• Title/Summary/Keyword: baseline risk

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A FEASIBILITY STUDY ON THE ADVANCED PERFORMANCE INDICATOR CONCEPT FOR IMPROVING KINS SAFETY PERFORMANCE INDICATORS (SPI)

  • Lee, Yong-Suk;Cho, Nam-Chul;Chung, Dae-Wook
    • Nuclear Engineering and Technology
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    • v.43 no.2
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    • pp.105-132
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    • 2011
  • The concept of improved performance indicators (PIs) for use in the KINS Safety Performance Indicator (SPI) program for reactor safety area is proposed in this paper. To achieve this, the recently developed PIs from the USNRC that use risk information were investigated, and a feasibility study for the application of these PIs in Korean NPPs was performed. The investigated PIs are Baseline Risk Index for Initiating Events (BRIIE), Unplanned Scrams with Complications (USwC), and Mitigating System Performance Index (MSPI). Moreover, the thresholds of the existing safety performance indicators of KINS were evaluated in consideration of the risk and regulatory response to different levels of licensee performance in the graded inspection program.

Educational Intervention Based on the Health Belief Model to Modify Risk Factors of Cardiovascular Disease in Police Officers in Iran: A Quasi-experimental Study

  • Saffari, Mohsen;Sanaeinasab, Hormoz;Jafarzadeh, Hassan;Sepandi, Mojtaba;O'Garo, Keisha-Gaye N.;Koenig, Harold G.;Pakpour, Amir H.
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.4
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    • pp.275-284
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    • 2020
  • Objectives: Police officers may be at a greater risk for cardiovascular disease (CVD) than the general population due to their highstress occupation. This study evaluated how an educational program based on the health belief model (HBM) may protect police officers from developing CVD. Methods: In this single-group experimental study, 58 police officers in Iran participated in a 5-week intervention based on HBM principles. Outcomes included changes in scores on an HBM scale, time spent on moderate to vigorous physical activity (International Physical Activity Questionnaire), body mass index (BMI), blood lipid profile, blood glucose, and blood pressure. The intervention consisted of 5 HBM-based educational sessions. Follow-up was conducted at 3 months post-intervention. The paired t-test was used to examine differences between baseline and follow-up scores. Results: All aspects of the HBM scale improved between baseline and follow-up (p<0.05), except the cues to action subscale. Self-efficacy and preventive behaviors improved the most. BMI decreased from 26.7±2.9 kg/㎡ at baseline to 25.8±2.4 kg/㎡ at follow-up. All components of the lipid profile, including triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein, showed significant improvements post-intervention. Blood glucose and blood pressure also decreased, but not significantly. Nearly 25% of participants who were not physically active at baseline increased their physical activity above or beyond the healthy threshold. Conclusions: A relatively brief educational intervention based on HBM principles led to a significant improvement in CVD risk factors among police officers. Further research is needed to corroborate the effectiveness of this intervention.

A plasma circulating miRNAs profile predicts type 2 diabetes mellitus and prediabetes: from the CORDIOPREV study

  • Jimenez-Lucena, Rosa;Camargo, Antonio;Alcala-Diaz, Juan Francisco;Romero-Baldonado, Cristina;Luque, Raul Miguel;van Ommen, Ben;Delgado-Lista, Javier;Ordovas, Jose Maria;Perez-Martinez, Pablo;Rangel-Zuniga, Oriol Alberto;Lopez-Miranda, Jose
    • Experimental and Molecular Medicine
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    • v.50 no.12
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    • pp.13.1-13.12
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    • 2018
  • We aimed to explore whether changes in circulating levels of miRNAs according to type 2 diabetes mellitus (T2DM) or prediabetes status could be used as biomarkers to evaluate the risk of developing the disease. The study included 462 patients without T2DM at baseline from the CORDIOPREV trial. After a median follow-up of 60 months, 107 of the subjects developed T2DM, 30 developed prediabetes, 223 maintained prediabetes and 78 remained disease-free. Plasma levels of four miRNAs related to insulin signaling and beta-cell function were measured by RT-PCR. We analyzed the relationship between miRNAs levels and insulin signaling and release indexes at baseline and after the follow-up period. The risk of developing disease based on tertiles (T1-T2-T3) of baseline miRNAs levels was evaluated by COX analysis. Thus, we observed higher miR-150 and miR-30a-5p and lower miR-15a and miR-375 baseline levels in subjects with T2DM than in disease-free subjects. Patients with high miR-150 and miR-30a-5p baseline levels had lower disposition index (p = 0.047 and p = 0.007, respectively). The higher risk of disease was associated with high levels (T3) of miR-150 and miR-30a-5p ($HR_{T3-T1}=4.218$ and $HR_{T3-T1}=2.527$, respectively) and low levels (T1) of miR-15a and miR-375 ($HR_{T1-T3}=3.269$ and $HR_{T1-T3}=1.604$, respectively). In conclusion, our study showed that deregulated plasma levels of miR-150, miR-30a-5p, miR-15a, and miR-375 were observed years before the onset of T2DM and pre-DM and could be used to evaluate the risk of developing the disease, which may improve prediction and prevention among individuals at high risk for T2DM.

