• 제목/요약/키워드: Risk Checklist

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Risk Factors of Delirium in ICU Patients with Acute Poisoning (중환자실 급성중독환자에서 섬망의 위험인자)

  • Kim, Hee Yeon;Cha, Kyung Man;So, Byung Hak
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.14-20
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    • 2019
  • Purpose: This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning. Methods: Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis. Results: A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy. Conclusion: The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.

Preliminary Report of Validity for the Infant Comprehensive Evaluation for Neurodevelopmental Delay, a Newly Developed Inventory for Children Aged 12 to 71 Months

  • Hong, Minha;Lee, Kyung-Sook;Park, Jin-Ah;Kang, Ji-Yeon;Shin, Yong Woo;Cho, Young Il;Moon, Duk-Soo;Cho, Seongwoo;Hwangbo, Ram;Lee, Seung Yup;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.1
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    • pp.16-23
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    • 2022
  • Objectives: Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study's objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12-71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool's validity and cut-off. Methods: Multidisciplinary experts devised the "Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND)," an assessment method that comes in two versions depending on the age of the child: 12-36 months and 37-71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. Results: A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach's alpha was positive (0.533-0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5-0.7 and specificity 0.7-0.9. Conclusion: The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12-36 months and 37-71 months.

Anesthetic efficacy of supplemental intraligamentary injection in human mandibular teeth with irreversible pulpitis: a systematic review and meta-analysis

  • Gupta, Alpa;Wadhwa, Jitesh;Aggarwal, Vivek;Mehta, Namrata;Abraham, Dax;Aneja, Kritika;Singh, Arundeep
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.1
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    • pp.1-10
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    • 2022
  • Background: Inferior alveolar nerve block (IANB) is known to have a lower success rate for anesthesia in patients with irreversible pulpitis. This calls for supplementary techniques to effectively anesthetize such patients. This systematic review aimed to evaluate the published literature for determining the success rate of anesthesia induction using post-IANB intraligamentary (IL) injection in the mandibular teeth of patients with symptomatic irreversible pulpitis. The review question was, "What is the success rate of IL injection in the mandibular teeth of patients with irreversible pulpitis as a supplementary technique for endodontic treatment?" Methods: A thorough search of electronic databases and manual searches were performed. The protocol of the review was framed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with a proper criterion for inclusion and exclusion of studies. The included studies were analyzed using the Cochrane Collaboration "Risk of Bias" tool. A meta-analysis that included a comparison of primary nerve block and supplemental IL injection was performed. The success rate was evaluated using the combined risk ratio (RR) with a random risk model. A funnel plot was created to measure publication bias. Results: After all analyses, four studies were included. In the forest plot representation, RRs were 3.56 (95% CI: 2.86, 4.44), which were in favor of the supplemental IL injections. Statistical heterogeneity was found to be 0%. These values suggest that supplemental IL injections provide better success rates for anesthesia. Conclusion: According to the pooled qualitative and quantitative analyses, supplemental IL injections increased anesthetic efficacy.

An investigation of the relationship between cutaneous allodynia and kinesiophobia, gastrointestinal system symptom severity, physical activity and disability in individuals with migraine

  • Hafize Altay;Seyda Toprak Celenay
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.137-246
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    • 2023
  • Background: To investigate the relationship between cutaneous allodynia (CA) and kinesiophobia, gastrointestinal system (GIS) symptom severity, physical activity, and disability, and to determine whether CA, pain, and disability were influencing factors for kinesiophobia, GIS symptoms, and physical activity in individuals with migraine. Methods: The study included 144 individuals with migraine. CA, kinesiophobia, GIS symptoms, physical activity level, and migraine-related disability were evaluated with the Allodynia Symptom Checklist, the Tampa Kinesiophobia Scale (TKS), the Gastrointestinal Symptom Rating Scale (GSRS), the International Physical Activity Questionnaire-7, and the Migraine Disability Assessment Scale (MIDAS), respectively. Results: The CA severity was only associated with TKS (r = 0.515; P < 0.001), GSRS-total (r = 0.336; P < 0.001), GSRS-abdominal pain (r = 0.323; P < 0.001), GSRS-indigestion (r = 0.257; P = 0.002), GSRS-constipation (r = 0.371; P < 0.001), and MIDAS scores (r = 0.178; P = 0.033). Attack frequency (P = 0.015), attack duration (P = 0.035) and presence of CA (P < 0.001) were risk factors for kinesiophobia. Attack frequency (P = 0.027) and presence of CA (P = 0.004) were risk factors for GIS symptoms. Conclusions: There was a relationship between the CA and kinesiophobia, GIS symptoms, and disability. CA and attack frequency were found to be risk factors for kinesiophobia and GIS symptoms. Migraine patients with CA should be assessed in terms of kinesiophobia, GIS, and disability. Lifestyle changes such as exercise and dietary changes and/or pharmacological treatment options for CA may increase success in migraine management.

Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

  • Paula Lambert;Sergio Augusto Quevedo Miguens Jr;Caroline Solda;Juliana Tomaz Sganzerla;Leandro Azambuja Reichert;Carlos Estrela;Fernando Branco Barletta
    • Restorative Dentistry and Endodontics
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    • v.45 no.4
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    • pp.48.1-48.11
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    • 2020
  • Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

Behavioral Theory-Based Risk Node Judgment Algorithm for Evaluating the Crime Risk Level in Restrooms (화장실의 범죄위험도 평가를 위한 행동이론 기반 리스크 노드 판정 알고리즘)

  • Shin-Sook Yoon;Jeong-Hwa Song
    • The Journal of the Korea institute of electronic communication sciences
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    • v.18 no.6
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    • pp.1197-1206
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    • 2023
  • To assess the risk level of a public restroom implemented in virtual reality, we sought to evaluate the spatial elements present in the restroom. To provide the theoretical foundation for the evaluation subjects and criteria, we introduced prior research that proposed a checklist to entance the safety of public restroom. To set up evaluation criteria, we analyzed and established based on the theories of Paul J. Brantingham and Patricia L. Brantingham, focusing on the interaction between space and criminals. Ronald V. Clarke's "Routine Activity Theory" was also introduced and incorporated into the evaluation approach. We analyzed based on the correlation between the criminal, user, and spatial elements of the public restroom in terms of the criminal's actions, the spatial relevance to crime, and user exposure during use. Using these criteria, we developed an algorithm to evaluate th spatial elements of public restroom. Based on this, we created an application, demonstrating the feasibility of developing on evaluation tool.

Determining the Onset Age for Early Intervention of Oral Frailty

  • Hye-Lim Hong;Nam-Hee Kim
    • Journal of dental hygiene science
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    • v.24 no.1
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    • pp.1-8
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    • 2024
  • Background: Oral frailty is defined as the functional decline of the oral function due to aging, and it is associated with frailty and chronic disease. Most of the frailty intervention is for adults aged 65 years and older. However, early intervention for preventive disorder is most important. The objective of this study was to identify the age at which oral frailty surpass the "normal" range. Methods: This cross-sectional study included 719 adults (aged 30~89 years) residing in Gangwon province in May 2023. Risk of oral frailty was assessed using criteria from The Korean Academy of Geriatric Dentistry including oral function such as swallowing and mastication, and frailty. Frailty was assessed using the Kihon Checklist. To determine when oral frailty surpass the "normal" status, statistical analysis including chi-squared tests and multiple logistic regression analysis were performed using R (ver. 4.3.1). Results: There were 388 (54.0%) individuals who had a "normal" status risk of oral frailty. The risk of oral frailty was higher in the 50~54 age group compared to the 30~34 age group (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28~0.91), after adjusting for gender, education, income, occupation, and frailty (OR 0.46, 95% CI 0.22~0.94). This means that from 50~54 years old, regardless of gender, education, income, occupation, or frailty condition, there is a distinction from the "normal" status. Conclusion: We found that intervention for oral frailty is needed starting from age 50 years. This is the stage where early indications of oral frailty become apparent. Early intervention for oral frailty can lead to a decrease in the prevalence of diseases and medical expenditure. Therefore, early intervention in middle-aged adults of oral frailty is necessary to improve the quality of life related to oral health.

The Effect of Metabolic syndrome Management Program Applying Participatory Action-Oriented Training Principle (참여형 개선기법(PAOT)의 원리를 적용한 대사증후군 관리 프로그램 효과분석)

