• Title/Summary/Keyword: Risk-based assessment

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A Study on Community Perceptions of Common Cancers, Determinants of Community Behaviour and Program Implementation in New Delhi, India

  • Seth, Tulika;Kotwal, Atul;Thakur, Rakesh Kumar;Ganguly, K.K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2781-2789
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    • 2012
  • Assessment of perceptions of the community, the determinants and development of their behavior regarding common malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer. However information on this important aspect is lacking in our country. Qualitative methods were here used to obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories of identified stakeholders. Most were unaware of the activities of the cancer control program. Even the providers were not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government, primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why many community members did not attend screening camps and other services reflect the determinants of community behavior, acting independently as well as in combination. The cancer control program was thought to be restricted only to some private facilities and overcrowded government tertiary care facilities where the visits were time consuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring and feedback were inadequately addressed by providers who were inadequately trained in many program activities. The program lacked effective planning, coordination and appropriate implementation at the grass roots level in Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of the existence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatment were common amongst community members as well as many of the providers. Thus the national cancer control program in our country needs further community participation and social mobilization. Accessibility, availability, acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoral coordination, training, supervision and monitoring of program activities, all need to be addressed to ensure the success of this important public health program.

A Systemic Review of Clinical Trials Using Medication for Acute Bronchitis: A Pre-study on the Development of Traditional Korean Medicine Clinical Practice Guideline (급성기관지염의 약물중재 임상시험에 대한 체계적 문헌 고찰: 임상시험 가이드라인 개발을 위한 예비연구)

  • Lyu, YeeRan;Park, So jung;Lee, Eun Jung;Jeon, Ju Hyun;Jung, In Chul;Park, Yang Chun
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.93-111
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    • 2017
  • Objectives: The aim of this study is to make evidence-based data for developing a traditional Korean medicine clinical practice guideline for acute bronchitis. Methods: We searched 3 international databases(PubMed, EMBASE, CENTRAL) and 7 domestic databases (KoreaMed, Kmbase, NDSL, KISS, KISTI, OASIS, KoreaTK) to identify randomized controlled trials (RCTs) of acute bronchitis using medicine in recent 10 years. The chosen trials were analyzed by their study design, age range, intervention group, control group, primary and second outcome measure, inclusion and exclusion of participants and adverse events. Results: 15 RCTs are finally included in this study and most of their medications are herbal medicine. For diagnosis and outcome measure of acute bronchitis, Bronchitis Severity Score(BSS) was mostly used. Other measurements eligible are coughing fits, quality of life scale, sputum viscosity, change of individual symptoms and patient's satisfaction. Test duration was for average 7days and safety assessment was held by recording adverse events. Except for anti-inflammatory and antibiotic trials, all medications are found to be effective and well-tolerated. General risk of bias of chosen trials is evaluated low. Conclusions: A well designed clinical trials for traditional Korean medicine of acute bronchitis is needed and this study is expected to make it available.

Understanding the Treatment Strategies of Intracranial Germ Cell Tumors : Focusing on Radiotherapy

  • Kim, Joo-Young;Park, Jeonghoon
    • Journal of Korean Neurosurgical Society
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    • v.57 no.5
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    • pp.315-322
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    • 2015
  • Intracranial germ cell tumors (ICGCT) occur in 2-11% of children with brain tumors between 0-19 years of age. For treatment of germinoma, relatively low radiation doses with or without chemotherapy show excellent 10 year survival rate of 80-100%. Past studies showed that neoadjuvant chemotherapy combined with focal radiotherapy resulted in unacceptably high rates of periventricular tumor recurrence. The use of generous radiation volume which covers the whole ventricular space with later boost treatment to primary site is considered as standard treatment of intracranial germinomas. For non-germinomatous germ cell tumors (NGGCT), 10-year overall survival rate is still much inferior than that of intracranial germinoma despite intensive chemotherapy and high-dose radiotherapy. Craniospinal radiotherapy combined with cisplatin-based chemotherapy provides the best treatment outcome for NGGCT; 60-70% of overall survival rate. There is a debate on the surgical role whether surgery can contribute to improved treatment outcome of NGGCT when added to combined chemoradiotherapy. Because higher dose of radiotherapy is required for treatment of NGGCT than for germinoma, it is tested whether whole ventricular irradiation can replace craniospinal irradiation in intermediate risk group of NGGCT to minimize radiation-related late toxicity in the recent studies. To minimize the treatment-related neural deficit and late sequelae while maintaining long-term survival rate of ICGCT patients, optimized administration of chemotherapy and radiotherapy should be selected. Use of technically upgraded radiotherapy modalities such as intensity-modulated radiotherapy or proton beam therapy is expected to bring an improved neurocognitive outcome with longitudinal assessment of the patients.

