The rapid increase in food borne illness outbreaks in Korea has been one of the major threats to the Nation's Health. Foodservice establishments have been identified as the major place for these outbreaks, mainly due to the lack of sanitary management and sanitary facility management practices. The purposes of the study were to develop hospital foodservice facility evaluation tools, based on the general HACCP-based standards and guidelines, for hospital food service establishments, to ensure the safety of these foodservices and to reduce the risk of food home illness. The scope of this study included: 1) an assessment of the current foodservice sanitation practices and managements for 6 general hospitals, with more than 400 beds, and 3 general hospitals, with less than 400 beds; 2) the development of foodservice establishments sanitation evaluation tools and sanitation standards, based on the HACCP system. The survey data showed varied results between the hospitals surveyed. Most of the hospital foodservice operations had many problems with ventilation and the plumbing. The total dimensional mean scores for the hospitals with more than 400 beds and less than 400 beds were 31.5 and 27.0, respectively. The highest dimension scores were for the water supply facility and lighting, with the lowest for insect and rodent control and toxic materials management. The levels of the mean scores were very low, especially for the general hospitals with less than 400 beds. These low mean scores may have arisen from critical problems within the hospital foodservice operations. The most needed facility management items for improvement were: storage shelf should be spaced 6 inches from the floor and walls, the use of three compartment sinks, utility sinks and cleaning facilities, with a floor drain for cleaning mops or liquid wastes, a ventilation hood designed to prevent dripping onto food, cooking facilities should be disassembled for washing and sanitizing, a separated hand washing sink and a sanitized food board for each area should be provided, all toxic material must have warning labels attached, and be stored in an area away from food preparation under padlock. The evaluation tool consisted of 14 dimensions, with 65 check-off items. The results of this study will provide basic facilities' guidelines to regulators, or foodservice industry personnel, wishing to build, or expend, and establish an efficient flow of food. As a result, food borne illnesses will be effectively prevented, and the Nation's health will be promoted for the development of their own sanitation standards, with a checklist for the safe production of foods.
Wang, Bohan;Yang, Jin;Tan, Adrian;Tan, Fabian Hadipriono;Parke, Michael
Journal of Construction Engineering and Project Management
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v.8
no.4
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pp.1-24
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2018
In the last decade, the use of Building Information Modeling (BIM) as a new technology has been applied with traditional Computer-aided design implementations in an increasing number of architecture, engineering, and construction projects and applications. Its employment alongside construction management, can be a valuable tool in helping move these activities and projects forward in a more efficient and time-effective manner. The traditional stakeholders, i.e., Owner, A/E and the Contractor are involved in this BIM system that is used in almost every activity of construction projects, such as design, cost estimate and scheduling. This article extracts major features of the application of BIM from perspective of participating BIM components, along with the different phrases, and applies to them a logistic analysis using a fuzzy performance tree, quantifying these phrases to judge the effectiveness of the BIM techniques employed. That is to say, these fuzzy performance trees with fuzzy logic concepts can properly translate the linguistic rating into numeric expressions, and are thus employed in evaluating the influence of BIM applications as a mathematical process. The rotational fuzzy models are used to represent the membership functions of the performance values and their corresponding weights. Illustrations of the use of this fuzzy BIM performance tree are presented in the study for the uninitiated users. The results of these processes are an evaluation of BIM project performance as highly positive. The quantification of the performance ratings for the individual factors is a significant contributor to this assessment, capable of parsing vernacular language into numerical data for a more accurate and precise use in performance analysis. It is hoped that fuzzy performance trees and fuzzy set analysis can be used as a tool for the quality and risk analysis for other construction techniques in the future. Baldwin's rotational models are used to represent the membership functions of the fuzzy sets. Three scenarios are presented using fuzzy MEAN, AND and OR gates from the lowest to intermediate levels of the tree, and fuzzy SUM gate to relate the intermediate level to the top component of the tree, i.e., BIM application final performance. The use of fuzzy MEAN for lower levels and fuzzy SUM gates to reach the top level suggests the most realistic and accurate results. The methodology (fuzzy performance tree) described in this paper is appropriate to implement in today's construction industry when limited objective data is presented and it is heavily relied on experts' subjective judgment.
The purpose of this study was to investigate the usefulness of the cognitive function test tool in the clinical or multi-life environment for the elderly and high-risk demented subjects after the development of the non-clinical dementia early diagnosis test content(Co-Wis) based on the contents of the International Clinical Data Standard(CDISC TAUG-Alzheimer's v 2.0, SDTMIG v3.3) And to verify the validity and reliability of the data. To do this, after searching for dementia diagnosis process, we developed a non-clinical dementia diagnosis content(Co-Wis) that can supplement the shortcomings of the existing paper test. We selected 30 subjects from elders who were over 60 years old and verified the validity of test and the reliability of retest among cognitive domains of the Korean MMSE-K, Seoul Neuropsychological Test(SNSB-II) and non-medication dementia diagnosis content(Co-Wis). As a result, we showed high correlation and reliability in all cognitive domains. However, the limitations of insufficient subjects and regional distribution were identified. Based on the results of the study, we discussed the necessity of supplementing and expanding further studies such as various methods of verifying validity and reliability.
