• Title/Summary/Keyword: risk process

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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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    • v.20 no.3
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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.

Utilization of Technical Resources in the Emergency Recovery Process of Flood Damage of Local Governments (지방자치단체의 홍수피해 응급복구 과정에서의 기술자원 활용방안)

  • Heo, Sun Bum;Cho, Won Cheol;Lee, Tae Shik
    • Journal of Korean Society of Disaster and Security
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    • v.5 no.1
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    • pp.7-12
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    • 2012
  • This study analyzed appropriate equipment combination for emergency recovery after flood disasters and proposed an alternative approach for economic and rapid emergency recovery based on the utilization of human resources who have practical experience in construction business and in equipment operation. The current countermeasures and response to flood disaster including emergency procedures and methodologies are investigated and related legal framework was also analyzed. Currently, some emergency recovery works are over payed and delayed due to unclear and inefficient processes on equipment and human resources mobilization during and after flood disasters, particularly in local governments. Best practices in mobilizing equipment and human resources were compiled, theoretical foundation was investigated and analyzed, and improved emergency recovery schemes were proposed for effective flood disaster countermeasures in local government. Prioritization in equipment and human resources mobilization was also proposed considering equipment transportation distance and accessability to disaster sites. This study also proposed improved ways to utilize experts in local areas in supporting community emergency response volunteers for disaster risk management.

Update of Head and Neck Cancer Staging in the 8th Edition Cancer Staging Manual of the American Joint Committee on Cancer (두경부암 병기 설정의 최신 변화: AJCC 암 병기설정 매뉴얼8판)

  • Hong, Hyun Jun
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.9-15
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    • 2017
  • The recently released the $8^{th}$ edition of the American Joint Committee on Cancer (AJCC) Staging Manual introduces significant modifications from the prior $7^{th}$ edition. In this paper, the contents of the new changes in the decision of cancer of the head and neck is summarized except changes in staging of skin and thyroid cancer. In addition to the 8th edition, 1) Addition of extracapsular involvement in metastatic lymph nodes (N category) 2) Oral cancer T classification change, 3) Staging of the pharyngeal cancer was divided into 3 chapters: high-risk human papilloma virus (HR-HPV) associated oropharyngeal cancer (OPC), non HR-HPV associated OPC and hypopharynx cancer (HPC), and nasopharynx cancer (NPC) 4) Changes in T and N classification in NPC, 5) In the case of cancer of unknown primary, P16-positive case is defined as HR-HPV related OPC, and EBV-positive case is defined as NPC. The process that led to these changes highlights the need to collect high-fidelity cancer registry-level data that can be used to confirm prognostic observations identified in institutional data sets. Clinicians will continue to use the latest information for patient care, including scientific content of the 8th Edition Manual. All newly diagnosed cases through December $31^{st}$ 2017 should be staged with the 7th edition. The time extension will allow all partners to develop and update protocols and guidelines and for software vendors to develop, test, and deploy their products in time for the data collection and implementation of the 8th edition in 2018. The 8th edition strikes a balance between a personalized, complex system and a more general, simpler one that maintains the user-friendliness and worldwide acceptability of the traditional TNM staging paradigm.

Migration of Additives from Domestic Plastic Food Contact Materials and Application of Alternative Fatty Food Simulant (국내 합성수지 식품포장재에서의 첨가제 이행과 유지식품용 대체시뮬란트의 응용)