Misclassification Adjustment of Family History of Breast Cancer in a Case-Control Study: a Bayesian Approach

  • Moradzadeh, Rahmatollah;Mansournia, Mohammad Ali;Baghfalaki, Taban;Ghiasvand, Reza;Noori-Daloii, Mohammad Reza;Holakouie-Naieni, Kourosh
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8221-8226
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    • 2016
  • Background: Misreporting self-reported family history may lead to biased estimations. We used Bayesian methods to adjust for exposure misclassification. Materials and Methods: A hospital-based case-control study was used to identify breast cancer risk factors among Iranian women. Three models were jointly considered; an outcome, an exposure and a measurement model. All models were fitted using Bayesian methods, run to achieve convergence. Results: Bayesian analysis in the model without misclassification showed that the odds ratios for the relationship between breast cancer and a family history in different prior distributions were 2.98 (95% CRI: 2.41, 3.71), 2.57 (95% CRI: 1.95, 3.41) and 2.53 (95% CRI: 1.93, 3.31). In the misclassified model, adjusted odds ratios for misclassification in the different situations were 2.64 (95% CRI: 2.02, 3.47), 2.64 (95% CRI: 2.02, 3.46), 1.60 (95% CRI: 1.07, 2.38), 1.61 (95% CRI: 1.07, 2.40), 1.57 (95% CRI: 1.05, 2.35), 1.58 (95% CRI: 1.06, 2.34) and 1.57 (95% CRI: 1.06, 2.33). Conclusions: It was concluded that self-reported family history may be misclassified in different scenarios. Due to the lack of validation studies in Iran, more attention to this matter in future research is suggested, especially while obtaining results in accordance with sensitivity and specificity values.

Correlation of Cancer Incidence with Diet, Smoking and Socio-Economic Position Across 22 Districts of Tehran in 2008

  • Rohani-Rasaf, Marzieh;Abdollahi, Morteza;Jazayeri, Shima;Kalantari, Naser;Asadi-Lari, Mohsen
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1669-1676
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    • 2013
  • Background: Variation in cancer incidence in geographical locations is due to different lifestyles and risk factors. Diet and socio-economic position (SEP) have been identified as important for the etiology of cancer but patterns are changing and inconsistent. The aim of this study was to investigate correlations of the incidence of common cancers with food groups, total energy, smoking, and SEP. Materials and Methods: In an ecological study, disaggregated cancer data through the National Cancer Registry in Iran (2008) and dietary intake, smoking habits and SEP obtained through a population based survey within the Urban Health Equity Assessment (Urban-HEART) project were correlated across 22 districts of Tehran. Results: Consumption of fruit, meat and dairy products adjusted for energy were positively correlated with bladder, colorectal, prostate and breast and total cancers in men and women, while these cancers were adversely correlated with bread and fat intake. Also prostate, breast, colorectal, bladder and ovarian cancers had a positive correlation with SEP; there was no correlation between SEP and skin cancer in both genders and stomach cancer in men. Conclusions: The incidence of cancer was higher in some regions of Tehran which appeared to be mainly determined by SEP rather than dietary intake. Further individual data are required to investigate reasons of cancer clustering.

