• 제목/요약/키워드: Risk Appraisal

검색결과 85건 처리시간 0.025초

Health Impact Assessment of Free Immunization Program in Jinju City, Korea

  • Kim, Keon-Yeop;Jeon, So-Youn;Jeon, Man-Joong;Lee, Kwon-Ho;Lee, Sok-Goo;Kim, Dong-Jin;Kang, Eun-Jeong;Bae, Sang-Geun;Kim, Jin-Hee
    • Journal of Preventive Medicine and Public Health
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    • 제45권4호
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    • pp.267-275
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    • 2012
  • Objectives: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. Methods: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. Results: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. Conclusions: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis

  • Suchitra Hudrudchai;Charin Suwanwong;Pitchada Prasittichok;Kanu Priya Mohan;Nopphadol Janeaim
    • Journal of Preventive Medicine and Public Health
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    • 제57권1호
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    • pp.8-17
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    • 2024
  • Objectives: The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors. Methods: The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale. Results: Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM. Conclusions: Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

절차 미준수 행동의 재해석 : 국내 원전 사건을 중심으로 (Reinterpretation of Behavior for Non-compliance with Procedures : Focusing on the Events at a Domestic Nuclear Power Plants)

  • 김동진
    • 한국안전학회지
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    • 제39권1호
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    • pp.82-95
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    • 2024
  • Analyzing the aftermath of events at domestic nuclear power plants brings in the question: "Why do workers not comply with the prescribed procedures?" The current investigation of nuclear power plant events identifies their reasons considering the factors affecting the workers' behaviors. However, there are some complications to it: in addition to confirming the action such as an error or a violation, there is a limit to identifying the intention of the actor. To overcome this limitation, the study analyzed and examined the reasons for non-compliance identified in nuclear power plant events by Reason's rule-related behavior classification. For behavior analysis, I selected unit behaviors for events that are related to human and organizational factors and occurred at domestic nuclear power plants since 2017, and then I applied the rule-related behavior classification introduced by Reason (2008). This allowed me to identify the intentions by classifying unit behaviors according to quality and compliance with the rules. I also identified the factors that influenced unit behaviors. The analysis showed that most often, non-compliance only pursued personal goals and was based on inadequate risk appraisal. On the other hand, the analysis identified cases where it was caused by such factors as poorly written procedures or human system interfaces. Therefore, the probability of non-compliance can be reduced if these factors are properly addressed. Unlike event investigation techniques that struggle to identify the reasons for employee behavior, this study provides a new interpretation of non-compliance in nuclear power plant events by examining workers' intentions based on the concept of rule-related behavior classification.

노측 가드레일용 단부처리시설 성능평가기준 정립 및 개발 (A Study on Development & Establishment of Performance Evaluation Criteria for Guardrail End Treatments)

  • 주재웅;금기정;박제진;장대영
    • 한국도로학회논문집
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    • 제10권1호
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    • pp.123-134
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    • 2008
  • 국내에 설치되고 있는 가드레일의 단부처리시설(end treatments)은 차량의 관통이나 전복을 유발할 수 있는 형상을 하고 있어 사고 시 탑승자가치명상을 입을 가능성이 매우 높다. 실제로 차량이 가드레일의 단부에 충돌하였을 경우, 가드레일이 차량내부를 관통하여 탑승자에게 직접적인 상해를 입히는 경우가 발생되고 있다. 본 연구에서는 미국과 유럽의 성능평가기준(performance evaluation criteria)에 근거하여 국내 실정에 적합한 단부처리시설에 관한 성능평가기준(안)을 제시하였다. 또한 외국의 설치사례 및 연구사례를 조사하여 단부처리시설의 mechanism을 파악하고 국내 도로환경 에 적합한 단부처리시설을 제안하였다. LS-DYNA 프로그램을 이용한 컴퓨터 시뮬레이션을 통해 제안된 단부처 리시설에 대한 성능을 검증한 결과 성능평가기준(안)에 모두 만족한 결과를 보였으며, 개발 단부처리시설에 대한 실물차량 충돌시험을 수행한 결과 성능평가기준(안)의 탑승자 보호성능, 단부처리시설의 거동, 충돌 후 차량의 거동을 모두 만족하였다. 국내 최초로 탑승자의 안전을 고려하여 개발된 단부처리시설이 고속도로나 국도에 설치된다면 단부충돌사고의 심각성을 감소시켜 도로의 안전성을 향상시킬 수 있을 것으로 사료된다.

