• Title/Summary/Keyword: risk assessment

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Multivariate Analysis of Predictive Factors for the Severity in Stable Patients with Severe Injury Mechanism (중증 손상 기전의 안정된 환자에서 중증도 예측 인자들에 대한 다변량 분석)

  • Lee, Jae Young;Lee, Chang Jae;Lee, Hyoung Ju;Chung, Tae Nyoung;Kim, Eui Chung;Choi, Sung Wook;Kim, Ok Jun;Cho, Yun Kyung
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.49-56
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    • 2012
  • Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

Analysis of the Effect of the Revised Ground Amplification Factor on the Macro Liquefaction Assessment Method (개정된 지반증폭계수의 Macro적 액상화 평가에 미치는 영향 분석)

  • Baek, Woo-Hyun;Choi, Jae-Soon
    • Journal of the Korean Geotechnical Society
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    • v.36 no.2
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    • pp.5-15
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    • 2020
  • The liquefaction phenomenon that occurred during the Pohang earthquake (ML=5.4) brought new awareness to the people about the risk of liquefaction caused by the earthquake. Liquefaction hazard maps with 2 km grid made in 2014 used more than 100,000 borehole data for the whole country, and regions without soil investigation data were produced using interpolation. In the mapping of macro liquefaction hazard for the whole country, the site amplification effect and the ground water level 0 m were considered. Recently, the Ministry of Public Administration and Security (2018) published a new site classification method and amplification coefficient of the common standard for seismic design. Therefore, it is necessary to rewrite the liquefaction hazard map reflecting the revised amplification coefficient. In this study, the results of site classification according to the average shear wave velocity in soils before and after revision were compared in the whole country. Also, liquefaction assessment results were compared in Gangseo-gu, Busan. At this time, two ground accelerations corresponding to the 500 and 1,000 years of return period and two ground water table, 5 m for the average condition and 0 m the extreme condition were applied. In the drawing of liquefaction hazard map, a 500 m grid was applied to secure a resolution higher than the previous 2 km grid. As a result, the ground conditions that were classified as SC and SD grounds based on the existing site classification standard were reclassified as S2, S3, and S4 through the revised site classification standard. Also, the result of the Liquefaction assessments with a return period of 500 years and 1,000 years resulted in a relatively overestimation of the LPI applied with the ground amplification factor before revision. And the results of this study have a great influence on the liquefaction assessment, which is the basis of the creation of the regional liquefaction hazard map using the amplification factor.

A Critical Review about Application of IUCN Red List Criteria at Regional Level to Korean Endangered Vascular Plants Assessed by the Ministry of Environment, Republic of Korea (환경부 멸종위기 관속식물 지정 기준으로 사용된 IUCN 지역 적색목록 평가 분석)

  • Chang, Chin-Sung;Kwon, Shin-Young;Son, Sungwon;Kim, Hui
    • Journal of Korean Society of Forest Science
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    • v.107 no.4
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    • pp.361-377
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    • 2018
  • The aim of this study was to examine whether the guideline by the Ministry of Environment (ME) successfully and appropriately applied the IUCN Red List criteria at regional level and the rare and endangered national list considered eligible. A certain number of vascular plants, which are widely distributed in the world or in east Asia, deemed to be ineligible for assessment at a regional level as Not Applicable category (NA), because it occurs at very low numbers in South Korea. Among 377 vascular plant taxa evaluated by the ME, NA included 238 species, which represented 63.1%. The number of synonymized species or illegitimate name species were 13 species, which accounted for 3.4%. 21 species (9.3%) were threatened at global level and 103 species were possibly candidates species list for Red List assessments at regional level in the near future. The proportion of NA or waiting list was 66.6% among the list assessed by the ME. The most common errors involved incorrectly application of species extinction in case of population extinction in South Korea to the assessment and provided incorrect interpretation of the Red List criteria at regional level. The most assessments proposed by ME were not backed up without quantitative data quality, justifications, and sources. It is suggested that the risk of extinction should be reassessed at least in the Korean peninsula within the light of their overall distribution including far eastern Russia and North eastern China in north and for Japan and Taiwan in south for regional assessment. The results obtained here using the IUCN criteria at regional level showed that the list proposed by the ME produced an overestimation of the number of threatened vascular plants. Also, the misapplication of the term 'species extinction' for regional assessment was open to some degree of subjectivity and misinterpretation.

A Study on the Development of Assessment Index for Catastrophic Incident Warning Sign at Refinery and Pertrochemical Plants (정유 및 석유화학플랜트 중대사고 전조신호 평가지표 개발에 관한 연구)

