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Arm Morbidity after Breast Cancer Treatments and Analysis of Related Factors (유방암 환자의 상지 부작용과 관련 요인)

  • Chun Mi Son;Moon Seong Mi;Lee hye Jin;Lee Eun-Hyun;Song Yeoung Suk;Chung Yong Sik;Park Hee Bung;Kang Seung Hee
    • Radiation Oncology Journal
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    • v.23 no.1
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    • pp.32-42
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    • 2005
  • Purpose : To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. Materials and Methods : One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. Results : The incidence of lymphedema ($\geqq$2 cm difference comparing to unaffected arm) was $6.3\%$, $10.7\%$, $22.5\%$ and $23.3\%$ at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint ($\geqq$ 20 degree difference comparing to unaffected arm) was noted In more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe ($>50\%$ reduction) in 1/3 patients. Approximately 50 to $60\%$ of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. Conclusion : Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation In shoulder joint should be developed.

A Trend of Research in Community Health Nursing (지역사회간호학 관련 논문 연구동향 분석 -학회지 발표 논문을 중심으로-)

  • Lee, In-Sook;Kim, Yu-Na;Choi, Key-Won;Chin, Young-Ran
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.288-298
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    • 2001
  • This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

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Financial Fraud Detection using Text Mining Analysis against Municipal Cybercriminality (지자체 사이버 공간 안전을 위한 금융사기 탐지 텍스트 마이닝 방법)

  • Choi, Sukjae;Lee, Jungwon;Kwon, Ohbyung
    • Journal of Intelligence and Information Systems
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    • v.23 no.3
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    • pp.119-138
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    • 2017
  • Recently, SNS has become an important channel for marketing as well as personal communication. However, cybercrime has also evolved with the development of information and communication technology, and illegal advertising is distributed to SNS in large quantity. As a result, personal information is lost and even monetary damages occur more frequently. In this study, we propose a method to analyze which sentences and documents, which have been sent to the SNS, are related to financial fraud. First of all, as a conceptual framework, we developed a matrix of conceptual characteristics of cybercriminality on SNS and emergency management. We also suggested emergency management process which consists of Pre-Cybercriminality (e.g. risk identification) and Post-Cybercriminality steps. Among those we focused on risk identification in this paper. The main process consists of data collection, preprocessing and analysis. First, we selected two words 'daechul(loan)' and 'sachae(private loan)' as seed words and collected data with this word from SNS such as twitter. The collected data are given to the two researchers to decide whether they are related to the cybercriminality, particularly financial fraud, or not. Then we selected some of them as keywords if the vocabularies are related to the nominals and symbols. With the selected keywords, we searched and collected data from web materials such as twitter, news, blog, and more than 820,000 articles collected. The collected articles were refined through preprocessing and made into learning data. The preprocessing process is divided into performing morphological analysis step, removing stop words step, and selecting valid part-of-speech step. In the morphological analysis step, a complex sentence is transformed into some morpheme units to enable mechanical analysis. In the removing stop words step, non-lexical elements such as numbers, punctuation marks, and double spaces are removed from the text. In the step of selecting valid part-of-speech, only two kinds of nouns and symbols are considered. Since nouns could refer to things, the intent of message is expressed better than the other part-of-speech. Moreover, the more illegal the text is, the more frequently symbols are used. The selected data is given 'legal' or 'illegal'. To make the selected data as learning data through the preprocessing process, it is necessary to classify whether each data is legitimate or not. The processed data is then converted into Corpus type and Document-Term Matrix. Finally, the two types of 'legal' and 'illegal' files were mixed and randomly divided into learning data set and test data set. In this study, we set the learning data as 70% and the test data as 30%. SVM was used as the discrimination algorithm. Since SVM requires gamma and cost values as the main parameters, we set gamma as 0.5 and cost as 10, based on the optimal value function. The cost is set higher than general cases. To show the feasibility of the idea proposed in this paper, we compared the proposed method with MLE (Maximum Likelihood Estimation), Term Frequency, and Collective Intelligence method. Overall accuracy and was used as the metric. As a result, the overall accuracy of the proposed method was 92.41% of illegal loan advertisement and 77.75% of illegal visit sales, which is apparently superior to that of the Term Frequency, MLE, etc. Hence, the result suggests that the proposed method is valid and usable practically. In this paper, we propose a framework for crisis management caused by abnormalities of unstructured data sources such as SNS. We hope this study will contribute to the academia by identifying what to consider when applying the SVM-like discrimination algorithm to text analysis. Moreover, the study will also contribute to the practitioners in the field of brand management and opinion mining.