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역사기록물(Archives)의 항구적인 보존화 이용 : 보존전략과 디지털정보화 (Permanent Preservation and Use of Historical Archives : Preservation Issues Digitization of Historical Collection)

  • 이상민
    • 기록학연구
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    • 제1호
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    • pp.23-76
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    • 2000
  • In this paper, I examined what have been researched and determined about preservation strategy and selection of preservation media in the western archival community. Archivists have primarily been concerned with 'preservation' and 'use' of archival materials worth of being preserved permanently. In the new information era, preservation and use of archival materials were faced with new challenge. Life expectancy of paper records was shortened due to acidification and brittleness of the modem papers. Also emergence of information technology affects the traditional way of preservation and use of archival materials. User expectations are becoming so high technology-oriented and so complicated as to make archivists act like information managers using computer technology rather than traditional archival handicraft. Preservation strategy plays an important role in archival management as well as information management. For a cost-effective management of archives and archival institutions, preservation strategy is a must. The preservation strategy encompasses all aspects of archival preservation process and practices, from selection of archives, appraisal, inventorying, arrangement, description, conservation, microfilming or digitization, archival buildings, and access service. Those archival functions should be considered in their relations to each other to ensure proper preservation of archival materials. In the integrated preservation strategy, 'preservation' and 'use' should be combined and fulfilled without sacrificing the other. Preservation strategy planning is essential to determine the policies of archives to preserve their holdings safe and provide people with a maximum access in most effective ways. Preservation microfilming is to ensure permanent preservation of information held in important archival materials. To do this, a detailed standardization has been developed to guarantee the permanence of microfilm as well as its product quality. Silver gelatin film can last up to 500 years in the optimum storage environment and the most viable option for permanent preservation media. ISO and ANIS developed such standards for the quality of microfilms and microfilming technology. Preservation microfilming guidelines was also developed to ensure effective archival management and picture quality of microfilms. It is essential to assess the need of preservation microfilming. Limit in resources always put a restraint on preservation management. Appraisal (and selection) of what to be preserved was the most important part of preservation microfilming. In addition, microfilms with standard quality can be scanned to produce quality digital images for instant use through internet. As information technology develops, archivists began to utilize information technology to make preservation easier and more economical, and to promote use of archival materials through computer communication network. Digitization was introduced to provide easy and universal access to unique archives, and its large capacity of preserving archival data seems very promising. However, digitization, i.e., transferring images of records to electronic codes, still, needs to be standardized. Digitized data are electronic records, and st present electronic records are very unstable and not to be preserved permanently. Digital media including optical disks materials have not been proved as reliable media for permanent preservation. Due to their chemical coating and physical character using light, they are not stable and can be preserved at best 100 years in the optimum storage environment. Most CD-R can last only 20 years. Furthermore, obsolescence of hardware and software makes hard to reproduce digital images made from earlier versions. Even if when reformatting is possible, the cost of refreshing or upgrading of digital images is very expensive and the very process has to be done at least every five to ten years. No standard for this obsolescence of hardware and software has come into being yet. In short, digital permanence is not a fact, but remains to be uncertain possibility. Archivists must consider in their preservation planning both risk of introducing new technology and promising possibility of new technology at the same time. In planning digitization of historical materials, archivists should incorporate planning for maintaining digitized images and reformatting them in the coming generations of new applications. Without the comprehensive planning, future use of the expensive digital images will become unavailable. And that is a loss of information, and a final failure of both 'preservation' and 'use' of archival materials. As peter Adelstein said, it is wise to be conservative when considerations of conservations are involved.

한국의 의료폐기물 발생 및 처리의 공간적 분포에 관한 연구 (A Study on the Spatial Distribution of Medical Waste Generation and Treatment in Korea)

  • 오세은;이진헌;안호기;김기연;박석환;하권철;지경희;황성호;윤오섭;홍영습;이은일;김판기;이경무
    • 한국환경보건학회지
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    • 제41권6호
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    • pp.449-457
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    • 2015
  • Objectives: In Korea, the system of management of medical waste largely relies on the incineration method. Our study aimed to identify any regional imbalances between the generation and treatment of medical waste, and provide reference data for future policy in Korea. Methods: We analyzed data on the amount of medical waste from 2,000 hospitals in 2012, 2013, and 2014 obtained from the Korea Environment Corporation. In the Arc GIS program (version 10.2.3), the addresses of hospitals and incinerators were transformed into map coordinates. The amount of waste generated by each hospital and the amount incinerated were represented by density and size of a triangle symbol, respectively. Results: As of 2014, the total amount of medical waste from the top 2,000 hospitals was 136,073 tons, out of which about half (49%) was generated in the capital area. Eleven incineration companies (three in the capital area, two in the Chungcheong Provinces area, one in the Jeolla Provinces area, and five in the Gyeongsang Provinces area) treated this waste. For the years 2012, 2013, and 2014, about 60% of the medical waste generated from the hospitals in the capital area was treated within the capital area and about 40% was transported to other areas, especially the Gyeongsang Provinces area, for treatment. On the other hand, about 90% of the medical waste incinerated in the capital area originated from the capital area. Conclusion: Our results suggest a spatial imbalance between the generation and treatment of medical waste in Korea and warrants multilateral policies, including the expansion of on-site treatment, strengthening regulation of the containment of medical wastes, promoting reductions in medical waste and more.