  • Yun, Yong Jin;Park, Dal Jae
    • Korean Chemical Engineering Research
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    • v.57 no.5
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    • pp.637-651
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    • 2019
  • In the event of a major accident such as an explosion in a refinery or a petrochemical plant, it has caused a serious loss of life and property and has had a great impact on the insurance market. In the case of catastrophic incidents occurring in process industries such as refinery and petrochemical plants, only the proximate causes of loss have been drawn and studied from inspectors or claims adjustors responsible for claims of property insurers, incident cause investigators, and national forensic service workers. However, it has not been done well for conducting root cause analysis (RCA) and identifying the factors that contributed to the failure and establishing preventive measures before leading to chemical plant's catastrophic incidents. In this study, the criteria of warning signs on CCPS catastrophic incident waning sign self-assessment tool which was derived through the RCA method and the contribution factor analysis method using the swiss cheese model principle has been reviewed first. Secondly, in order to determine the major incident warning signs in an actual chemical plant, 614 recommendations which have been issued during last the 17 years by loss control engineers of global reinsurers were analyzed. Finally, in order to facilitate the assessment index for catastrophic incident warning signs, the criteria for the catastrophic incident warning sign index at chemical plants were grouped by type and classified into upper category and lower category. Then, a catastrophic incident warning sign index for a chemical plant was developed using the weighted values of each category derived by applying the analytic hierarchy process (pairwise comparison method) through a questionnaire answered by relevant experts of the chemical plant. It is expected that the final 'assessment index for catastrophic incident warning signs' can be utilized by the refinery and petrochemical plant's internal as well as external auditors to assess vulnerability levels related to incident warning signs, and identify the elements of incident warning signs that need to be tracked and managed to prevent the occurrence of serious incidents in the future.

Development of a Semi-quantitative Food Frequency Questionnaire Based on Dietary Data from the Korea National Health and Nutrition Examination Survey

  • Younjhin Ahn;Lee, Ji-Eun;Paik, Hee-Young;Lee, Hong-Kyu;Inho Jo;Kim, Kuchan m
    • Nutritional Sciences
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    • v.6 no.3
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    • pp.173-184
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    • 2003
  • Objective : This study was carried out to develop a semi-quantitative food frequency Questionnaire (SQFFQ) for estimating average dietary intake to determine the risk factor for lifestyle-related diseases in a conjoint cohort study. Design : We developed an SQFFQ for genomic epidemiological studies based on the data in the'98 Korea Health and Nutrition Examination Survey. A subset of data on informative food items was collected using the 24-hr recall method with 2,714 adults aged 40 or older living in middle-sized cities or in rural areas in Korea. The cumulative percent contribution and cumulative multiple regression coefficients of 17 nutrients (energy, fat, carbohydrate, protein, fiber, iron, potassium, sodium, calcium, phosphorus, vitamin A, retinol, $\beta$-carotene, vitamin $B_1$, vitamin $B_2$, niacin and vitamin C) of each food were computed. Results : Two hundred and forty-nine foods, which were selected based on their 0.9 cumulative percent contribution, and 254 foods, which were selected based on their 0.9 cumulative multiple regression coefficients, respectively, were grouped into 97 food groups according to their nutrient contents. Several popular Korean foods, which were missing from the list due to the seasonality of the survey, were included. The portion sizes were derived from the same data set. The SQFFQ covered 84.8 percent of the intake of 17 nutrients in the one day diet record data of our 326 cohort study subjects. Conclusions . The final list included 103 food items. The foods list in the SQFFQ described herein accounted for 84.8 percent of the average intake of 17 nutrients. Therefore, the list could be used for the assessment of the baseline dietary intakes of the conjoint cohort studies.

An Estimation of the Amount of Ship's Ballast Water to be Discharged at Korean Major Ports (국내 주요항만에서의 선박평형수 배출량 추정)

  • Choi, Hark-Sun;Kim, Han-Soo;Lee, Seung-Guk
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.12 no.4
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    • pp.284-288
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    • 2009
  • The International Convention for the Control and Management of Ships Ballast Water & Sediments was adopted by consensus at a diplomatic conference of IMO at 2004. To prepare the Ballast Water Management Convention, fundamental technologies such as treatment system, type approval, risk assessment and various technical informations for formulation of the regulation for national strategy shall be developed. The information item of voyage and discharge of ship's ballast water are gathered by visiting vessel and agent at port. Using the 97 results by ships type characteristic analysis on the relation between loading/unloading and discharge/uptake of ballast water, the amounts of discharge/uptake of ballast water at each port and all of country in Korea are predicted. Hence, It is apparent that the uptake of ballast water is predicted to about 70 million ton in total of Busan, Incheon, Kwangyang and Ulsan ports at 2006 which is over 3 times than discharges.

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A Study on Safety and Operational Management System for CNG Filling Stations (CNG충전소 안전.운영 관리를 위한 시스템 구축에 관한 연구)

  • Yang, Jae-Mo;Kim, Bum-Su;Yong, Jong-Won;Ko, Byung-Seok;Lee, Dong-Hyuk;Ko, Jae-Wook
    • Journal of the Korean Institute of Gas
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    • v.15 no.6
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    • pp.8-13
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    • 2011
  • All over the nation, a lot of industrial complex utilize gas as their energy source. Possibilities are fire, explosion, and leakage could happen any time in these large complexes. To prevent these tragic accidents and to minimize the damage when the accident occurs, the development of diagnostic technology for these facilities is imperative. The safety check is conducted on an individual and partial basis, currently. Accordingly, the accumulation and improvement of the safety management technology is necessary in order to make all the different checking techniques and management systems compatible, since checking processes, result interpretation techniques, and subsequent prognoses are not the same. The program provides damage scenarios from gas leakage. The output enables policy makers to predict the degree of infliction. Through this program, engineers are able to design an effective gas safety program to operate and maintain ubiquitous gas facilities.

