• 제목/요약/키워드: Confidence Evaluation

검색결과 795건 처리시간 0.028초

LI-RADS Version 2018 Treatment Response Algorithm: Diagnostic Performance after Transarterial Radioembolization for Hepatocellular Carcinoma

  • Jongjin Yoon;Sunyoung Lee;Jaeseung Shin;Seung-seob Kim;Gyoung Min Kim;Jong Yun Won
    • Korean Journal of Radiology
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    • 제22권8호
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    • pp.1279-1288
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    • 2021
  • Objective: To assess the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 treatment response algorithm (TRA) for the evaluation of hepatocellular carcinoma (HCC) treated with transarterial radioembolization. Materials and Methods: This retrospective study included patients who underwent transarterial radioembolization for HCC followed by hepatic surgery between January 2011 and December 2019. The resected lesions were determined to have either complete (100%) or incomplete (< 100%) necrosis based on histopathology. Three radiologists independently reviewed the CT or MR images of pre- and post-treatment lesions and assigned categories based on the LI-RADS version 2018 and the TRA, respectively. Diagnostic performances of LI-RADS treatment response (LR-TR) viable and nonviable categories were assessed for each reader, using histopathology from hepatic surgeries as a reference standard. Inter-reader agreements were evaluated using Fleiss κ. Results: A total of 27 patients (mean age ± standard deviation, 55.9 ± 9.1 years; 24 male) with 34 lesions (15 with complete necrosis and 19 with incomplete necrosis on histopathology) were included. To predict complete necrosis, the LR-TR nonviable category had a sensitivity of 73.3-80.0% and a specificity of 78.9-89.5%. For predicting incomplete necrosis, the LR-TR viable category had a sensitivity of 73.7-79.0% and a specificity of 93.3-100%. Five (14.7%) of 34 treated lesions were categorized as LR-TR equivocal by consensus, with two of the five lesions demonstrating incomplete necrosis. Interreader agreement for the LR-TR category was 0.81 (95% confidence interval: 0.66-0.96). Conclusion: The LI-RADS version 2018 TRA can be used to predict the histopathologic viability of HCCs treated with transarterial radioembolization.

Formulations of Job Strain and Psychological Distress: A Four-year Longitudinal Study in Japan

  • Mayumi Saiki;Timothy A. Matthews;Norito Kawakami;Wendie Robbins;Jian Li
    • Safety and Health at Work
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    • 제15권1호
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    • pp.59-65
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    • 2024
  • Background: Different job strain formulations based on the Job Demand-Control model have been developed. This study evaluated longitudinal associations between job strain and psychological distress and whether associations were influenced by six formulations of job strain, including quadrant (original and simplified), subtraction, quotient, logarithm quotient, and quartile based on quotient, in randomly selected Japanese workers. Methods: Data were from waves I and II of the Survey of Midlife in Japan (MIDJA), with a 4-year followup period. The study sample consisted of 412 participants working at baseline and had complete data on variables of interest. Associations between job strain at baseline and psychological distress at follow-up were assessed via multivariable linear regression, and results were expressed as β coefficients and 95% confidence intervals including R2 and Akaike information criterion (AIC) evaluation. Results: Crude models revealed that job strain formulations explained 6.93-10.30% of variance. The AIC ranged from 1475.87 to 1489.12. After accounting for sociodemographic and behavioral factors and psychological distress at baseline, fully-adjusted models indicated significant associations between all job strain formulations at baseline and psychological distress at follow-up: original quadrant (β: 1.16, 95% CI: 0.12, 2.21), simplified quadrant (β: 1.01, 95% CI: 0.18, 1.85), subtraction (β: 0.39, 95% CI: 0.09, 0.70), quotient (β: 0.37, 95% CI: 0.08, 0.67), logarithm quotient (β: 0.42, 95% CI: 0.12, 0.72), and quartile based on quotient (β: 1.22, 95% CI: 0.36, 2.08). Conclusion: Six job strain formulations showed robust predictive power regarding psychological distress over 4 years among Japanese workers.

