• Quality Improvement in Health Care
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• v.24 no.2
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• Journal of Ginseng Research
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• v.45 no.5
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• pp.546-554
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• 2021

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes. Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring. Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed. Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes. Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837;

• Korean Journal of Food Science and Technology
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• v.42 no.3
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• pp.373-376
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• 2010

The objective of this study was to present the proper probability distribution model based on the data obtained from surveys on domestic refrigerator food storage temperatures in home. Domestic refrigerator temperatures were determined as risk factors in foodborne disease outbreaks for microbial risk assessment (MRA). The temperature was measured by directly visiting 139 homes using a data logger from May to September of 2009. The overall mean temperature for all the refrigerators in the survey was $3.53{\pm}2.96^{\circ}C$, with 23.6% of the refrigerators measuring above $5^{\circ}C$. Probability distributions were also created using @RISK program based on the measured temperature data. Statistical ranking was determined by the goodness of fit (GOF, i.e., the Kolmogorov-Smirnov (KS) or Anderson-Darling (AD) test) to determine the proper probability distribution model. This result showed that the LogLogistic (-10.407, 13.616, 8.6107) distribution was found to be the most appropriate for the MRA model. The results of this study might be directly used as input variables in exposure evaluation for conducting MRA.

• Journal of The Korean Society of Clinical Toxicology
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• v.19 no.2
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• pp.93-99
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• 2021

Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

• Safety and Health at Work
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• v.11 no.4
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• pp.543-549
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• 2020

Background: The working conditions of bus drivers are difficult; they lead to occupational diseases and require careful study, particularly in Ukraine. The objective of the article is the description of occupational health risks of passenger bus drivers that lead to deteriorating health. Methods: The risk assessment was performed using a modified Risk Score method, which allowed determining the generalized level of danger to the driver's health. The hygienic hazards level was assessed as based on Stevenson's law, which was generalized later. Results: Based on the modification of the Risk Score method, it was possible to depart from expert assessments method of the risk level and calculate the general indicator based on the degree of dependence of the impact on the human body on its intensity, proposed by V. Minko. This allows objective determining of the impact of hygiene hazards on the health of the driver and to predict the occurrence of occupational diseases associated with the cardiovascular system, musculoskeletal system, and partial or complete disability due to the accumulation of emotional fatigue. The hazard assessment was carried out for three brands of passenger buses common in Ukraine, in which the driver is exposed to the dangers of fever, vibration, noise, harmful impurities in the bus cabin, and emotional load. Conclusion: The health of drivers in the cabins of passenger buses is most affected by hygiene hazards: fever, vibration, and emotional stress. The generalized level of risk is calculated by the modified method of Risk Score is 0.83; -0.99, -0.92 respectively.

• Journal of the Korean Society of Safety
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• v.17 no.3
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• pp.66-72
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• 2002

During the last ten years, effort has been made for reducing maintenance cost for aged equipments and ensuring safety, efficiency and profitability of petrochemical and refinery plants. Hence, it was required to develop advanced methods which meet this need. RBI(Risk Based Inspection) methodology is one of the most promising technology satisfying the requirements in the field of integrity management. In this study, a qualitative assessment algorithm for RBI based on the API 581 code was reconstructed for developing an RBI software. The user-friendly realRBI software is developed with a module for evaluating qualitative risk category using the potential consequence factor and the likelihood factor.

• Korean Journal of Adult Nursing
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• v.27 no.2
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• pp.156-169
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• 2015

Purpose: This study identified the reasons why tuberculosis (TB) patients withhold treatment in a bid to develop a assessment scale to select patients who needs nursing intervention in the early stage and decrease the risk of discontinuation of treatment. Sample: There were two samples. A sample of 191 patients with TB and having primary treatment and a second sample of N who were under re-treatment Methods: The study design included qualitative and quantitative methods. Qualitative data were collected from in-depth interviews of TB patients under re-treatment. The quantitative data were collected from 191 patients with TB under primary treatment. Results: Exploratory factor analysis revealed 11 factors explaining 69.6% of total variance. These factors were categorized into four subgroups. A depression scale was used to establish concurrent validity. The depression scale had a positive relationship (r=54) with the discontinuing of primary treatment. The internal consistency reliability for the four subgroups was over .84. The confidence coefficient was Cronbach's ${\alpha}$ .95. The final scale was a self-reported four Likert scale including 50 items. Conclusion: Reliability and validity was established for the scale and the scale can be used to examine the risk of treatment discontinuation for TB. The scale is an important resource for nursing interventions in identifying and treating high risk clients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4913-4916
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• 2016

