based on daily lifestyle and social status. The frequency and volume of cosmetic usage were randomly approximated by sex and age. Post-menarcheal and premenopausal women were assumed to use feminine hygiene products. Non-carcinogenic aggregated risks were estimated using the Aggregate Risk Index from EPAs and the Total Exposure Hazard Index from Korean government guidelines. For carcinogenic risk assessment, excessive cancer risk was estimated. Ingestion, especially food, was the major route for both cadmium and lead exposure. Smoking was also associated with high cadmium exposure. Exposure to lead from cosmetics was remarkable but not critical. In aggregate risk assessments, median cadmium and lead exposure did not exceed the reference value. Sex, age, smoking status, and income affected exposure levels, unlike to regional variations.

• Journal of the Korean Society of Marine Environment & Safety
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• v.24 no.1
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• pp.36-42
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• 2018

This paper considers the Marine Traffic Risk Assessment for fixed and moving targets, which threaten officers during a voyage. The Collision Risk Assessment Formula was calculated based on a dynamic ship domain considering the length, speed and maneuvering capability of a vessel. In particular, the Navigation Risk Assessment Model that is used to quantitatively index the effect of a ship's size, speed, etc. has been reviewed and improved using a hybrid combination of a vessel's dynamic area and the Collision Risk Assessment Formula. Accordingly, a new type of Marine Traffic Risk Assessment Model has been suggested giving consideration to the Speed Length Ratio, which was not sufficiently reflected in the existing Risk Assessment Model. The larger the Speed Length Ratio (dimensionless speed), the higher the CJ value. That is, the CJ value is presented well by the Speed Length Ratio. When the Speed Length Ratio is large, states ranging from [Caution], [Warning], [Dangerous] or [Very Dangerous] are presented from a greater distance than when the Speed Length Ratio is small. The results of this study, can be used for route and port development, including dangerous route avoidance, optimum route planning, breakwater width, bridge span, etc. as well as the development of costal navigation safety charts. This research is also applicable for the selection of optimum ship routing and the prevention of collisions for smart ships such as autonomous vessels.

• Health Policy and Management
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• v.27 no.3
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

• Journal of Korean Neurosurgical Society
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• v.65 no.1
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• pp.96-106
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• 2022

Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.