• 제목/요약/키워드: multifactorial risk assessment

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식품이물의 다인자기반 위해평가 및 우선순위 설정 (Multifactorial Risk Based Prioritization of Foreign Matters in Food)

  • 김현정;최성욱;전향숙
    • 한국식품위생안전성학회지
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    • 제28권1호
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    • pp.83-88
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    • 2013
  • 식품 이물의 검출 및 저감화 기술 개발과 안전관리를 위한 정보를 제공하고자, 국내 보고된 식품 이물의 혼입 자료를 바탕으로 식품별, 이물별 검출율과 건강 위해도, 경제 산업적, 소비자 민감성 등의 인자를 고려한 다인자기반 위해평가를 수행하고 이를 바탕으로 식품-이물의 위해 순위를 분석하였다. 사용한 인자 중 이물별 발생 빈도와 건강 위해도는 이물에 대한 위험지표로 이용하였으며 식품별 국내 연간 생산량과 해당 식품의 이물 혼입율은 식품 중 이물발생이 관련 산업에 미치는 영향을 나타내는 지표로 이용하였다. 식품-이물에 대한 소비자의 민감성에 대한 간접적인 지표로는 각 식품별 이물 저감화에 따른 추가비용부담률을 활용하였다. 이와 같은 여러 인자를 종합적으로 고려한 다인자기반 종합위해지수는 금속-면류가 가장 높게 추정되었다. 그 외에도 곤충-면류 및 금속-음료의 위해순위가 높은 것으로 산출되었다. 본 결과는 지금까지 단순히 이물별 발생 순위 또는 식품별 발생 순위 중심의 자료 제공에서 나아가 식품 안전 관리에서 고려해야 할 여러 인자를 종합적으로 분석하여 위해지수를 산출함으로써 향후 식품 중 이물의 관리와 이물의 검출 기술 개발 등 식품안전 분야의 연구에서 자원의 배분과 연구개발시 유용한 정보로 활용될 것으로 사료된다.

도시 빈곤 노인의 낙상발생 위험요인에 관한 연구 (Fall Risk in Low-Income Elderly People in One Urban Area)

  • 최경원;이인숙
    • 대한간호학회지
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    • 제40권4호
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    • pp.589-598
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    • 2010
  • Purpose: The purpose of this study was to investigate the factors that increase of the risk for falls in low-income elders in urban areas. Methods: The participants were elderly people registered in one of public health centers in one city. Data were collected by interviewing the elders, assessing their environmental risk factors, and surveying relevant secondary data from the public health center records. For data analysis, descriptive statistics and multiple logistic regression were performed using SPSS version 14. Results: Stroke, diabetes, visual deficits, frequency of dizziness, use of assistive devices and moderate depression were statistically significant risk factors. The comorbidity of chronic diseases with other factors including depression, visual deficit, dizziness, and use of assistive devices significantly increased the risk of falls. From multiple logistic regression analysis, statistically significant predictors of falls were found to be stroke, total environmental risk scores, comorbiditiy of diabetes with visual deficits, and with depression. Conclusion: Fall prevention interventions should be multifactorial, especially for the elders with stroke or diabetes, who were identified in this study as the high risk group for falls. A fall risk assessment tool for low-income elders should include both the intrinsic factors like depression, dizziness, and use of assistive devices, and the extrinsic factors.

Application of Crossover Analysis-logistic Regression in the Assessment of Gene- environmental Interactions for Colorectal Cancer

  • Wu, Ya-Zhou;Yang, Huan;Zhang, Ling;Zhang, Yan-Qi;Liu, Ling;Yi, Dong;Cao, Jia
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권5호
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    • pp.2031-2037
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    • 2012
  • Background: Analysis of gene-gene and gene-environment interactions for complex multifactorial human disease faces challenges regarding statistical methodology. One major difficulty is partly due to the limitations of parametric-statistical methods for detection of gene effects that are dependent solely or partially on interactions with other genes or environmental exposures. Based on our previous case-control study in Chongqing of China, we have found increased risk of colorectal cancer exists in individuals carrying a novel homozygous TT at locus rs1329149 and known homozygous AA at locus rs671. Methods: In this study, we proposed statistical method-crossover analysis in combination with logistic regression model, to further analyze our data and focus on assessing gene-environmental interactions for colorectal cancer. Results: The results of the crossover analysis showed that there are possible multiplicative interactions between loci rs671 and rs1329149 with alcohol consumption. Multifactorial logistic regression analysis also validated that loci rs671 and rs1329149 both exhibited a multiplicative interaction with alcohol consumption. Moreover, we also found additive interactions between any pair of two factors (among the four risk factors: gene loci rs671, rs1329149, age and alcohol consumption) through the crossover analysis, which was not evident on logistic regression. Conclusions: In conclusion, the method based on crossover analysis-logistic regression is successful in assessing additive and multiplicative gene-environment interactions, and in revealing synergistic effects of gene loci rs671 and rs1329149 with alcohol consumption in the pathogenesis and development of colorectal cancer.