Uniform Hazard Spectrum Evaluation Method for Nuclear Power Plants on Soil Sites based on the Hazard Spectra of Bedrock Sites (암반 지반의 재해도 스펙트럼에 기반한 토사지반 원전 부지의 등재해도 스펙트럼 평가 기법)

  • Hahm, Dae-Gi;Seo, Jeong-Moon;Choi, In-Kil;Rhee, Hyun-Me
    • Journal of the Earthquake Engineering Society of Korea
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    • v.16 no.3
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    • pp.35-42
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    • 2012
  • We propose a probabilistic method to evaluate the uniform hazard spectra (UHS) of the soil of nuclear power plant(NPP) sites corresponding to that of a bedrock site. To do this, amplification factors on the surface of soil sites were estimated through site response analysis while considering the uncertainty in the earthquake ground motion and soil deposit characteristics. The amplification factors were calculated by regression analysis with spectral acceleration because these two factors are mostly correlated. The proposed method was applied to the evaluation of UHS for the KNGR (Korean Next Generation Reactor) and the APR1400 (Advanced Power Reactor 1400) nuclear power plant sites of B1, B4, C1 and C3. The most dominant frequency range with respect to the annual frequency of earthquakes was evaluated from the UHS analysis. It can be expected that the proposed method will improve the results of integrated risk assessments of NPPs rationally. We expect also that the proposed method will be applied to the evaluation of the UHS and of many other kinds of soil sites.

Morphological Measurements of Anatomic Landmarks in Human Mandibular Molar Pulp Chambers - An in vivo Study

  • Lokade, Joyti;Rawlani, Shivlal;Baheti, Rakhi (Chandak);Roy, Shelly;Chandak, Manoj;Lohe, Vidya
    • Journal of Korean Dental Science
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    • v.4 no.1
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    • pp.1-5
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    • 2011
  • Purpose: Exact knowledge of the location and dimension of the pulp chamber help to maintain the pulp healthy during operative procedure and also reduces the risk of perforation of pulp chamber during root canal treatment. This in-vivo study was carried out to measure critical morphology of pulp chamber of mandibular molar using intra-oral periapical radiograph. Materials and Methods: Mandibular molar teeth of 56 patients were evaluated. The mandibular molar teeth whose pulp chamber was not violated by caries, restoration, fracture crown and those having closed apex were included in the study. The intraoral periapical radiographs were taken with paralleling angle technique using radio-opaque grid with 1 mm space. This grid was placed directly on the film. Results: In 94% of the mandibular first molars specimens the pulp chamber ceiling was at the level of the cemento-enamel junction. The measurements showing the lowest percentage variance were buccal cusp to furcation (approximately 11%) and buccal cusp to pulp chamber ceiling (approximately 15%). The distance from the cusp tip to pulp chamber ceiling height was approximately 6.0 mm, the distance from the pulpal floor to the furcation was approximately 3.0 mm, and the average height of a pulp chamber was 1.5 to 2.0 mm. Conclusion: The exact knowledge of distances of pulp chamber from various anatomical landmarks helps in proper assessment of root canals and ultimately avoids the failure of root canal treatment.

Quality Assessment of Hypertension Management of Office-based Physicians in Korea (우리 나라 개원의 고혈압 관리의 질 평가)

  • Cho, Hong-Jun;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.36-49
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    • 1997
  • Background : Hypertension is one of the most important risk factors of the cerebrovascular accident and coronary artery disease which are the major causes of mortality in Korea. In Korea, the quality of care provided by office-based physicians has not been evaluated formally. The purpose of this study is to assess the quality of hypertension management of office-based physicians. Method : Self-administered questionnaires were mailed to the office-based physicians with the speciality of internal medicine, general surgery, family medicine, and general practitioners. Among 2,045 physicians, 981 doctors(48.0%) replied the questionnaires. Contents of questionnaires were based on the recommendation from the JNC-V report(the Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure), and included the criteria of diagnosis, treatment, follow-up interval, and other characteristics of physicians(age, sex, type of speciality, and location of practice). Results : Eighty four percent of the office-based physicians made diagnosis of hypertension with less than 3 times of blood pressure measurements. The performance rate of required examination for hypertensives was very low in most items. Rate of fundoscopic examination is the lowest one among them(5.9%). The performance rate of laboratory examination was also low in most items. Internists tended to order more frequent laboratory examinations than any other type of physicians. Only 11.4% of the physicians did appropriate treatments for the mild hypertension case. The antihypertensives selected by the physicians as a first line drug were in the order of beta blocker(26.4%), calcium channel blocker(23.4%), diuretics(23.1%), ACE inhibitors(14.3%). The visit interval for established hypertensives was very short. Proportion of physicians with follow-up interval longer than 4 weeks was only 4.3%. Conclusions : The overall quality of hypertension management of office-based physicians in Korea is very problematic in many aspects. So further investigations to find out the reasons of low quality arid quality of care should be initiated.

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