• Child Health Nursing Research
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• v.20 no.3
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• pp.215-224
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• 2014

Purpose: This study was conducted to identify risk factors in hospitalized children, and to develop and validate a fall-risk assessment tool for hospitalized children. Methods: A retrospective chart review was performed at one university children's hospital, and an analysis was done of the characteristics of all patients who fell during a 44-month period (n=48). These patients were compared with another 149 hospitalized children who did not fall. Results: Significant predictors of falls as identified in a multivariate logistic regression analyses were age of less than 3 years old, neurological diagnosis including epilepsy, children's dependency of ADL, physical developmental delay, multiple usage of fall-risk-increasing drugs. The respective odds ratios ranged from 2.4 to 7.1 with 95% confidence interval (p<0.05). Accordingly, defining patients with either 5 risk factors as fall-prone hospitalized children provided a sensitivity of 93.6% and specificity of 16.2%. Conclusion: The results show that this tool has an acceptable level of sensitivity to assess the risk factors of fall in hospitalized children even though the specificity was low, suggesting that this tool may enable nurses to predict the risk level of childhood falls, and develop preventive strategies against pediatric falls in children's units.

• Korean Journal of Adult Nursing
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• v.22 no.5
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• pp.537-551
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• 2010

Purpose: This study was designed to identify meaningful themes related to the recognition of lifestyle risk factors and barriers in seeking treatment following an acute event of first-time acute myocardial infarction. Methods: A methodological mixed method of thematic content analysis and a quantitative analysis was used. The sample consisted of 120 male patients < 65 years of age who agreed to be in the study were interviewed using a semistructured during 2008-2009. Data were analyzed according to the procedure of thematic content analysis and the meaningful themes were coded into SPSS data for quantitative analysis. Results: Pre-hospital delay greater than three hours reported by 58.3% (n=70) of the sample and similarly 63.3% had no recognition about their symptoms as cardiac in origin. The mean number of risk factors was $3.9{\pm}1.8$ out of 11 when lifestyle and psychosocial factors were included. From the interview data among the 70 patients delayed greater than three hours, thirty-five themes categorized into 12 main themes influenced the delayed decision which was identified according to personal-cognitive, socio-cultural, and contextual factors. Conclusion: Health care providers should consider these themes in designing individual interventions to make lifestyle changes and to facilitate more prompt decisions to seek care.

• Nutrition Research and Practice
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• v.4 no.4
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• pp.259-269
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• 2010

Resistance training (RT) is associated with reduced risk of low grade inflammation related diseases, such as cardiovascular disease and type 2 diabetes. The majority of the data studying cytokines and exercise comes from endurance exercise. In contrast, evidence establishing a relationship between RT and inflammation is more limited. This review focuses on the cytokine responses both following an acute bout, and after chronic RT. In addition, the effect of RT on low grade systemic inflammation such as individuals at risk for type 2 diabetes is reviewed. Cytokines are secreted proteins that influence the survival, proliferation, and differentiation of immune cells and other organ systems. Cytokines function as intracellular signals and almost all cells in the body either secrete them or have cytokine receptors. Thus, understanding cytokine role in a specific physiological situation such as a bout of RT can be exceedingly complex. The overall effect of long term RT appears to ameliorate inflammation, but the specific effects on the inflammatory cytokine, tumor necrosis factor alpha are not clear, requiring further research. Furthermore, it is critical to differentiate between chronically and acute Interleukin-6 levels and its sources. The intensity of the RT and the characteristics of the training protocol may exert singular cytokine responses and as a result different adaptations to exercise. More research is needed in the area of RT in healthy populations, specifically sorting out gender and age RT acute responses. More importantly, studies are needed in obese individuals who are at high risk of developing low grade systemic inflammatory related diseases. Assuring adherence to the RT program is essential to get the benefits after overcoming the first acute RT responses. Hence RT could be an effective way to prevent, and delay low grade systemic inflammatory related diseases.