  • Yoon, Seong-Yong;Woo, Kuck-Hyeun;Kim, Hwa-Sung;Kim, Yong-Bae;Kim, Jin-Seok;Jo, Seong-Yong;Lee, Sung-Soo
    • Korean Journal of Health Education and Promotion
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    • v.31 no.5
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    • pp.81-95
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    • 2014
  • Objectives: The purpose of this study was to apply participatory action-oriented training (PAOT) principle for the management of metabolic syndrome and to assess its effectiveness in the workplace. Methods: The metabolic syndrome management program applying participatory action-oriented training (PAOT) principle is constructed action checklist, Group discussion, self-creation of an action plan, after 3 months, 6 months, 1 year, the practice carried out check up and encourage practice activity. Results: The seventy-seven workers who participated in the metabolic syndrome management program made a total of 246 action plans, 3.8 action plans per person and 234 action plans were achieved after one year, so that 81.0% of action plans have been achieved. After 1 year, in the intervention group, systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), the risk factors score decreased statistically significant, and metabolic syndrome prevalence decreased 54.8%. whereas the control group also showed a significant decreased in the mean systolic and diastolic blood pressure, the risk factors score. but, low-density lipoprotein (LDL) was significantly increased. Conclusions: To improve the effectiveness of metabolic syndrome management program applying participatory action-oriented training (PAOT) principle, the need to continues implementing programs and analysis of the long-term effects are required. Participatory action-oriented training (PAOT) principle can applying without cost and time, the human burden for the prevention and management of chronic diseases such as metabolic syndrome.

Relationship between Prevalence of Musculoskeletal Symptoms and Occupational and Personal Factors among Street Cleaners (일부 거리환경미화원의 근골격계 증상 유병률과 직업적 및 개인적 요인의 관련성)

  • Jung, Suk-Chul;Lee, Kyung-Sun;Jung, Myung-Chul;Lee, In-Seok;JungChoi, Kyung-Hee;Bahk, Jin-Wook;Kim, Hyun-Joo
    • Journal of the Korean Society of Safety
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    • v.25 no.6
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    • pp.169-179
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    • 2010
  • The aim of this study was to investigate occupational and individual risk factors and working conditions in relation to musculoskeletal symptoms in street cleaners. Investigation was conducted through a survey of 395 male street cleaners employed by the government office in Seoul, Gyeonggi and Chung-Nam from July to August of 2009. The control group was comprised of 143 male drivers and security guards. Risk factors for musculoskeletal symptoms in street cleaners were investigated by multiple logistic regression analysis and also evaluated ergonomic risk factors by assessing working conditions of 4 street cleaners. As a result of symptom questionnaires, all of the prevalent rates of musculoskeletal symptoms in street cleaners had significantly higher results than those of the control group(p<0.05). On binary logistic regression analysis of musculoskeletal symptoms, street cleaners showed significant higher odds ratio as 18.84(95%CI: 6.56-54.12) in the arm/elbow, 10.49(95%CI: 4.29-25.65) in the hand/wrist compared to the control group. Both absence of rest breaks and exposure to ergonomic risk factors showed to be important internal risk factors of musculoskeletal symptoms among street cleaners. The exposure levels of QEC(Quick exposures checklist) in street cleaners were revealed to be higher on the shoulder/arm, wrist/hand, and neck than back, or from stress. The findings appear to show that street cleaners were high-risk group of work-related musculoskeletal disorders. Therefore street cleaners require a holistic interventional strategy, including adequate arrangement of rest breaks, improvement of working tools and control of individual risk factors such as obesity and smoking.

Development of evaluation items for adolescents' dietary habits and nutritional practices reflecting eating behaviors and food environment (식행동, 식생활 환경을 반영한 청소년의 식생활·영양 실천 평가 항목 개발)

  • Jimin Lim;Hye Ji Seo;Jieun Oh
    • Journal of Nutrition and Health
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    • v.57 no.1
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    • pp.136-152
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    • 2024
  • Purpose: A comprehensive evaluation item was developed to assess adolescent dietary habits and nutritional practices, considering food intake, eating behaviors, and food culture, such as social support and food environment. Methods: The 59 candidate items of the evaluation checklist were obtained based on the results of the eighth Korea National Health and Nutrition Examination Survey data, Korea Dietary Reference Intakes, dietary guidelines for adolescents, Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. Four hundred and three middle and high school students residing in metropolitan areas participated in a survey using the 58-item checklist, which was selected through expert evaluation and content validity ratio analysis. The construct validity of the assessment tool for the quality of adolescent diets was assessed by exploratory factor analyses to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately. Results: The Bartlett sphericity test was significant for each area (p <0.001), and the eigen values were greater than one. The Kaiser-Meyer-Olkin and cumulative proportions by areas were food intake (0.765 and 56.8%, respectively), eating behaviors (0.544 and 64.8%, respectively), and food environment (0.699 and 62.4%, respectively). Twenty-two checklists were determined for the final evaluation items for the adolescents' dietary habits and nutritional practices and were categorized into three distinct factors: food intake (10 items), eating behaviors (4 items), and food environment (8 items). Conclusion: The evaluation items for adolescent dietary habits and nutritional practices is a useful checklist for easily and quickly assessing the dietary qualities and reflecting Korean adolescents and their food environmental factors related to a sustainable diet.