The relationship between skeletal muscle mass and the KOSHA cardiovascular risk in obese male workers

  • Hyo Won Chong;JunSeok Son;Changho Chae;Changho Jae
    • Annals of Occupational and Environmental Medicine
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    • 제35권
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    • pp.40.1-40.10
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    • 2023
  • Background: Efforts for the prevention and management of cardiovascular diseases (CVDs) in workers have been actively pursued. Obesity is one of the important risk factors related to CVDs. Obesity has various metabolic characteristics, and some individuals can be metabolically healthy. Body composition including skeletal muscle mass is known to have protective effect in obesity. The study aims to investigate the association between skeletal muscle mass and Korea Occupational Safety and Health Agency (KOSHA) CVD risk among obese male manufacturing workers in Korea and to identify appropriate indicators of skeletal muscle mass for predicting risk of CVDs. Methods: The study was conducted on 2,007 obese male workers at a manufacturing industry aged more than 19 years. Skeletal muscle mass, skeletal muscle index (SMI), skeletal muscle mass percent (SMM%) and skeletal muscle to body fat ratio (MFR) were used to evaluate body composition and these indicators were divided into quartiles. The odds ratios (ORs) and 95% confidence intervals (CIs) for the KOSHA CVD risk groups according to quartiles of skeletal muscle mass indicators were estimated using ordinal logistic regression analysis. Results: The OR for the KOSHA CVD risk groups in the highest quartile of SMI was 1.67 (95% CI: 1.42-1.92), while the ORs for the KOSHA CVD risk groups in the highest quartiles of SMM%, SMM/body mass index (BMI), and MFR were 0.47 (95% CI: 0.22-0.72), 0.51 (95% CI: 0.05-0.76), and 0.48 (95% CI: 0.23-0.74), respectively. Conclusions: We found that high SMI increase the likelihood of high risk of CVDs, while high SMM%, SMM/BMI, and MFR lower the likelihood of high risk of CVDs. Accurate evaluation of skeletal muscle mass can help assess the cardiovascular risk in obese male workers.

Hybrid argon plasma coagulation in Barrett's esophagus: a systematic review and meta-analysis

  • Sagar N. Shah;Nabil El Hage Chehade;Amirali Tavangar;Alyssa Choi;Marc Monachese;Kenneth J. Chang;Jason B. Samarasena
    • Clinical Endoscopy
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    • 제56권1호
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    • pp.38-49
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    • 2023
  • Background/Aims: Patients with Barrett's esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett's esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872-0.939; I2=0%). Pooled stricture rate was 2.0% (95% CI, 0.005-0.042; I2=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007-0.055; I2=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

지역사회치위생학 실습 교육에서의 프로젝트 기반 학습 효과 평가 (Evaluation of Project-Based Learning on Community Dental Hygiene Practice Education)