Objective: As a source of information, medical data can feature hidden relationships. However, the high volume of datasets and complexity of decision-making in medicine introduce difficulties for analysis and interpretation and processing steps may be needed before the data can be used by clinicians in their work. This study focused on the use of Bayesian models with different numbers of nodes to aid clinicians in breast cancer risk estimation. Methods: Bayesian networks (BNs) with a retrospectively collected dataset including mammographic details, risk factor exposure, and clinical findings was assessed for prediction of the probability of breast cancer in individual patients. Area under the receiver-operating characteristic curve (AUC), accuracy, sensitivity, specificity, and positive and negative predictive values were used to evaluate discriminative performance. Result: A network incorporating selected features performed better (AUC = 0.94) than that incorporating all the features (AUC = 0.93). The results revealed no significant difference among 3 models regarding performance indices at the 5% significance level. Conclusion: BNs could effectively discriminate malignant from benign abnormalities and accurately predict the risk of breast cancer in individuals. Moreover, the overall performance of the 9-node BN was better, and due to the lower number of nodes it might be more readily be applied in clinical settings.

• Environmental Analysis Health and Toxicology
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• v.12 no.3_4
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• pp.31-41
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• 1997

Public concerns about hazardous health effect from the exposure to organic by-products of the chlorination have been increased. There are numerous studies reporting that chlorination of drinking water produces numerous chlorinated organic by-products including THMs, HAAs, HANs. Some of these products are known to be animal carcinogens. The purpose of this study was to estimate health risk of DBPs by chlorinated drinking water ingestion in Seoul based on methodologies that have been developed for conducting risk assessment of complex-chemical-mixture. The drinking water sample was collected seperately at six water treatment plant in Seoul at March, April, 1996. In tap water of households in Seoul, DBPs were measured wilfh the mean value of 36.6 $\mu$g/L. Risk assessment processes,. which include processes for the estimation of human cancer potency using animal bioassay data and calculation of human exposure, entail uncertainties. In the exposure assessment process, exposure scenarios with various assumptions could affect the exposure amount and excess cancer risk. The reference dose of haloacetonitriles was estimated to be 0.0023 mg/kg/day by applying dibromoacetonitrile NOAEL and uncertainty factor to the mean concentration. In the first case, human excess cancer risk was estimated by the US EPA method used to set the MCL (maximum contaminant level). In the second and third case, the risk was estimated for multi-route exposure with and without adopting Monte-Carlo simulation, respectively. In the second case, exposure input parameters and cancer potencies used probability distributions, and in the third case, those values used point estimates (mean, and maximum or 95% upper-bound value). As a result, while the excess cancer risk estimated by US EPA method considering only direct ingestion tended to be underestimated, the risk which was estimated by considering multi-route exposure without Monte-Carlo simulation and then using the maximum or 95% upper-bound value as input parameters tended to be overestimated. In risk assessment for Trihalomethanes, considering multi-route exposure with adopting Monte-Carlo analysis seems to provide the most reasonable estimations.

• Health Policy and Management
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• v.32 no.1
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• pp.45-52
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• 2022

Background: There are regional variations in the incidence of coronavirus disease 2019 (COVID-19), which means that some regions are more exposed to the risk of COVID-19 than others. Therefore, this study aims to investigate regional variations in the incidence of COVID-19 in Korea and identify risk factors associated with the incidence of COVID-19 using community-level data. Methods: This study was conducted at the districts (si·gun·gu) level in Korea. Data of COVID-19 incidence by districts were collected from the official website of each province. Data was also obtained from the Korean Statistical Information Service and the Community Health Survey; socio-demographic factor, transmission pathway, healthcare resource, and factor in response to COVID-19. Community risk factors that drive the incidence of COVID-19 were selected using a least absolute shrinkage and selection operator regression. Results: As of June 2021, the incidence of COVID-19 differed by more than 80 times between districts. Among the candidate factors, sex ratio, population aged 20-29, local financial independence, population density, diabetes prevalence, and failure to comply with the quarantine rules were significantly associated with COVID-19 incidence. Conclusion: This study suggests setting COVID-19 quarantine policy and allocating resources, considering the community risk factors. Protecting vulnerable groups should be a high priority for these policies.