Risk assessment of genetically engineered rice Bt-9 resistant to Cnaphalocrocis medinalis: influence on above-ground arthropods in Korea

  • Oh, Sung-Dug;Bae, Eun Ji;Park, Soo-Yun;Lee, Bumkyu;Yun, Do Won;Suh, Sang Jae
    • Korean Journal of Agricultural Science
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    • v.46 no.4
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    • pp.827-841
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    • 2019
  • The effect of genetically engineered rice Bt-9 on the diversity and abundance of plant-dwelling insects and spiders was tested under field conditions. Genetically engineered rice Bt-9, expressing mCry1Ac1 from Bacillus thuringiensis, confers resistance to rice leaf roller (Cnaphalocrocis medinalis) and provides tolerance to the herbicide glufosinate (PPT). The study compared Bt-9 and two non-GM reference varieties, Ilmi-byeo and Dongjin-byeo, at LMO isolated fields in Gunwi (Kyungpook National University) and Jeonju (National Institute Agricultural Sciences) in Southern Korea in 2016 - 2017. A total of 40,817 individuals from 62 families and 11 orders were collected from the two living modified organism (LMO) isolated fields. From the three types of rice fields, a total of 13,982, 14,105, and 12,730 individuals from the Bt-9, Ilmi-byeo and Dongjin-byeo were collected, respectively. Throughout the study, the analysis of variance indicated no significant differences (p < 0.05). Multivariate analysis showed that the abundance and diversity of plant dwelling insects were similar. The data on insect species population densities were subjected to principal component analysis (PCA), which did not distinguish among the three varieties, Bt-9 and the non-GM, reference cultivars, during the cultivation years. However, the results of the PCA analysis were completely divided into four groups based on the yearly survey areas. Therefore, there was no evidence for a negative impact of Bt-9 on the above-ground insects and spiders.

Comparison of condylar displacement between three biotypological facial groups by using mounted models and a mandibular position indicator

  • Ponces, Maria Joao;Tavares, Jose Pedro;Lopes, Jorge Dias;Ferreira, Afonso Pinhao
    • The korean journal of orthodontics
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    • v.44 no.6
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    • pp.312-319
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    • 2014
  • Objective: Facial-type-associated variations in diagnostic features have several implications in orthodontics. For example, in hyperdivergent craniofacial types, growth imbalances are compensated by displacement of the condyle. When diagnosis and treatment planning involves centric relation (CR), detailed knowledge of the condylar position is desirable. The present study aimed to measure condylar displacement (CD) between CR and maximum intercuspation in three facial types of an asymptomatic orthodontic population. Methods: The study was conducted in 108 patients classified into three groups of 36 individuals each (27 women and 9 men; mean age, 20.5 years), based on the following facial patterns: hyperdivergent, hypodivergent, and intermediate. To quantify CD along the horizontal and vertical axes, the condylar position was analyzed using mounted casts on a semi-adjustable articulator and a mandibular position indicator. The Student t-test was used to compare CD between the groups. Results: Vertical displacement was found to be significantly different between the hyperdivergent and hypodivergent groups (p < 0.0002) and between the hyperdivergent and intermediate groups (p < 0.0006). The differences in horizontal displacement were not significant between the groups. In each group, vertical CD was more evident than horizontal displacement was. Conclusions: All facial types, especially the hyperdivergent type, carried a significantly high risk of CD. Therefore, the possibility of CD should be carefully evaluated and considered in the assessment of all orthodontic cases in order to accurately assess jaw relationships and avoid possible misdiagnosis.

