• Title/Summary/Keyword: Health technology assessment

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Trend and Implication of Primary Care Evaluation in U.S. (미국의 일차의료 평가 동향 및 시사점: 미국의 리얼월드 평가 안내서를 중심으로)

  • Suh, Youshin;Kim, Hee-Sun;Yoo, Bit-Na;Kim, Jin-Hee;Park, Chong Yon
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.88-94
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    • 2018
  • This review aims to provide implications for relevant domestic policies and researches from Patient-Centered Medical Home (PCMH), a reinforcement model for primary care and its evaluations in the United States. As chronic diseases became dominant, changes in the health care delivery system in which primary care is central was required. The United States initiated primary care-reinforcing policies based on the PCMH following the increased demand for evidence-based health care policies. The current activities of the United States such as sharing research tools used to evaluate primary care interventions and circulating evaluation findings provide examples to Korea. Systematic evaluations for primary care interventions are required and appropriate methods using various types of data to reflect the real-world settings should be prepared. It is necessary to conduct policy assessment studies of public interests considering regional context. Support for the researches to make and advance from the existing environment must be examined.

Indoor Air Quality and Human Health Risk Assessment for Un-regulated Small-sized Sensitive Population Facilities (소규모 다중이용시설의 실내공기질 실태조사 및 건강위해성평가: 민감군 이용시설을 중심으로)

  • Shin, Hyejin;Park, Woosang;Kim, Bokyung;Ji, Kyunghee;Kim, Ki-Tae
    • Journal of Environmental Health Sciences
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    • v.44 no.4
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    • pp.397-407
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    • 2018
  • Objectives: The purpose of this study is to investigate human health risk assessment of indoor air pollutants at small-sized public-use facilities (e.g., daycare centers, hospital and elderly care facilities) that the susceptible population is mainly used. Methods: To assess indoor air quality (IAQ), the concentrations of indoor air contaminants such as HCHO, benzene, toluene, ethylbenzene, xylene, styrene, PM-10, CO, $NO_2$ and $O_3$ in air samples were measured according to the Indoor Air Quality Standard Method. By conducting the questionnaire survey, the major factors influencing IAQ were identified. Human health risk assessment was carried out in the consideration of type of use (user and worker) at 75 daycare centers, 34 hospitals and 40 elderly care facilities. Results: As a result of measurement of indoor air contaminants, the average concentration of HCHO and TVOCs in hospitals was higher than daycare centers and elderly care facilities, about 8.8 and 23.5% of hospitals were exceeded by IAQ standard. In human health risk assessment, for the user of daycare centers and elderly care facilities, the mean carcinogenic risk of HCHO inhalation was higher than acceptable value. Except for HCHO, other values were determined under acceptable risk. Similarly, for the worker of hospitals, the mean carcinogenic risk of HCHO inhalation was higher than acceptable value and other values were evaluated under acceptable risk. In contrast, the risk levels of other contaminants measured in elderly care facilities were acceptable. In the determination of factors influencing IAQ, the construction year, building type, ventilation time, and the use of air cleaner were identified. Conclusions: This study provides the information for establishing the plans of public health management of IAQ at small-sized public-use facilities that have not yet been placed under the regulation. The findings suggest the consideration of human health risk assessment results for the IAQ standards.

The Analysis of the Developmental Approaches in Science, Health and Technology (DASH) Program Using Posner's Curriculum Model

  • Son, Yeon-A;Chae, Dong-Hyun;Min, Byeong-Mee
    • Journal of The Korean Association For Science Education
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    • v.23 no.4
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    • pp.386-400
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    • 2003
  • This paper presents an analysis of the Developmental Approaches in Science, Health and Technology (DASH) program, a K-6 curriculum developed by the Curriculum Research & Development Group (CRDG) at the University of Hawaii employing the curriculum analysis framework created by Posner. Using this framework the analyst found that the DASH design is based on the research on learning, teaching, and assessment now driving efforts to reform science education at the elementary level. DASH embraces the constructivist idea that learning is a personal and social process and the recapitulation model that new concepts are built out of theories previously learned. DASH provides an understandable, exciting, and memorable experience in the operations of science, health, and technology, and develops their capacity to use the skills and knowledge of science, health, and technology both in and outside school. A number of studies of DASH have examined its functionality, effectiveness of pedagogy and what students learn. The innovative nature of DASH necessitated a multidimensional assessment that included both quantitative and qualitative research techniques. Ongoing development of the DASH program in the research setting of a university laboratory school permits ever deeper connections with emerging curriculum theory and curriculum practice, and allows new linkages as ideas are tested in research classrooms.