Objective : The objective of this study was to present the components of frailty by organizing the definitions of frail elderly and analyzing the tools used to screen them. Methods : This study searched for articles at involved frailty screening assessments in the elderly. Databases including CINAHL, Embase, Medline Complete, and PubMed were searched. The search terms were "assess" AND "frailty" AND "screening" AND ("frail elderly" OR "elderly"). Results : A total of 539 articles were identified by the search and 11 articles were selected. Frailty occurs due to the depressed function of multidimensional factors, and a frail elderly person is defined as one at high risk of health degeneration, functional impairment, and occurrence of disability, and having a high level of threat to life. Seven tools were selected from 11 articles. The most frequently used tool was the frailty phenotype, which was used in five articles (45.4%). The identified components of frailty were physical, activity participation, nutrition, psychological, social, overall health, and age. Conclusion : The results confirmed the definition and components of frailty. This study is expected to contribute to the future development of standardized evaluation tools for screening frail elderly individuals and intervention programs for the management of the frail elderly.
Recent years have witnessed the increased usage of flammable metals, such as aluminum or magnesium, in wide range of high-tech industries. These metals are indispensable for the improvement of physical properties of materials as well as the design capability of the final product. During the process, unwanted metal dusts could be released to the environment. This can lead to an occupational health and safety issues. Due to their flammable nature, more serious problem of an explosion can happen in extreme cases. The explosion is the combustion of tiny solid particles and vapor mixture, caused by pyrolysis. This complex composition makes engineering analysis more difficult, compared to simple gas explosions or vapor cloud combustions. The study was conducted to assess this light metal dust explosion in an effort to provide the bases for a risk assessment. Dust explosion characteristics of each material was carefully evaluated and an appropriate analysis tool was developed. A comprehensive database was also constructed and utilized for the calibration of the developed response model and the verification for its accuracy. Subsequently, guidelines were provided to prevent dust explosions that could occur in top-notch industrial processes.
Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
Asian Pacific Journal of Cancer Prevention
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v.15
no.3
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pp.1313-1320
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2014
Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.
Journal of agricultural medicine and community health
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v.44
no.4
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pp.209-219
/
2019
Objectives: This study investigated musculoskeletal symptoms in upper limbs according to the working environment (job stress) of dental hygienists and examine their relationship with upper limb functions. Methods: The subjects include 198 dental hygienists in dental hospitals and dental clinics in Pusan and Gyeongnam. The questionnaire was consisted of general characteristics of the subjects, job stress, musculoskeletal symptoms in upper limbs and function (Disability Measurement Tool for Upper Extremity Disorders-11, DASH-11). Results: The study was analyzed their musculoskeletal symptoms in upper limbs according to their general characteristics and found that the symptoms occurred in the neck (39.4%), the shoulders (54.6%), elbows (14.7%), and the hands (50.0%). Job stress was associated with upper limb functions (DASH-11) (model 3, B=5.210, p=0.012) and repeated elbow bending and spreading posture was associated with DASH-11 (model 3, B=6.561, p=0.029). Elbow symptoms were associated with DASH-11 in the upper limbs (B=10.679, p=0.003). Conclusion: Dental hygienists are experiencing limitations of upper limb function due to job stress. In particular, even if the correction of their uncomfortable posture is significantly related to the job stress and upper limb function, in order to improve the upper limb function of the dental hygienist, efforts to reduce the job stress as well as the uncomfortable posture are necessary.
Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Journal of The Korean Society of Integrative Medicine
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v.9
no.3
/
pp.87-97
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2021
Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.
Ka-Hyun Kim;Sung-Won Choi;Hae-Won Hong;Ju-Young Yoon;Yong-Jun Kim;Jung-Hyun Kim
Journal of Korean Medicine Rehabilitation
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v.33
no.3
/
pp.135-148
/
2023
Objectives To investigate the effectiveness of acupuncture in the treatment of post-disaster musculoskeletal pain by reviewing relevant clinical studies. Methods A systematic search was conducted across 10 electronic databases to identify relevant clinical studies on acupuncture treatment for post-disaster musculoskeletal pain until May 2023. The methodological quality was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias Assessment tool for non-randomized studies tools. Results Six articles were analyzed, including two randomized controlled trials (RCTs), two before-after studies, one qualitative research, and one case series. Overall, acupuncture therapy showed some improvement in pain scale among musculoskeletal pain survivors. However, no significant improvement was observed in the Short-Form McGill Pain Questionnaire (SF-MPQ-2). Subgroup analysis of participants who completed at least four acupuncture sessions revealed a significant effect on the SFMPQ-2. Additionally, a significant improvement in 36-Item Short Form Survey (SF36P) was observed after 6 months of treatment, but the 2-month treatment period did not show statistically significant effects on SF-36P improvement. The evaluation of the methodological quality of the RCTs identified some concerns of bias. Conclusions The results suggest that acupuncture is effective in alleviating post-disaster musculoskeletal pain. However, considering the limited number of selected studies and the inclusion of subjective evaluation measures, caution should be exercised in interpreting the results. Further large-scale follow-up studies are needed to determine the optimal frequency and duration of acupuncture treatment. Well-designed controlled trials should be conducted to provide more robust evidence regarding the effectiveness of acupuncture for post-disaster musculoskeletal pain.
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