• Journal of the Earthquake Engineering Society of Korea
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• v.12 no.6
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• pp.47-53
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• 2008

This research focuses on the issue of seismic retrofit prioritization based on the Caltrans' highway network serving Los Angeles and Orange counties. Retrofit prioritization is one of most important problems in earthquake engineering, and it is a problem that most decision makers face in the process of resource allocation. This study demonstrates the methods of prioritized resource allocation in the process of retrofitting a regional highway network. For the criteria of a retrofit ranking, seismic vulnerability and the importance of network link are first introduced. Subsequently, link-based seismic retrofit cases are simulated, investigating the effects of the seismic retrofit in terms of seismic performance, such as driver's delay. In this study, probabilistic scenario earthquakes are used to perform a probabilistic seismic risk analysis. The results show that the retrofit prioritization can be differently defined and ranked depending on the stakeholders. This study provides general guidelines for prioritization strategy for the effective retrofitting of a highway network system.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.13
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• pp.5439-5444
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• 2015

Background: One of the main causes of delay in diagnosis of oral cancer is lack of awareness about aetiology and symptoms among the general population. The aim of this study was to assess the knowledge and practice of patients regarding oral cancer and their attitude towards tobacco cessation. Materials and Methods: This study was carried out in Isfahan-Iran in 2014. A 29-item self-administrated questionnaire was designed and piloted and distributed to patients attending dental clinics. Questions were focused on awareness about oral cancer risk factors, signs and symptoms, places in the mouth which are more susceptible and attitude toward tobacco cessation. Chi-square, T-test, ANOVA and logistic regression tests were used for statistical analysis. Results: A total of 546 valid completed questionnaires were obtained. The mean knowledge score of patients was 4.1(${\pm}2.7$) out of 13. Some 80% of patients did not know about early manifestations of oral cancer. Only 18% knew the most likely sites of oral cancer. Only 43.1% and 65.2% of patients reported alcohol and tobacco consumption as the main risk factors but they had a fair knowledge about other risk factors. There was no significant difference in Knowledge level between patients regarding their sex, educational levels and age. Most patents (90%) expected their dentists to warn them about the harmful effects of smoking and showed willingness to quit if recommended. Conclusions: Knowledge about oral cancer was found to be quite low. It seems necessary to increase the level of public awareness using educational programs with cooperation of dentists in tobacco cessation programs.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5257-5264
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• 2016

Background: Though people of color (POC) are less likely to become afflicted with skin cancer, they are much more likely to die from it due to delay in detection or presentation. Very often, skin cancer is diagnosed at a more advanced stage in POC, making treatment difficult.The purpose of this research was to improve awareness regarding skin cancers in people of color by providing recommendations to clinicians and the general public for early detection and photo protection preventive measures. Methods: Data on different types of skin cancers were presented to POC. Due to limited research, there are few resources providing insights for evaluating darkly pigmented lesions in POC. Diagnostic features for different types of skin cancers were recorded and various possible risk factors were considered. Results: This study provided directions for the prevention and early detection of skin cancer in POC based on a comprehensive review of available data. Conclusions: The increased morbidity and mortality rate associated with skin cancer in POC is due to lack of awareness, diagnosis at a more advanced stage and socioeconomic barriers hindering access to care. Raising public health concerns for skin cancer prevention strategies for all people, regardless of ethnic background and socioeconomic status, is the key to timely diagnosis and treatment.

• Archives of Plastic Surgery
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• v.38 no.5
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• pp.621-626
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• 2011

Purpose: Implant-based breast reconstruction has multiple advantages such as decreased morbidity, shorter operative time and faster recovery. However, postoperative infection with tissue expander increases medical cost and causes a delay in concurrent antineoplastic treatment. To reduce tissue expander infection, it is important to identify related risk factors and minimize them when possible. Methods: A retrospective review of patient records in a single breast cancer center was performed. Eighty-six tissue expanders were placed in 80 women for postmastectomy breast reconstruction. Variables including patients'age, body mass index (BMI), preoperative breast volume, operation time, drain indwelling time, postoperative seroma/hematoma formation, chemotherapy, and radiation therapy were evaluated. Infection was defined as the status that shows any symptom of local inflammation and identification of pathogens. Representative values were compared through Student's t-test and univariate and multivariate analyses. Results: We examined 86 postmastectomy tissueexpanders which were placed between June 2004 and April 2010. Seven cases of tissue expander infection (8.1%) were identified. The infected tissue expander was removed in three of the cases. The relationship between BMI, and preoperative breast volume and that between infection and non-infection groups were significant ($p$ <0.05). Univariate analysis showed significant association between BMI ($p$=0.023) and preoperative breast volume ($p$=0.037). Multivariate analysis revealed that BMI and preoperative breast volume were independent variables regarding tissue expander infection. Conclusion: Certain characteristics of implant-based breast reconstruction patients increase infection rate of tissue expander. These risk factors should be monitored and evaluated before surgeries for more successful outcome.