Acute and Subchronic Inhalation Toxicity of n-Octane in Rats

  • Sung, Jae-Hyuck;Choi, Byung-Gil;Kim, Hyeon-Yeong;Baek, Min-Won;Ryu, Hyun-Youl;Kim, Yong-Soon;Choi, Young-Kuk;Yu, Il-Je;Song, Kyung-Seuk
    • Safety and Health at Work
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    • v.1 no.2
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    • pp.192-200
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    • 2010
  • Objectives: We have investigated the toxic effects of the inhalation of subchronic and acute levels of n-octane. Methods: The rats were exposed to n-octane of 0, 2.34, 11.68 and 23.36 mg/L (n = 5 rats/group/gender) in an acute inhalation test (Organization for Economic Co-operation and Development (OECD) TG 403), or to 0, 0.93, 2.62 and 7.48 mg/L (n = 10 rats/group/gender) for a subchronic inhalation test (OECE TG 413), to establish a national chemical management system consistent with the Globally Harmonized Classification System (GHS). Results: Acutely-exposed rats became lethargic but recovered following discontinuation of inhalation. Other clinical symptoms such as change of body weight and autopsy finds were absent. The LC50 for the acute inhalation toxicity of n-octane was determined to exceed 23.36 mg/L and the GHS category was 'not grouping'. Subchronically-treated rats displayed no significant clinical and histopathological differences from untreated controls; also, target organs were affected hematologically, biochemically and pathologically. Therefore, the no observable adverse effect level was indicated as exceeding 7.48 mg/L and the GHS category was 'not grouping' for the specific target organ toxicity upon repeated exposure. Conclusion: However, n-octane exposure should be controlled to be below the American Conference of Industrial Hygienists recommendation (300 ppm) to prevent inhalation-related adverse health effects of workers.

Recapitulation of previously reported associations for type 2 diabetes and metabolic traits in the 126K East Asians

  • Choi, Ji-Young;Jang, Hye-Mi;Han, Sohee;Hwang, Mi Yeong;Kim, Bong-Jo;Kim, Young Jin
    • Genomics & Informatics
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    • v.17 no.4
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    • pp.48.1-48.6
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    • 2019
  • Over the last decade, genome-wide association studies (GWASs) have provided an unprecedented amount of genetic variations that are associated with various phenotypes. However, previous GWAS were mostly conducted in European populations, and these biased results for non-Europeans may result in a significant reduction in risk prediction for non-Europeans. An issue with the early GWAS was the winner's curse problem, which led to misleading results when constructing the polygenic risk scores (PRS). Therefore, more non-European population-based studies are needed to validate reported variants and improve genetic risk assessment across diverse populations. In this study, we validated 422 variants independently associated with glycemic indexes, liver enzymes, and type 2 diabetes in 125,872 samples from a Korean population, and further validated the results by assessing publicly available summary statistics from European GWAS (n = 898,130). Among the 422 independently associated variants, 284, 320, and 361 variants were replicated in Koreans, Europeans, and either one of the two populations. In addition, the effect sizes for Koreans and Europeans were moderately correlated (r = 0.33-0.68). However, 61 variants were not replicated in both Koreans and Europeans. Our findings provide valuable information on effect sizes and statistical significance, which is essential to improve the assessment of disease risk using PRS analysis.

Water Quality Monitoring and Risk Assessment for Groundwater at Hoengseong, Gangwon-do Province (강원도 횡성지역의 지하수 수질 모니터링 및 인체 위해성 평가)