  • 유상희;배수명;신보미;신선정
    • 치위생과학회지
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    • 제17권4호
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    • pp.368-374
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    • 2017
  • 본 연구는 G대학교 지역사회치위생학 실습 수업을 수강한 치위생학과 4학년 학생 27명을 대상으로 구강건강증진사업을 학습 내용에 적용하기 위해 목표 집단에 대한 현황조사, 사업 기획, 수행, 평가, 중간 및 결과 발표로 구성된 프로젝트 기반의 수업을 진행하였다. 수업 전 후 문제해결능력에 대한 자신감, 프로젝트 가치, 팀워크 역량, 지역사회 치과위생사 역량에 대한 비교 결과, 문제해결능력에 대한 자신감은 수업 전 35.74점, 수업 후 39.59점(p=0.001), 프로젝트 가치는 수업 전 25.11점, 수업 후 26.41점(p=0.181), 팀워크 역량은 수업 전 79.63점, 수업 후 84.07점(p=0.070), 지역사회치과위생사 역량은 수업 전 38.26점에서 수업 후 46.26점(p=0.001)으로 향상되었다. 수업 후 프로젝트의 실제성, 학습성과, 만족도를 분석한 결과, 프로젝트 실제성은 19.30점, 학습성과는 45.19점, 만족도는 19.19점으로 보통 이상의 긍정적인 결과로 나타났다. 수업 효과성의 질적 평가를 위해 각 팀별 동료평가에서 최저점과 최고점을 받은 학생 2명씩 총 8명을 대상으로 1:1 면담조사를 실시하였으며, 피면접자 모두 학습자가 자율성을 갖고 주도적으로 프로젝트를 수행함으로써 지역사회 치과위생사의 역할에 대한 이해도와 추후 배운 기술의 적용가능성이 높은 것으로 나타났다. 또한 현 사회에서 요구하고 있는 문제에 대한 해결력 및 자신감, 협동심과 같은 팀 워크 역량, 역할에 대한 책임감, 창의적인 사고력, 의사사통 등의 사회적 기술을 배울 수 있는 것으로 나타났다. 프로젝트 기반의 지역사회치위생학 실습 교과목은 학습자들이 지역사회에서 적용할 수 있는 주제를 선정하여 프로젝트를 주도적으로 수행함으로써 현장과 밀접한 경험을 할 수 있기 때문에 실무적인 역량을 증진시키기 위해서는 프로젝트 학습법이 적합한 것으로 생각된다. 타 치위생(학)과에서도 지역사회치위생학 실습이 현장과 밀접한 교과목으로 운영될 수 있도록 프로젝트 기반의 체계적인 학습모듈이 개발될 필요가 있다고 생각된다.

지역 주민의 공공병원에 대한 부정적 인식에 영향을 미치는 요인 (Factors Affecting the Negative Perception of Public Hospitals among Local Residents)

  • 최은혜;조정희;엽경은;박보희;김소영;박종혁
    • 보건행정학회지
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    • 제34권2호
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    • pp.211-221
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    • 2024
  • 연구배경: 코로나바이러스감염증-19로 인한 공중보건 위기는 공공병원의 확충 및 강화의 필요성을 강조하지만, 공공병원에 대한 전반적인 인식은 여전히 부정적인 것으로 나타났다. 공공병원에 대한 부정적 인식은 공공병원의 역할과 기능 수행에 어려움을 초래할 수 있어 이 연구에서는 공공병원에 대한 부정적 인식에 영향을 미치는 요인을 분석하고자 한다. 방법: 이 연구는 충청북도공공보건의료지원단에서 수행한 충청북도 도민의 공공보건의료 인식에 대한 실태조사 자료를 활용하였다. 연구에는 조사에 응답한 만 19세 이상 성인 1,916명이 포함되었으며, 공공병원 이용 경험과 공공의료 및 공공병원 정책 평가가 공공병원의 부정적 인식에 미치는 영향을 분석하기 위해 로지스틱 회귀분석을 활용하였다. 결과: 공공병원 미이용 경험(adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74)과 공공의료 및 공공병원 정책에 대한 부정적인 평가는 공공병원의 부정적 인식에 유의한 영향을 미치는 것으로 나타났다. 구체적으로, 공공의료 정책에서 필수의료 제공이 부족하다고 느낀 경우(aOR, 4.14; 95% CI, 2.59-6.62), 지역 간 격차가 크다고 느낀 경우(aOR, 1.59; 95% CI, 1.02-2.49), 보장성(aOR, 1.99; 95% CI, 1.25-3.16)과 의료의 질(aOR, 2.39; 95% CI, 1.50-3.80)이 낮다고 평가한 경우 공공병원에 대한 부정적 인식이 증가하였으며, 공공병원 정책에서는 시설·장비가 열악하다고 느낀 경우(aOR, 3.74; 95% CI, 2.36-5.94), 진료과목 및 서비스가 부족하다고 느낀 경우(aOR, 1.91; 95% CI, 1.21-3.01), 진료수준이 낮다고 평가한 경우(aOR, 2.71; 95% CI, 1.72-4.25) 공공병원에 대한 부정적 인식이 증가하는 것으로 나타났다. 결론: 이 연구는 공공병원 이용 경험과 공공의료 및 공공병원 정책 평가를 고려한 공공병원 인식 제고의 필요성을 강조한다.