Monitoring and Risk Assessment of Cadmium and Lead in Agricultural Products (국내 농산물의 카드뮴 및 납 함량 조사 및 위해 평가)

  • Kim, Ji-Young;Choi, Nam-Geun;Yoo, Ji-Hyock;Lee, Ji-Ho;Lee, Young-Gu;Jo, Kyoung-Kyu;Lee, Cheol-Ho;Hong, Su-Myeong;Im, Geon-Jae;Hong, Moo-Ki;Kim, Won-Il
    • Korean Journal of Environmental Agriculture
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    • v.30 no.3
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    • pp.330-338
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    • 2011
  • BACKGROUND: This study was conducted to investigate the agricultural product (Pulses, Lettuces, Pumpkins, Apples, Pears and Tangerines) in Korea, monitoring of cadmium (Cd) and lead (Pb) contaminations of agricultural products in cultivated areas and abandoned mine areas were investigated, and risk assessment was performed through dietary intake of agricultural products. METHODS AND RESULTS: The average contents of Cd and Pb ranged from 0.001 to 0.018 mg/kg and from 0.007 to 0.032 mg/kg respectively. The result was showed that contents of Cd and Pb did not exceed maximum residual levels established by CODEX except pumpkins and apples. The average daily intake were in the range of $1.06{\times}10^{-3}$ to $4.76{\times}10^{-2}{\mu}g/kg$ b.w./day at the mean and 95th percentile for Cd, $4.53{\times}10^{-3}$ to $8.35{\times}10^{-2}{\mu}g/kg$ b.w./day at the mean and 95th percentile for Pb for general population, based on the Korean public nutrition report 2008. The Hazard Index (HI) from the ratio analysis between daily exposure and safety level values was smaller than 1.0. CONCLUSION(s): This results demonstrated that human exposure to Cd and Pb through dietary intake of agricultural produces from abandoned mine areas might not cause adverse effect exceeding to those from non-contaminated areas.

A Study on the Seropositivity of HBsAg among Biennial Health Examinees ; A Nation-wide Multicenter Survey (1998년 한국인 성인에서 혈청 HBsAg 양성률 추정을 위한 조사연구)

  • Kim, Dae-Sung;Kim, Young-Sik;Kim, Jae-Yong;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.129-135
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    • 2002
  • Objective : The primary objective of this study was to estimate the prevalence of HBsAg-positives in the late 1990's among Korean adults. In addition, we evaluated the association of age, a residential area, a vaccination rate, a family history of chronic liver diseases and a past history of acute liver disease with the seropositivity of HBsAg, and estimated the prevalence of chronic HBV infection by follow-up for 6 month or more. Methods : A total of 10 areas, six metropolitan and four small cities, were selected. In each cities, one health screening center was selected for recruitment of study subjects. The study subjects were enrolled from a general health examination program that is provided by medical insurance companies. Questionnaires on various risk factors were administered to the study subjects. Sera was drawn and tested for HBsAg by radioimmunoassay. HBeAg and ALT were also tested for those of HBsAg positive. The HBsAg positives was retest for HBsAg 6 months later Results : Among the study subjects (n= 1816), the seroprevalence of HBsAg was 5.5% (95% CI=4.5%-6.6%), 7.4% in men (95% CI=5.8-9.4) and 3.6% in women (95% CI=2.5-5.0). A past history of acute liver disease and a family history of chronic liver diseases was shown to be risk factors for HBsAg positivity. Among the 31 HBsAg-positives, negative seroconversion rate was estimated to be 3.2%, Thus, prevalence of chronic HBV infection was estimated to be 5.3% (95% CI=3.7-6.6). Conclusion : In this study, the HBsAg seroprevalence rate was lower than that of the other studies in 1980's, particularly in young adult and women. Considering the public health importance of liver cancer and chronic liver diseases, the further effort is needed to prevent and reduce the HBV infection.

A Study on Fall Accident (1개 종합병원 환자의 낙상에 관한 조사)