  • Gang, Seung-Hye;Kim, Ki-Tae
    • Journal of Environmental Health Sciences
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    • v.47 no.4
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    • pp.356-365
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    • 2021
  • Background: Concerns have been raised regarding the criteria of groundwater, in particular in Gwangwon-do Province where many residents drink groundwater due to the poor supply of tap water and a high nonconformity rate with water quality criteria nationwide. Objectives: Water quality monitoring and risk assessment were conducted for groundwater in Hoengseong, Gangwon-do Province. Methods: A total of 46 items required for meeting drinking water criteria were analyzed from 258 samples collected from March 2017 through August 2018 (152 sites in 2017 and 106 sites in 2018). Risk assessment was conducted for two non-carcinogens (F- and NO3-N), and one carcinogen (i.e., arsenic) based on their high nonconformity to water quality criteria. Results: Water quality analysis revealed that the total proportion of nonconformities was determined to be 27.9%. The nonconformity rate for each content item is as follows: total colony counts (1.6%), total coliform (6.2%), Escherichia coli (1.2%), F- (8.1%), arsenic (4.7%), NO3-N (8.1%), pH (1.2%), manganese (0.4%), and turbidity (5.8%). Risk assessment indicated that fluoride induced a hazard quotient greater than 1 with the 95% UCL (Upper Confidence Limit) concentration of the total 258 sites and average, median, and 95% UCL concentrations of nonconformity sites. For NO3-N, there was no human health risk. For arsenic, the excess cancer risk exceeded the acceptable cancer risk of 1×10-6 with the average and 95% UCL concentrations of total 258 sites and average, median, and 95% UCL concentrations of nonconformity sites. Conclusions: This study suggests that it is necessary to expand water quality monitoring of groundwater and conduct a more detailed risk assessment in order to establish a health care plan for the residents of Hoengseong, Gangwon-do Province.

Risk Assessment for Health and Environmental Hazards of Nanomaterials (나노물질의 인체 및 환경유해성에 관한 위해성평가 방안의 고찰)

  • Kim, Mi-Sug;Choi, Kyung-Hee;Kim, Young-Hun;Yi, Jong-Heop
    • Clean Technology
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    • v.13 no.3
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    • pp.161-172
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    • 2007
  • Fusion technology based on the nanotechnology should be introduced to clean technology for the breakthrough advances. Today, nanoparticles, nanotubes and other engineered nanomaterials are already in use in hundreds of everyday consumer products, and these materials are able to move around the human and environmental mediamore readily than larger particles of pollution. Because of their extremely small size and large surface area, nanoparticles are known to be more reactive and toxic than larger particles. Consequently, this feature raised many concerns of significant health, safety and environment. Herein, we reviewed risk assessment for health and environmental hazards of nanomaterials, and then revealed the potential hazardous of nanomaterials.

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The Primary Process and Key Concepts of Economic Evaluation in Healthcare

  • Kim, Younhee;Kim, Yunjung;Lee, Hyeon-Jeong;Lee, Seulki;Park, Sun-Young;Oh, Sung-Hee;Jang, Suhyun;Lee, Taejin;Ahn, Jeonghoon;Shin, Sangjin
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.5
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    • pp.415-423
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    • 2022
  • Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Comprehensive Comparative Assessment of National Energy and Power Systems

  • Kim, Tae-Woon;Ha, J.J.;Lee, Sung-Jin;Chang, Soon-H.;Kim, Seong-Ho
    • Proceedings of the Korean Nuclear Society Conference
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    • 2004.10a
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    • pp.1459-1460
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    • 2004
  • An AHP-based framework for comprehensive comparison of several power technologies haas been developed. A questionnaire has been designed and is about to surveyed for extracting boty weight vectors and subjective evaluation values. The attitude of evaluator groups will be incorporated into these two types of quantification.

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Regional Variations and Related Factors of Mastication Difficulty Rate among the Korean Elderly (우리나라 노인의 저작불편 호소율의 지역 간 변이와 관련 특성)

  • Kim, Ranhee;Kim, Ji Man;Park, Chong Yon;Park, Keun-Young;Lee, Changwoo;Shin, Euichul
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.100-105
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    • 2018
  • Objectives: The purpose of this research is to investigate regional variations of mastication difficulty rates in the elderly over 65 in 229 primary autonomous districts in Korea and explore relevant characteristics. For the research data, local community health survey conducted in 2015 and data from Ministry of the Interior and Safety, Ministry of Health & Welfare, National Health Insurance Service and Statistics Korea were used. Methods: Frequency analysis was conducted for general characteristics and mastication difficulty rates of each region, and distribution of mastication difficulty rates was displayed for each town, city and province by mapping them. Extremal quotient (EQ), coefficient of variation (CV) values were calculated for regional variations, and logistic regression analysis was performed to reveal the relationship between each independent variable and mastication difficulty rates. Results: The average of standardized mastication difficulty rate was 46.78%, and regional variations were significant with EQ 3.46, CV 0.18. Characteristic factors that have significant effects on mastication difficulty rate included sex ratio, elderly population and the number of dentists per 10000 people. Conclusion: As a result, there were variations among mastication difficulty rates in 229 primary local governments across the country, and the distribution of health care resources by the characteristics of the local environment by region affected mastication difficulty rates. Accordingly, it is required to provide political supports to overcome regional inequality of oral health levels and develop cooperative system between local governments and local dentists.