• The Journal of the Korea Contents Association
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• v.13 no.1
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• pp.30-39
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• 2013

In recent years, with the development of devices to collect multimedia data such as small CMOS camera sensor and micro phone, studies on wireless multimedia sensor network technologies and their applications that extend the existing wireless sensor network technologies have been actively done. In such applications, various basic schemes such as the processing, storage, and transmission of multimedia data are required. Especially, a security for real world environments is essential. In this paper, in order to defend the sniffing attack in various hacking techniques, we propose a multipath routing scheme for physically avoiding the data transmission path from the risk factors. Our proposed scheme establishes the DEFCON of the sensor nodes that are geographically close to risk factors and the priorities according to the importance of the data. Our proposed scheme performs risk factor detour multipath routing through a safe path considering the DEFCON and data priority. Our experimental results show that although our proposed scheme takes the transmission delay time by about 5% over the existing scheme, it reduces the eavesdropping rate that can attack and intercept data by the risk factor by about 18%.

• Korean Journal of Construction Engineering and Management
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• v.24 no.2
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• pp.59-69
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• 2023

FIDIC White Book is a Model Services Agreement between the Client and the Consultant. This study aimed to derive the Key Risk Sub-Clauses out of 63 Sub-Clauses of General Conditions of the FIDIC White Book by using the Delphi technique. A panel of 40 experts with more than 10 years of experience and expertise in overseas construction services agreements and FIDIC White Book was formed, and the reliability was improved in the direction of increasing the consensus of experts through a total of three Delphi survey processes. In the first Delphi survey, a closed-type survey was conducted on the impact of risk among 63 Sub-Clauses of General Conditions on a Likert 5-point scale, and 26 main risk Sub-Clauses were derived. The Content Validity of the results of the first Delphi survey was verified with the CVR value. In the 2nd and 3rd Delphi surveys, a closed-type survey was conducted on a Likert 10-point scale for 26 main risk Sub-Clauses and the risk possibility and impact of each main risk Sub-Clause were evaluated. The reliability of the 3rd Delphi survey result was verified with the COV value. Total 14 Key Risk Sub-Clauses were derived by applying the average risk possibility and impact of each of the 26 main risk Sub-Clauses to the PI Risk Matrix. The results of deriving Key Risk Sub-Clauses showed that agreement on specific scope of service, delay management, and change management were the most important. As a result of this study, from a practical point of view, consultants of consulting companies provide guidelines that should be reviewed to minimize contractual risks when signing service contracts with clients. From an academic point of view, the direction of research on deriving key risks related to service contracts for consultants participating in overseas construction is presented.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.759-765
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• 2016

Background: Breast cancer is the most frequent cancer of women in Pakistan with the majority presenting with stage III or IV lesionsat initial diagnosis. Patient and health system related factors are well known determinants of delay in presentation and diagnosis. Additionally, breast cancer being a heterogeneous disease, the various molecular subtypes featuring different aggressiveness also need to be considered. The present study evaluated the association of stage at initial diagnosis of breast cancer with these two factors in local women at a tertiary level health care facility in Lahore, Pakistan. Materials and Methods: Patient and tumor features were recorded separately during diagnostic workup in Breast Clinics at INMOL and at Services Hospital, Lahore. Data were entered in MS Excel and analyzed by descriptive statistics and Chi-Square test. Results: Among the 261 patients, 64% were staged as late breast cancer (LBC), the mean age was 46.8 with standard deviation of 13 years. Some 92% had invasive ductal carcinoma (IDC), 61% had luminal types (LT) of non-aggressive tumor while 39% had the non-luminal types (NLT) of of HER2-enriched or basal aggressive tumors. While 70% of patients presented within one year of symptomatic disease (early report group "ERG"), 30% reported after a mean delay of 4 years with a standard deviation of 3.75 years. The stage distribution among ERG patients was not statistically different from those reporting late (P=0.123). Statistically larger proportion of patients with NLT presented as LBC as compared to the LT (P =0.034). Among the ERG, statistically different stage distribution of disease was observed for the NLT versus LT (P=0.047). Among those presenting late, this difference was insignificant (P=0.416). Conclusions: Breast cancer is a distinct disease in Pakistan with a high frequency of aggressive molecular types affecting younger women, with the majority presenting as LBC. Association of NLT with higher stage at diagnosis is statistically significant whereas time delay in diagnosis is not. Further research is required to define the risk profile and features in local patients. The burden of LBC can be reduced by promoting breast health awareness and by establishing easily accessible dedicated breast care set ups in the hospitals.