  • Lee, Hyeon-Suk;Kim, Mae-Ja
    • The Korean Nurse
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    • v.36 no.5
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    • pp.45-62
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    • 1998
  • The study was conducted from November 1995 to May 1996 at the one general hospital in Seoul. The total subjects of this study were 412 patients who have the experience of fall accident, among them 31 was who have fallen during hospitalization and 381 was who visited emergency room and out patient clinic. The purposes of this study were to determine the characteristics, risk factors and results of fall accident and to suggest the nursing strategies for prevention of fall. Data were collected by reviewing the medical records and interviewing with the fallers and their family members. For data analysis, spss/pc+ program was utilized for descriptive statistics, adjusted standardized $X^2$-test. The results of this study were as follows: 1) Total subjects were 412 fallers, of which 245(59.5%) were men and 167(40.5%) were women. Age were 0-14 years 79(19.2%), 15-44 years 125(30.4%), 45-64 years 104(25.2%), over 65 years 104(25.2%). 2) There was significant association between age and the sexes ($X^2$=39.17, P=0.00). 3) There was significant association between age and history of falls ($X^2$=44.41. P= .00). And history of falls in the elderly was significantly associated with falls. 4) There was significant association with age and medical diagnosis ($X^2$=140.66, P= .00), chief medical diagnosis were hypertension(34), diabetis mellitus(22), arthritis(11), stroke(8), fracture(7), pulmonary tuberculosis(6), dementia(5) and cataract(5), 5) There was significant association between age and intrinsic factors: cognitive impairment, mobility impairment, insomnia, emotional problems, urinary difficulty, visual impairments, hearing impairments, use of drugs (sedatives , antihypertensive drugs, diuretics, antidepressants) (P < 0.05). But there was no significant association between age and dizziness ($X^2$=2.87, P=.41). 6) 15.3% of total fallers were drunken state when they were fallen. 7) Environmental factors of fall accident were unusual posture (50.9%), slips(35.2%), trips (9.5%) and collision(4.4%). 8) Most of falls occurred during the day time, peak frequencies of falls occurred from 1pm to 6pm and 7am to 12am. 9) The places of fall accident were roads(22.6%), house-stairs 06.7%), rooms, floors, kitchen (11.2%), the roof-top, veranda, windows(10.9%), hospital(7.5%), ice or snowy ways(5.8%), bathroom(4.9%), playground, park(4.9%), subway-stairs(4.4%) and public-bathrooms (2.2%). 10) Activities at the time of fall accident were walking(37.6%), turning around or reaching for something(20.9%), going up or down stairs09.2%), exereise, working07.4%), up or down from a bed(2.7%), using wheelchair or walking aids, standing up or down from a chair(2.2%) and standing still(2.2%). 11) Anatomical locations of injuries by falls were head, face, neck(31.3%), lower extremities (29.9%). upper extremities(20.6%), spine, thorax, abdomen or pelvic contents(l1.4%) and unspecified(2.9%). 12) Types of injures were fracture(47.6%), bruises03.8%), laceration (13.3%), sprains(9.0%), headache(6.6%), abrasions(2.9%), intracranial hemorrage(2.4%) and burns(0.5%). 13) 41.5% of the fallers were hospitalized and average of hospitalization was 22.3 days. 14) The six fallers(1.46%) died from fall injuries. The two fallers died from intracranial hemorrage and the four fallers died of secondary infection; pneumonia(2), sepsis(1) and cell lulitis(1). It is suggested that 1) Further study is needed with larger sample size to identify the fall risk factors. 2) After the fall accident, comprehensive nursing care and regular physical exercise should be emphasized for the elderly person. 3) Safety education and safety facilities of the public place and home is necessary for fall prevention.

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Key Methodologies to Effective Site-specific Accessment in Contaminated Soils : A Review (오염토양의 효과적 현장조사에 대한 주요 방법론의 검토)

  • Chung, Doug-Young
    • Korean Journal of Soil Science and Fertilizer
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    • v.32 no.4
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    • pp.383-397
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    • 1999
  • For sites to be investigated, the results of such an investigation can be used in determining foals for cleanup, quantifying risks, determining acceptable and unacceptable risk, and developing cleanup plans t hat do not cause unnecessary delays in the redevelopment and reuse of the property. To do this, it is essential that an appropriately detailed study of the site be performed to identify the cause, nature, and extent of contamination and the possible threats to the environment or to any people living or working nearby through the analysis of samples of soil and soil gas, groundwater, surface water, and sediment. The migration pathways of contaminants also are examined during this phase. Key aspects of cost-effective site assessment to help standardize and accelerate the evaluation of contaminated soils at sites are to provide a simple step-by-step methodology for environmental science/engineering professionals to calculate risk-based, site-specific soil levels for contaminants in soil. Its use may significantly reduce the time it takes to complete soil investigations and cleanup actions at some sites, as well as improve the consistency of these actions across the nation. To achieve the effective site assessment, it requires the criteria for choosing the type of standard and setting the magnitude of the standard come from different sources, depending on many factors including the nature of the contamination. A general scheme for site-specific assessment consists of sequential Phase I, II, and III, which is defined by workplan and soil screening levels. Phase I are conducted to identify and confirm a site's recognized environmental conditions resulting from past actions. If a Phase 1 identifies potential hazardous substances, a Phase II is usually conducted to confirm the absence, or presence and extent, of contamination. Phase II involve the collection and analysis of samples. And Phase III is to remediate the contaminated soils determined by Phase I and Phase II. However, important factors in determining whether a assessment standard is site-specific and suitable are (1) the spatial extent of the sampling and the size of the sample area; (2) the number of samples taken: (3) the strategy of taking samples: and (4) the way the data are analyzed. Although selected methods are recommended, application of quantitative methods is directed by users having prior training or experience for the dynamic site investigation process.