  • 이창성;이근택;이광호
    • Journal of Food Hygiene and Safety
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    • v.12 no.2
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    • pp.132-140
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    • 1997
  • Additives in plastics are capable of migrating from the packaging materials into the foodstuffs, thereby presenting a source of contamination and a potential health risk to the consumer. The migration from packaging materials into foodstuffs is first of all regulated by examining the amounts of global and specific migrated components. Besides, there is worldwide still a need for practical methods for measuring and monitoring migration from polymers, especially for the testing of migration into fatty foodstuffs. Therefore, these studies were undertaken to investigate the safety status of domestic plastic packaging materials with respect to migration. Another objective of this study was to examine the applicability of ethanol as an alternative fatty food simulant substituting for olive oil and n-heptane. The evaporation residues for various dometic plastic samples determined as described in Korean food laws were in the level from 4.3 to 14.5 mg/$\ell$, which were much lower than the limit value of 150 mg/$\ell$. The global migration values into 95 % ethanol showed to be comparable to those into n-heptane, while the olive oil migration values were comparably higher than those into ethanol or n-heptane and moreover they were not reproducible. The kinetic migration begavior of additives in polyolefin samples into 95% ethanol showed a Fickian diffusion process. The results of these studies on global migration and kinetic testings demonstrate that the ethanol could be successfully substitute for the olive oil and n-heptane as an alternative fatty food simulant, at least in contact with polyoefins.

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Management of Citrus Canker in Argentina, a Success Story

  • Canteros, B.I.;Gochez, A.M.;Moschini, R.C.
    • The Plant Pathology Journal
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    • v.33 no.5
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    • pp.441-449
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    • 2017
  • Citrus canker is an important bacterial disease of citrus in several regions of the world. Strains of Xanthomonas citri type-A (Xc-A) group are the primary pathogen where citrus canker occurs. After Xc-A entered the Northeast of Argentina in 1974, the disease spread rapidly from 1977 to 1980 and then slowed down and remained moving at slow pace until 1990 when it became endemic. Citrus canker was detected in Northwest Argentina in 2002. This paper presents the main steps in the fight of the disease and the management strategies that have been used to control citrus canker at this time. We think the process might be usefull to other countries with the same situation. Results from more than 40 years of research in Northeast (NE) Argentina indicate that we are at the limit of favorable environment for the disease. The severity of citrus canker is greatly affected by the environment and El $Ni{\tilde{n}}o$ Southern Oscillation (ENSO) phenomenon which causes cyclic fluctuations on the disease intensity in the NE region. Weather-based logistic regression models adjusted to quantify disease levels in field conditions showed that the environmental effect was strongly modulated by the distance from a windbreak. Production of healthy fruits in citrus canker endemic areas is possible knowing the dynamics of the disease. A voluntary Integrated Plan to Reduce the Risk of Canker has been in place since 1994 and it allows growers to export unsymptomatic, uninfested fresh fruit to countries which are free of the disease and require healthy, pathogen free fruits. The experience from Argentina can be replicated in other countries after appropriate trials.

Analysis of Environmental Impacts using LCA for the Carcass Burial (전과정평가를 활용한 가축매몰지의 환경영향 분석)

  • Kim, Mi Hyung;Kim, Geon Ha
    • Journal of Korean Society on Water Environment
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    • v.29 no.2
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    • pp.239-246
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    • 2013
  • The foot and mouth disease and AI were highly contagious. The virus can be transmitted in a number of ways, including close-contact animal to animal spread, long-distance aerosol spread and fomites, or inanimate objects, typically fodder and motor vehicles. A lot of burial sites were constructed in a short time for preventing the rapid spread of the virus. The carcass burial sites have a risk potential because the sites were constructed without any appropriate and systematic management. It resulted from lacking of time, equipments and man power. The carcass burial sites more than 4,700 constructed in 2011. Approximately 7 million poultry and 3.5 million livestock including head of cattle and swine were buried in farm land. It is time to be concerned if the secondary pollutions occur from the burial sites. The environmental impacts should be analyzed for managing the burial sites effectively and minimizing damages and risks to the environment and human health. This study was to analyze environmental impacts of the process of carcass burial construction using a life cycle assessment methodology. All input data of raw materials and energy usage were collected and the inventory was constructed. The results showed that 1 ton of carcass burial of the environmental impacts were $0.51yr^{-1}$ for ADP, 0.09 kg of 1,4DCB-eq for FAETP, 31.17 kg of $CO_2-eq$ for GWP, 0.04 kg of $C_2H_4-eq$ for POCP, 0.06 kg of $SO_2-eq$ for AP.