Pre-treatment Nutritional Risk Assessment by NRS-2002 Predicts Prognosis in Patients With Advanced Biliary Tract Cancer: A Single Center Retrospective Study

  • Se Eung Oh;Juong Soon Park;Hei-Cheul Jeung
    • Clinical Nutrition Research
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    • v.11 no.3
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    • pp.183-193
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    • 2022
  • We investigated the predictors of survival in patients with advanced BTC according to their baseline nutritional status estimated by the Nutritional Risk Screening (NRS)-2002. From September 2006 to July 2017, we reviewed the data of 601 inpatients with BTC. Data on demographic and clinical parameters was collected from electronic medical records, and overall survival (OS) and progression-free survival were analyzed using the Kaplan-Meier method and the stepwise Cox regression analysis. Patients with an NRS-2002 score of ≤ 2, 3, and ≥ 4 were respectively classified as "no risk," "moderate risk," "high risk." Following initial NRS-2002 score, 333 patients (55%) were classified as "no-risk," 109 patients (18%) as "moderate-risk," and 159 patients (27%) as "high-risk." Survival analysis demonstrated significant differences in the median OS: "no-risk": 12.6 months (95% confidence interval [CI], 11.5-13.7); "moderate-risk": 6.1 months (95% CI, 4.3-8.0); and "high-risk": 3.9 months (95% CI, 3.2-4.6) (p < 0.001). NRS-2002 score was an independent factor for OS (hazard ratio [HR], 1.616 for "moderate-risk", 95% CI, 1.288-2.027, p < 0.001; HR, 2.121 for "high-risk", 95% CI, 1.722-2.612, p < 0.001), along with liver metastasis, peritoneal seeding, white blood cell count, platelet count, neutrophil-to-lymphocyte ratio, cholesterol, carcinoembryonic antigen, and carbohydrate antigen 19-9. In conclusion, baseline NRS-2002 is an appropriate method for discriminating those who are already malnourished and who have poor prognosis in advanced BTC patient. Significance of these results merit further validation to be integrated in the routine practice to improve quality of care in BTC patients.

Effects of corrective exercises on selective functional movement assessment and health risk appraisal in middle-aged women

  • Kim, Jae Eun;Kim, Cheong;Kim, Sinseop
    • Physical Therapy Rehabilitation Science
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    • v.5 no.4
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    • pp.185-192
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    • 2016
  • Objective: The purpose of this study was to find the limited patterns of middle-aged women in selective functional movement evaluation and analyze the effects of pattern improvement exercises and general control groups on the Health Risk Appraisal (HRA). Design: Randomized controlled trial. Methods: The 31 subjects were physically healthy middle-aged women aged 40-59 living in Seoul, The subjects were randomly divided into an experimental group and a control group. Forty-three physically healthy women were originally recruited and randomly assigned to either the experimental group (n=22) or the control group (n=21). However, due to lack of participation, a total of seventeen subjects in the exercise group and fourteen subjects in the control group participated in the study. All subjects were tested using Selective Functional Movement Assessment (SFMA) and HRA for the baseline measurement and joined an exercise program of their group for one hour per session, twice a week for four weeks. The experimental group was provided with the corrective exercises and the control group was given the general fitness program. A follow-up test was conducted after eight weeks from the baseline measurement. Results: Both experimental and control group showed significant changes in SFMA and HRA scores (p<0.05). In the experimental group and control groups, the SFMA and HRA showed significant improvement from baseline to 4 weeks (p<0.05). Also, in the experimental group, the SFMA was significantly improved from baseline to 8 weeks (p<0.05). For the experimental group, there was a significant improvement in SFMA after 4 weeks compared to the control group (p<0.05). Conclusions: The corrective exercise in the experimental group had a positive effect on the SFMA score as well as the general squat exercise in the control group. The corrective exercise and general control group had the same positive effect on the HRA score.

Analysis Model on Risk Factors of RCB Construction in Nuclear Power Plant (원자력 발전 플랜트 RCB 시공의 리스크 요인에 관한 분석 모델)

  • Shin, Dae-Woong;Shin, Yoonseok;Kim, Gwang-Hee
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2014.11a
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    • pp.212-213
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    • 2014
  • The purpose of this study is to suggest analysis model of RCB construction in nuclear power plant. For the objective, This study drew the risk factors of RCB construction from existing literature. The results of the study proposed analysis model made hierarchy in rebar, form, and concrete work. These will be baseline data for risk management in construction project of nuclear power plant.