간호사 이미지에 관한 연구 (A Study on Image of the Nurse)

  • 김형자;김현옥
    • 간호행정학회지
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    • 제7권1호
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    • pp.97-110
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    • 2001
  • An image exists in the thought of every subjective person and it exercises its influence over everything, having a great power in the real world. An positive image of the nurse has an influence on her faith, value and confidence, therefore increasing her job satisfaction, helping to upgrade her level of profession of nursing through qualitative nursing service as a result, considering the necessity of such an image when it comes to improvement of the profession, the confirmation of the image is indispensable to its evaluation of a speciality in nursing. This study is intended to help that improvement of the nursing profession in the present so that the total effort in every field of nursing is made and to offer basic material for developing a strategy to improve the image of nurses. This study is designed to investigate such an image descriptively. The subjects include 105 nurses, 60 doctors, 68 office workers, 88 medical engineers, 127 patients and there protectors with a total of 448 adapted with accidental sampling, who work at Y and W general hospital in Chonju. The measuring instrument consists of 40 question, with the researcher amended and made from on of Inja Song(1993), Donsoon Lee(1995), Ilsim yang(1998), and its Cronbach's alpha coefficient is .95. Data were collected from March 1 2000 to March 20, 2000 using self-reported questionnairs, analyzed with SPSS WIN 7.5 after encoding. The results are as follows: 1. Most of the subjects thinks the nursing as a hard, stressful, always busy job(more than 75%), and consider nurses as good-looking, supportive and responsible to co-workers to above average degree($50.0{\sim}74.9%$), especially it shows the idea that nursing is independently academic job and has come to fasten itself upon the public. But it shows below the everage($25.0%{\sim}49.9%$) in regard to self development as a specialist, affection for there job, an association activity, service to the community, high intelligence level and direct given patient nursing service. It also rated low as a recommendable job, independently nursing accomplishment, social position. 2. The nurses, patients and there protectors expressed more positive opinions than doctors, medical engineers, office workers about the image of the nurse(F=18.80, p=.00). This fact indicates that the former group evaluated the image similarly contrary to lowness of the latter. 3. In the study on what influenced upon the image, it defines to 79.8% by direct contact in the hospital or acquaintance with nurses, and 16.3% by mass media. 67.3% answered that they saw the image in a new light through hospitalization, which suggests an important source for the image management originates from caring for the quality of nursing service. Considering the evaluation of the image above, we need strategies to lead a unique professional knowledge and technological development, insurance of professional self-determination, high social position, participation in group activities, dedication to lifetime job, in order that nursing comes to expand as a professional occupation. Also, as for generating more positive images, we must take the quality of nursing service into account and offer and monitor correct information about the expanded role and function of the nurse continuously so that mass media reflect a more accurate image of nurses in general.

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만성적 소음노출과 혈압의 상관성에 관한 메타분석 (A Meta-analysis on the Association between Chronic Noise Exposure and Blood Pressure)

  • 김춘배;김재용;차봉석;최홍렬;이종태;남정모;이상윤;왕승준;박기호;김대열;고상백
    • Journal of Preventive Medicine and Public Health
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    • 제33권3호
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    • pp.343-348
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    • 2000
  • Objectives : This study was conducted to integrate the results of studies assessing the association between chronic noise exposure and blood pressure. Methods : Using a MEDLINE search with noise exposure, blood pressure and hypertension as key words, we retrieved articles from the literature that were published from 1980 to December 1999. The criteria for quality evaluation were as follows: 1) the study subjects must have been workers employed at a high noise level area 2) The paper should use average and cumulative noise exposure as method for exposure evaluation. 3) Blood pressure in each article should be reported in a continuous scale Among the 77 retrieved articles, six studies were selected for quantitative meta-analysis. Before the integration of the regression coefficients for the association between blood pressure and noise level, homogeneity tests were conducted. Results : All studies were a cross-sectional design and the study subjects were industrial workers. Five papers used a time-weighted average for noise exposure and only one paper calculated the cumulative noise exposure level. The measurement of blood pressure in the majority of studios were accomplished in a resting stale, and used an average of two or more readings. The homogeneity of studies was rejected in a fixed effect model, so we used the results in a random effect model. The results of the quantitative meta-analysis, the weighted regression coefficient of noise associated with systolic blood pressure and diastolic blood pressure were 0.05 (95% confidence interval [CI]: -0.03, 0.13) and 0.06 (95% CI: -0.01, 0.13), respectively. Conclusions : Our results suggested that chronic exposure to industrial noise does not cause elevated blood pressure.