Evaluating Appropriateness of Medication Use in the Operating Rooms of a Tertiary Hospital: Based on Survey (일개 병원의 수술실 약제관련 업무 적정화 방안연구: 설문조사를 중심으로)

  • Lee, Ye Ji;Jeong, Kyeong Hye;Kim, Young Nam;Kim, Eun Young
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.3
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    • pp.230-237
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    • 2016
  • Background: Since the use of opioid analgesics is frequent in operation rooms (OR), the risk of medication error is high; however the use of medication in the OR has been operating independently with the hospital pharmacy. Therefore, the assessment on management of medication use in operation and the pharmacist's role is needed. Methods: We conducted the literature review and survey from anesthesiologists, operating nurses at Chung-Ang Hospital on management of medication for operation use, awareness on need for medication management efficiency, need for satellite pharmacy in the operating room and its effect. Results: 56% of medical staffs responded that management of medication in the operating room is efficient; however, 82.6% responded that they felt the inconvenience in medication delivery to the OR when additional prescription was ordered. 51.5% also responded that extra time was required for management of narcotics and inventory/record keeping. 80% agreed that there could be lost costs due to prescription missed. Medical staffs responded improving the drug management system could increase the OR efficiency (87%), and eventually bring the increase in hospital revenue (80.4%). Those who responded that implementation of OR satellite pharmacy was needed include physicians (84.6%), nurses (63.6%), and also responded that it'd bring more profit to the hospital by increasing the efficiency in OR (60.9%). Conclusion: For efficient management of medications, implementation of OR satellite pharmacy would lead to improved drug management and increased efficiency in OR and reduced cost and improved patient care.

Developing Sequential Sampling Plans for Evaluating Maize Weevil and Indian Meal Moth Density in Rice Warehouse (쌀 저장창고에서 어리쌀바구미와 화랑곡나방 밀도 추정을 위한 축차추출 조사법 (Sequential sampling plans) 개발)

  • Nam, Young-Woo;Chun, Yong-Shik;Ryoo, Mun-Il
    • Korean journal of applied entomology
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    • v.48 no.1
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    • pp.45-51
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    • 2009
  • This paper presents sequential sampling plans for evaluating the pest density based on complete counts from probe in a rice storage warehouse. Both maize weevil and Indian meal moth population showed negative binomial dispersion patterns in brown rice storage. For cost-effective monitoring and action decision making system, sequential sampling plans by using the sequential probability ratio test (SPRT) were developed for the maize weevil and Indian meal moth in warehouses with 0.8 M/T storage bags. The action threshold for the two insect pests was estimated to 5 insects per kg, which was projected by a matrix model. The results show that, using SPRT methods, managers can make decisions using only 20 probe with a minimum risk of incorrect assessment.

Development and Ergonomic Evaluation of Spring and Autumn Working Clothes for Livestock Farming Workers

  • Kim, Insoo;Lee, Kyung-Suk;Seo, Min-Tea;Chae, Hye-Seon;Kim, Kyung-Su;Choi, Dong-Phil;Kim, Hyo-Cher
    • Journal of the Ergonomics Society of Korea
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    • v.35 no.5
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    • pp.343-359
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    • 2016
  • Objective:In this study, we designed working clothes for livestock farmers to wear in spring and autumn to improve their work efficiency, conducted a physiological test on their performance, and evaluated their comfort. Background: In recent years, livestock farming in Korea has expanded, yet farmers' safety and sanitation levels remain low in hazardous environments that include organic dust, toxic gas, and heat stress, as well as the risk of accidents. Furthermore, most livestock farmers wear ordinary or dust-resistant clothes that are unsuitable for rearing livestock and compromise their safety and health. Thus, it is important to design specialized working clothes for livestock farmers that are comfortable and that minimize their health and safety risks. Method: To this end, we examined the literature on livestock (poultry, swine, and cattle) farmers' safety and sanitation issues, designed appropriate working clothes, and tested them in terms of sensory feel, physiological response, and subjective comfort. Results: The respondents expressed satisfaction with the new working clothes. The results of a physiological test showed a decline in temperature and humidity inside the clothes, a lower pulse rate, and a lower oxygen intake compared to the measurements taken when famers wore their previous working clothes. This indicates a fall in heat stress and fatigue, which was mostly consistent with the results of the assessment of subjective comfort. Conclusion: The results of the analysis show an improvement in the comfort of the new working clothes compared to the dust-resistant clothes that are widely worn. Based on this study, the new working clothes need to be further tested and evaluated to improve the design. Application: This study is expected to contribute to designing better working clothes for livestock farmers.