도심 비즈니스호텔 개발사업의 투자결정요인에 관한 연구 (An analysis on the Investment Determinants for Urban Business Hotel Development)

  • 하정훈;정문오;이상엽
    • 한국건설관리학회논문집
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    • 제16권4호
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    • pp.107-117
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    • 2015
  • 최근 한국을 찾는 관광객이 급격한 증가로 비즈니스호텔의 수요가 확대되며 부동산 투자대상으로서 관심이 증가하고 있으나,이러한 개발사업의 투자결정에 영향을 미치는 요인과 기준이 불분명한 실정이다. 이에 본 연구에서는 계층적분석기법과 퍼지기법을 활용하여 투자결정에 영향을 미치는 요인들을 투자자의 관점에서 조사하고자 한다. 따라서 투자자를 직접투자자와 간접투자자로 구분하여 차이점을 비교분석하고 이를 기준으로 실제 수행된 개발사례를 평가하여 시사점을 도출하였다. 분석결과, 투자결정기준별 중요도로 '보행/교통 접근성', '객실 점유율 및 실당 매출액', '외래 관광객 수와 관광업계 현황 등이 높게 나타났으며, 투자형태별로는 직접투자 경우가 금융구조 조건이나 투자리스크 항목들이 높게 나타나 자기자본을 투자하는 직접투자자는 외부자본으로 투자하는 간접투자기구 운용사 대비, 금융 및 투자조건 관련사항을 중시하며, 간접투자의 경우 입지 현황 및 사회입지적 환경과 관련한 항목들이 높게 형성되어 간접투자 특성상 투자자 모집을 위한 부동산의 환경과 가치에 더욱 중점을 두는 것으로 나타났다. 또한, 사례분석결과, 직접투자가 실제 투자에 따른 금융 보강이라는 측면에서 임차인의 신용도에 민감하며 자기자본을 투자해야 하는 특성상 간접투자보다 보수적으로 투자대상을 파악하는 것으로 나타났다.

Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology

  • Jung, Pil Young;Yu, Byungchul;Park, Chan-Yong;Chang, Sung Wook;Kim, O Hyun;Kim, Maru;Kwon, Junsik;Lee, Gil Jae;Korean Society of Traumatology (KST) Clinical Research Group
    • Journal of Trauma and Injury
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    • 제33권1호
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    • pp.1-12
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    • 2020
  • Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

Study of Relationship Between Illness Perception and Delay in Seeking Help for Breast Cancer Patients Based on Leventhal's Self-Regulation Model

  • Attari, Seyedeh Maryam;Ozgoli, Giti;Solhi, Mahnaz;Majd, Hamid Alavi
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권sup3호
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    • pp.167-174
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    • 2016
  • One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

초등학생 대상의 건강 효능감과 지식을 중심으로 한 심혈관 건강증진 중재 효과 (Intervention Effect on Health Efficacy and Knowledge in Cardiovascular Health Promotion Behaviors in Children)

  • Tak, Young-Ran;Yun, E-Hwa
    • 보건교육건강증진학회지
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    • 제26권5호
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    • pp.97-113
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    • 2009
  • 목적: 본 연구는 학령기 아동 대상의 건강 효능감과 지식을 중심으로 한 심혈관 건강증진 중재 효과를 확인하기 위해 수행되었다. 방법: 본 연구는 반복측정 설계를 적용한 단일군 사전사후 연구 설계로 219명의 초등학생들 대상으로 하고 있다. 심혈관 건강증진 중재는 학교 수업을 기반으로 하는 주1회, 4주 교육으로 구성된 1차 중재와 부모에게 1차 중재 내용을 가정통신문의 형태로 전달하여 학생들의 건강 생활습관 유지에 있어서 부모의 역할을 강조하는 2차 중재로 구성되어 있다. 건강 효능감, 지식, 아동이 지각하는 부모의 모니터링에 대해 중재 전 기초 조사를 실시하고, 1차 중재 및 2차 중재 후 각각 실시하였다. 결과: 정신 건강 자아 효능감은 조사 시점에 따라 유의하게 증가하였다 (F = 32.88, p < 0.0001). 1차 및 2차 중재 후 신체 건강 자아 효능감의 경우 사전 조사에 비해 유의하게 증가하였으나 (F = 50.51, p < 0.0001), 부모 중재 기간 동안에는 건강 자아 효능감에 유의한 변화가 없었다. 지식수준은 전반적으로 증가하는 경향을 보였으나 (F =10.23, p < 0.0001), 부모 중재 후에는 오히려 감소하는 경향을 보였다. 또한 전반적인 자아 효능감에 영향을 미치는 요인으로 아동이 지각한 부모 모니터링인 것으로 나타났다. 결론: 본 연구의 결과는 학교 기반의 심혈관 건강 증진 프로그램이 건강 자아 효능감과 지식수준을 향상시키는 데 있어서 효과적이라는 기존 연구 결과를 지지하고 있다. 이 외에 학령기 아동의 건강 생활 습관 유도를 목적으로 건강 자아 효능감과 지식수준 향상을 위한 중재를 수행하는 데 있어서 부모의 영향을 고려해야 함을 제시하고 있다.