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흉부영상에서 평활화 시 심장저부 음영의 신호 대 잡음비 비교평가 (Evaluation and Comparison of Signal to Noise Ratio According to Histogram Equalization of Heart Shadow on Chest Image)

  • 김기원;이을규;정회원;손진현;강병삼;김현수;민정환
    • 대한방사선기술학회지:방사선기술과학
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    • 제40권2호
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    • pp.197-203
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    • 2017
  • 본 연구는 흉부영상에서 심장저부 음영 관심영역(Region of Interest; ROI)의 신호대잡음비(Signal to Noise Ratio; SNR)를 Post processing에서의 이퀄라이제이션 기법으로 측정 평가하였다. 연구대상은 대학병원에서 흉부검사를 실시한 환자 87명이다. 측정방법은 ImageJ 프로그램을 사용하여 표본의 인구사회학적 특성, 영상별 흉부영상의 SNR평균값, 95% 신뢰구간 값, SNR평균차이 값 등을 분석하였다. 이때 SPSS Statistics21 통계프로그램으로 ANOVA 분석을 하였으며, 95%(p < 0.05)에서 유의한 것으로 판단하였다. 영상별 분석결과의 SNR은 Original chest image, Original chest image heart shadow, Equalization chest image, Equalization chest image heart shadow순으로 높은 값을 나타냈다(p < 0.001). 결론적으로, 본 연구에서는 흉부영상의 평활화 시 심장저부 음영의 정량화한 평가결과를 보조적인 수단으로 활용할 수 있을 것으로 사료된다.

버블의 크기별 입도분포와 부상시간과의 상관특성에 관한 연구 (A Study on the Relation Characteristics between Bubble Size Distribution and Floating Time)

  • 전건;박철휘
    • 대한환경공학회지
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    • 제39권5호
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    • pp.277-281
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    • 2017
  • 최근 강우는 짧은 시간에 많은 비가 오는 특성을 자주 나타낸다. 이런 기상현상 때문에, 초기유출수와 합류식하수관거 월류수의 유입유량과 농도도 변화되고 있다. 이와 같이 유입조건이 변동되는 경우에는, 높은 수면적부하율을 가지는 부상방법이 공공수역의 수질관리에 적합하다. 왜냐하면 부상법은 공공수계의 요구조건을 충족 할 수 있기 때문이다. 현재까지 이러한 부상법의 검증과 진단을 위하여, 공급공기량과 유입SS량의 비율을 반영하여 왔다. 그러나 불행하게도 이러한 방식은 기술진단과 검증을 위한 판단기준으로는 그 한계를 가진다. 왜냐하면 부상속도와 시간요소가 상이한 버블분포에 의해 달라지기 때문이다. 부상속도와 시간은 처리시설의 용량에 영향을 준다. 왜냐하면 시간인자가 시설의 규모를 결정하기 때문이다. 그러므로, 동일한 공급공기량과 유입SS농도간 비율조건에서의 버블분포특성과 부상시간특성을 운영 및 기술진단 및 평가를 위한 판단기준으로 적용하여야만 한다. 따라서 이러한 필요에 따라, 이 논문 내용은 버블분포와 부상시간간 관계의 분석에 대한 실증적 일반화에 관한 연구이다.