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Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

Association between Perceived Susceptibility to Fine Dust Exposure and Wearing Masks, Attitude toward Respiratory Disease Prevention Education in Farmers (농업인의 미세먼지 노출에 대한 인지된 감수성과 마스크 착용 및 호흡기질환 예방교육 참여 태도와의 연관성)

  • Jung, HyeJeong;Lee, YunJin;Lee, SooYeon;Han, JiYoung;Kim, YangWoo;Lee, Soo-Jin
    • Journal of agricultural medicine and community health
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    • v.46 no.2
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    • pp.78-88
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    • 2021
  • Objectives: This study aimed to investigate health risk awareness pertaining to fine dust exposure and the use of face masks in farmers, as well as their attitude toward education regarding fine dust-related respiratory disease prevention. Methods: In total, 295 farmers were interviewed in a survey using a structured questionnaire to obtain data on general characteristics, farming-related characteristics, health risk awareness pertaining to fine dust exposure, attitude toward education on fine dust-related respiratory disease prevention and the use of face masks. This study was analyzed the correlation between the perceived susceptibility to fine dust exposure and willingness to participate in education on fine dust-related respiratory disease prevention. Results: The mean score for perceived susceptibility to fine dust exposure was 3.8 (out of 5), and the participants were highly willing to receive education on fine dust-related respiratory disease prevention. In Multiple response analysis of reactions to exposure to fine dust generated during work, 221 participants responded that they practiced at least one preventive action; participants gave a positive response to "wearing masks" (56.1%), "personal hygiene, such as hand washing." (52.9%). In terms of education methods, 94 (33.6%) participants preferred to learn online or via text messages. Conclusions: The significant correlation between the perceived susceptibility to fine dust exposure and willingness to participate in education on fine dust-related respiratory disease prevention shows the importance of promoting education on prevention. The results of this study can help understand as reference for education on fine dust-related respiratory disease prevention.

Comparison of the Injury Mechanism, Pattern and Initial Management Approach for Orthopedic Injuries According to the Injury Severity in Moderate-to-Severe Injured Patients (중등도 이상의 손상 환자에서 손상 중증도에 따른 정형외과적 손상에 대한 수상기전, 손상유형, 초기 치료적 접근의 비교)

  • Lee, Eui-Sup;Sohn, Hoon-Sang;Kim, Younghwan;Shon, Min Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.383-396
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    • 2020
  • Purpose: This study compared the injury mechanism, site, type, initial management approach of orthopedic injury, and outcomes according to the injury severity in moderate-to-severe injured patients. Materials and Methods: During 57-month, excluding the period when the authors' emergency/trauma center was not operating, from 2014 to 2019, a retrospective study was conducted on 778 patients with orthopedic injuries among patients with an Injury Severity Score (ISS)>9 scored. The patients were classified into moderate-injured group (group-1, 679) and severe-injured group (group-2, 99) according to the injury severity based on the ISS and physiologic parameters. The injury mechanism and non-orthopedic injury were evaluated. Orthopedic injuries were assessed according to the injury pattern and the number of anatomical regions and bone sites involved. The management approach for the orthopedic injuries in two groups was compared. Outcomes (hospital stay, systemic complications, and in-hospital mortality) were evaluated, and the risk factors for mortality were analyzed. Results: In group-2, the incidence of younger males, high-energy mechanisms, and accompanying injuries was significantly higher than in group-1. The number of anatomical regions and bone sites involved increased in group-2. The involvement of the pelvis, spine, and upper extremity was significantly higher in group-2, whereas group-1 was involved mainly by the lower extremities. Depending on the patient's condition, definitive or staged management for orthopedic injuries may be used. Group-1 was treated mainly with definite fixation after the physiological stabilization process, and group-2 was treated with staged management using temporary external fixation. The hospital stay was significantly longer in group-2. The overall systematic complications and in-hospital mortality was approximately 4.9% and 4.5%. A higher injury severity was associated with higher in-hospital mortality (2.9%, 15.2%; p<0.0001). Increasing age and high ISS are independent risk factors for mortality. Conclusion: A higher severity of injury was associated with a higher incidence of high-energy mechanism, younger, male, accompanying injuries, and the frequency and severity of orthopedic injuries. Severe polytrauma patients were treated mainly with a staged approach, such as external fixation. The hospital stay, systematic complications, and in-hospital mortality were significantly higher in severe-injured patients. Age and ISS are strong predictors of in-hospital mortality in polytrauma.