정신의학에서의 cDNA Microarray (cDNA Microarray in Psychiatry)

  • 양병환;김자윤
    • 생물정신의학
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    • 제7권2호
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    • pp.123-130
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    • 2000
  • The development of inexpensive high throughput methods to identify individual DNA sequences is important to the future growth of medical genetics. This has become increasingly apparent as psychiatric geneticists focus more attention on the molecular basis of complex multifactorial diseases at which most of psychiatric disease is estimated. Furthermore, candidate gene approaches used in identifying disease associated genes necessitate screening large sequence blocks for changes tracking with the disease state. Even after such genes are isolated, large scale mutational analysis will often be needed for risk assessment studies to define the likely medical consequences of carrying a mutated gene. This review provide basic knowledge of up-to-date technology, cDNA microarray which enables above mentioned various research themes.

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Clinical features and molecular mechanism of muscle wasting in end stage renal disease

  • Sang Hyeon Ju;Hyon-Seung Yi
    • BMB Reports
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    • 제56권8호
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    • pp.426-438
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    • 2023
  • Muscle wasting in end-stage renal disease (ESRD) is an escalating issue due to the increasing global prevalence of ESRD and its significant clinical impact, including a close association with elevated mortality risk. The phenomenon of muscle wasting in ESRD, which exceeds the rate of muscle loss observed in the normal aging process, arises from multifactorial processes. This review paper aims to provide a comprehensive understanding of muscle wasting in ESRD, covering its epidemiology, underlying molecular mechanisms, and current and emerging therapeutic interventions. It delves into the assessment techniques for muscle mass and function, before exploring the intricate metabolic and molecular pathways that lead to muscle atrophy in ESRD patients. We further discuss various strategies to mitigate muscle wasting, including nutritional, pharmacological, exercise, and physical modalities intervention. This review seeks to provide a solid foundation for future research in this area, fostering a deeper understanding of muscle wasting in ESRD, and paving the way for the development of novel strategies to improve patient outcomes.

유전의료시대의 "맞춤의학" (Challenge of Personalized Medicine in the Genomic Era)

  • 김현주
    • Journal of Genetic Medicine
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    • 제5권2호
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    • pp.89-93
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    • 2008
  • "Personalized medicine," the goal of which is to provide better clinical care by applying patient's own genomic information to their health care is a global challenge for the $21^{st}$ century "genomic era." This is especially true in Korea, where provisions for clinical genetic services are inadequate for the existing demand, let alone future demands. Genomics-based knowledge and tools make it possible to approach each patient as a unique biological individual, which has led to a paradigm-shift in medical practice, giving it more of a predictive focus as compared with current treatment oriented approach. With recent advancements in genomics, many genetic tests, such as susceptibility genetic tests, have been developed for both rare single gene diseases and more common multifactorial diseases. Indeed, genetic tests for presymtomatic individuals and genetic tests for drug response have become widely available, and personalized medicine will face the challenge of assisting patients who use such tests to make appropriate and wise use of genetic risk assessment. A major challenge of genomic medicine lies in understanding and communicating disease risk in order to facilitate and support patients and their families in making informed decisions. Establishment of a health care system with provisions for genetic counseling as an integral part of health care service, in addition to genomic literacy of health care providers, is vital to meet this growing challenge. Realization of the promise of personalized medicine in the era of genomics for improvement of health care is dependent on further development of next generation sequencing technology and affordable sequencing test costs. Also necessary will be policy development concerning the ethical, legal and social issues of genomic medicine and an educated and ready medical community with clinical practice guidelines for genetic counseling and genetic testing.

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Literature Review of Postoperative Delirium in Geriatric Patients After Elective Gastrointestinal Cancer Surgery

  • Park, Da-In;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • 제20권3호
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    • pp.177-186
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    • 2018
  • Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.