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Association between Dietary Acid Load and Insulin Resistance: Tehran Lipid and Glucose Study

  • Moghadam, Sajjad Khalili;Bahadoran, Zahra;Mirmiran, Parvin;Tohidi, Maryam;Azizi, Fereidoun
    • Preventive Nutrition and Food Science
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    • v.21 no.2
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    • pp.104-109
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    • 2016
  • In the current study, we investigated the longitudinal association between dietary acid load and the risk of insulin resistance (IR) in the Tehranian adult population. This longitudinal study was conducted on 925 participants, aged 22~80 years old, in the framework of the third (2006~2008) and fourth (2009~2011) phases of the Tehran Lipid and Glucose Study. At baseline, the dietary intake of subjects was assessed using a validated semi-quantitative food frequency questionnaire, and the potential renal acid load (PRAL) and net endogenous acid production (NEAP) scores were calculated at baseline. Fasting serum insulin and glucose were measured at baseline and again after a 3-year of follow-up; IR was defined according to optimal cut-off values. Multiple logistic regression models were used to estimate the risk of IR according to the PRAL and NEAP quartile categories. Mean age and body mass index of the participants were 40.3 years old of $26.4kg/m^2$, respectively. Mean PRAL and NEAP scores were -11.2 and 35.6 mEq/d, respectively. After adjustment for potential confounders, compared to the lowest quartile of PRAL and NEAP, the highest quartile was accompanied with increased risk of IR [odds ratio (OR)=2.81, 95% confidence interval (CI)=1.32~5.97 and OR=2.18, 95% CI=1.03~4.61, respectively]. Our findings suggest that higher acidic dietary acid-base load, defined by higher PRAL and NEAP scores, may be a risk factor for the development of IR and related metabolic disorders.

Repeat Auditing of Primary Health-care Facilities Against Standards for Occupational Health and Infection Control: A Study of Compliance and Reliability

  • Cloete, Brynt;Yassi, Annalee;Ehrlich, Rodney
    • Safety and Health at Work
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    • v.11 no.1
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    • pp.10-18
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    • 2020
  • Background: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. Methods: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011-2012 were compared with follow-up internal audits in 2014-2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. Results: At baseline, 25% of 60 facilities were "noncompliant" (audit score<50%), 48% "conditionally compliant" (score >50 < 80%), and only 27% "compliant" (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). Conclusion: Low baseline compliance with OHS-IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.

Predictive Value of Baseline Plasma D-dimers for Chemotherapy-induced Thrombocytopenia in Patients with Stage III Colon Cancer: A Pilot Study

  • Tanriverdi, Ozgur
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.293-297
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    • 2013
  • Background: : Chemotherapy-induced thrombocytopenia (CIT) is an important cause of morbitity in patients with cancer. Aim: To investigate the effect of the baseline plasma D-dimer level, an important marker for thrombotic activity, on chemotherapy-induced thrombocytopenia in patients with stage III colon cancer. Materials and Methods: A total of 43 (28 men) eligible patients were divided into two groups according to whether they exhibited chemotherapy-induced thrombocytopenia: Group 1 (n=21) and Group 2 (n=22). Comparison was made using demographic, histopathologic, and laboratory variables. Additionally, baseline plasma D-dimer levels underwent receiver operation characteristics curve analysis, and areas under the curve were calculated. Sensitivity, specificity, and positive and negative likelihood rates were then determined. Results: The incidence of chemotherapy-induced thrombocytopenia had a significant correlation with baseline platelet count (r=0.568, P=0.031) and baseline plasma D-dimer levels (r=0.617, P=0.036). When the cut-off point for the latter was set as 498 ng/mL, the area under the curve was 0.89 (95%CI: 0.74-0.93), the sensitivity was 91.4%, the specificity was 89.7%, the positive likelihood rate was 3.64 and the negative likelihood rate was 0.24 for chemotherapy-induced thrombocytopenia diagnosis. Conclusions: The baseline level of plasma D-dimer could help to differentiate high-risk patients for chemotherapy-induced thrombocytopenia.

Cognitive behavioral therapy for college students with smartphone addiction

  • Kim, Deokju
    • International Journal of Advanced Culture Technology
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    • v.9 no.4
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    • pp.29-39
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    • 2021
  • Cognitive behavioral therapy (CBT) is effective for people with an addiction tendency. This study aims to implement a CBT program for college students at high risk of smartphone addiction and investigate the impact of the program on their desire to use a smartphone, depression, impulsivity, and anxiety. Baseline/post-intervention evaluation and the ABA' single-case experimental design were used. The study consisted of the baseline phase (A), pre-evaluation, intervention phase (B), post-evaluation, and baseline phase (A'). Six participants were enrolled, and the main outcome variables were daily changes in the desire to use a smartphone and changes in depression, impulsivity, and anxiety after the program. Prior to the intervention, all six participants had mild to moderate depression, but after the intervention, three were normal, two had mild depression, and only one had moderate depression. Impulsivity and anxiety scores decreased after the intervention, with anxiety scores showing the most dramatic change. The percentage of non-overlapping data for the baseline phase (A)-intervention phase (B) was more than 75% and that for baseline phase (A)-baseline phase (A') was 100% for all 6 participants. This study presented a good protocol for people with low access to psychological therapy. We expect the findings will be highly useful for people suffering from psychological difficulties due to smartphone addiction.