Developing die and Peripheral Equipment Used for the Manufacture of Octagonal Outlet Boxes (8각 아웃렛 박스 제조용 금형 및 주변기기 개발)

  • Chio Kye-Kwang
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.6 no.6
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    • pp.560-565
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    • 2005
  • This paper deals with the development of manually operated die used for the manufacture of octagonal boxes into two sets of automated die. In particular, theoctagonal boxes are used fur the switch boxes intended fur the cable conduit of buildings or f3r wiring connection. Manufacturing these boxes requires forming the materials using the primary press before they undergo 2nd through 6th processing by the press machine including the four sides of the octagonal outlet box and bending. Such complicated process hikes up labor cost, slows down production, and results in defect rate of $10\%$ or higher; hence the overall rise in manufacturing cost. Moreover, workers avoid this type of work due to the roar and vibration coming from the press and the risk of accident. To eliminate such phenomenon, a CAM die made by integrating five sets of die into one set of die and an automatic conveyor system were developed. As a result, unmanned work was realized with only two units of press and two sets of die; thus solving the problem of work being avoided and saving on manufacturing cost.

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Development of Cyber Security Assessment Methodology for the Instrumentation & Control Systems in Nuclear Power Plants (원전 계측제어시스템에 대한 사이버보안성 평가 방법론 개발)

  • Kang, Young-Doo;Chong, Kil-To
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3451-3457
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    • 2010
  • Cyber security assessment is the process of determining how effectively an entity being assessed meets specific cyber security objectives. Cyber security assessment helps to measure the degree of confidence one has and to identify that the managerial, technical and operational measures work as intended to protect the I&C systems and the information it processes. Recently, needs for cyber security on digitalized nuclear I&C systems are increased. However the overall cyber security program, including cyber security assessment, is not established on those systems. This paper presents the methodology of cyber security assessment which is appropriate for nuclear I&C systems. This methodology provides the qualitative assessments that may formulate recommendations to bridge the security risk gap through the incorporated criteria. This methodology may be useful to the nuclear organizations for assessing the weakness and strength of cyber security on nuclear I&C systems. It may be useful as an index to the developers, auditors, and regulators for reviewing the managerial, operational and technical cyber security controls, also.

Module Suggestion to Develop an Integration System of Schedule and Change Control (공정 및 변경관리 통합시스템 개발을 위한 모듈 제안에 관한 연구)

  • So Young-Sung;Oh Seung-Jun;Kim Young-Su
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • autumn
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    • pp.393-396
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    • 2002
  • Purpose of this study is to suggest some modules to integrate schedule and change control. The study has been performed through the process of literature review, effect comparison of being not integrated and integrated of the schedule and change control, and finally suggest new integrated modules. The results of this study are as follows: 1) Suggestion of a Predicted Change Information Control Module: This nodule can be used to assess the impact of changes in advance and to prepare counteraction. 2) Suggestion of a Change Information Control Module: This module is used to update current schedule for the realized changes. 3) Suggestion of a Revision History Maintenance Module: This module is used to record schedule and cost revision history and to analyze the overall change trend.

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Architecture Modeling for Kiosk-based Public Services through Web (키오스크 기반 웹 민원처리시스템 구축을 위한 아키텍쳐 모델링)

  • 안임상;정기원
    • The Journal of Society for e-Business Studies
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    • v.9 no.1
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    • pp.285-301
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    • 2004
  • Public service provision through internet is one of major parts for e-government implementation. It is essential to link the internal administrative network with internet to provide the services through internet and to support kiosks through internet, which should result in critical issues for security. A relay server, as a front server for the public service processing system and a web server, a control server for kiosks, are placed between the public service processing system and kiosks to solve those security issues. It is the way to solve security issues through protecting direct communication between the public service processing system and a web server and authenticating a relay server and a web server through authentication process. In the implementation of the system this paper provide a design for an architecture model of the public service processing system through internet, which are aiming to develop high level of the quality system effectively, to reduce the risk of initial stage of development, and to reduce the incurring cost due to reworks.

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