• Title/Summary/Keyword: Risk Rating

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Bee Venom Acupuncture for Shoulder Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Shen, Lei;Lee, Jong Ha;Joo, Jong Cheon;Park, Soo Jung;Song, Yung Sun
    • Journal of Pharmacopuncture
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    • v.23 no.2
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    • pp.44-53
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    • 2020
  • Objectives: Our review aimed to summarize and evaluate evidence on the effectiveness of bee venom acupuncture (BVA) in the treatment of shoulder pain. Methods: Randomized controlled trials (RCTs) evaluating the effectiveness of BVA on shoulder pain were searched up to October 2019 in 11 electronic databases (Medline, Embase, CENTRAL, CiNii, CNKI, VIP, Wanfang, Kmbase, NDSL, RISS, OASIS). The methodological quality of the included RCTs were evaluated using Cochrane Risk of Bias tool and a meta-analysis was performed. Results: Seven studies were included in the review, and four studies were included in the meta-analysis. Comparing BVA plus conventional therapy (CT) with saline injection plus CT, it showed an effect in favor of BVA plus CT in visual analog scale (VAS) and pain rating scale (PRS) (p = 0.02, p = 0.009, respectively). Comparing BVA plus physiotherapy (PT) with saline injection plus PT, it showed that there was no significant difference in VAS and verbal rating scale (VRS) between the two groups. Conclusion: This systematic review and meta-analysis suggest that BVA could be beneficial as an adjuvant treatment for shoulder pain.

The effect of corporate risk on Korean bond market (기업의 위험이 회사채 수익률에 미치는 영향)

  • Choe, Yong-Shik;Choi, Jong-Yoon
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.175-183
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    • 2018
  • This study analyzes determinants of bond returns in terms of systematic risk versus idiosyncratic risk by examining relationship among those factors. First we examined the cross-sectional determinants of corporate bond returns with Korean bond market data from 2001 to 2014. This paper uses term factor and default factor for systematic risk, and duration factor and credit rating factor for idiosyncratic risk. The empirical result shows that systematic risk can explain cross-sectional differences of bond returns rather than idiosyncratic risk which is the same result in advanced markets(US or Europe). This result is different from the previous Korean studies which showed that idiosyncratic risk is more important than systematic risk in Korean bond market. The reason for the different result may be the longer sample period which includes the most recent period. It is insisted that Korean bond market is getting more synchronized with the advanced bond market. In conclusion, this empirical result implies that Korean bond portfolio managers should focus on systematic risk, which is contrary to current system in Korean asset management industry.

Alteration of Plasma ${\beta}$-Nerve Growth Factor Concentration in Depressed Patients with Suicidal Attempt (자살을 시도한 우울증 환자에서 혈장 ${\beta}$-Nerve Growth Factor 농도의 변화)

  • Shim, Se-Hoon;Won, Seong-Doo;Lee, Bun-Hee;Han, Chang Su;Yang, Jong-Chul;Kwon, Young-Joon;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.13 no.2
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    • pp.95-102
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    • 2006
  • Object : Nerve growth factor(NGF) is a protein involved in neuronal survival and plasticity in the central nervous system, which might play an important role in stress, depression and suicide. This study was performed to determine whether there is an alteration in plasma NGF concentrations in depressed patients with suicidal attempt. Methods : The subjects were 32 depressed patients who attempted suicide and admitted in emergency room. Forty-four hospitalized non-suicidal depressive patients and the 30 normal controls were closely matched with the suicidal group in terms of age and sex. Individuals in all 3 groups were evaluated independently by a semi-structured interview for the purpose of establishing a DSM-IV criteria diagnosis. The severity of depressive symptoms was evaluated using Hamilton depression rating scale(HDRS). The severity of the suicidal behavior was evaluated by Weisman and Worden's risk-rescue rating(RRR) system and the Lethality Suicide Attempt Rating Scale(LSARS). Plasma NGF level was measured by the enzyme linked immunosorbent assay(ELISA) method. Results : There were no statistically significant differences of the plasma NGF levels among groups. LSARS and RRR did not reveal any significant correlation with ${\beta}$-NGF level in suicidal depressive patients. Conclusion : This study do not support an association between ${\beta}$-NGF and suicidal depression. However it is necessary to investigate this association through other route such as postmortem brain.

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Epidural Infusion of Morphine and Levobupivacaine through a Subcutaneous Port for Cancer Pain Management

  • Heo, Bong Ha;Pyeon, Tae Hee;Lee, Hyung Gon;Kim, Woong Mo;Choi, Jeong Il;Yoon, Myung Ha
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.139-144
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    • 2014
  • Background: To manage intractable cancer pain, an alternative to systemic analgesics is neuraxial analgesia. In long-term treatment, intrathecal administration could provide a more satisfactory pain relief with lower doses of analgesics and fewer side-effects than that of epidural administration. However, implantable drug delivery systems using intrathecal pumps in Korea are very expensive. Considering cost-effectiveness, we performed epidural analgesia as an alternative to intrathecal analgesia. Methods: We retrospectively investigated the efficacy, side effects, and complications of epidural morphine and local anesthetic administration through epidural catheters connected to a subcutaneous injection port in 29 Korean terminal cancer patients. Patient demographic data, the duration of epidural administration, preoperative numerical pain rating scales (NRS), side effects and complications related to the epidural catheterization and the drugs, and the numerical pain rating scales on the 1st, 3rd, 7th and 30th postoperative days were determined from the medical records. Results: The average score for the numerical pain rating scales for the 29 patients decreased from $7{\pm}1.0$ at baseline to $3.6{\pm}1.4$ on postoperative day 1 (P < 0.001). A similar decrease in pain intensity was maintained for 30 days (P < 0.001). Nausea and vomiting were the most frequently reported side effects of the epidural analgesia and two patients (6.9%) experienced paresthesia. Conclusions: Epidural morphine and local anesthetic infusion with a subcutaneous pump seems to have an acceptable risk-benefit ratio and allows a high degree of autonomy to patients with cancer pain.

Disaster Risk Assessment using QRE Assessment Tool in Disaster Cases in Seoul Metropolitan (서울시 재난 사례 QRE 평가도구를 활용한 재난 위험도 평가)

  • Kim, Yong Moon;Lee, Tae Shik
    • Journal of Korean Society of Disaster and Security
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    • v.12 no.1
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    • pp.11-21
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    • 2019
  • This study assessed the risk of disaster by using QRE(Quick Risk Estimation - UNISDR Roll Model City of Basic Evaluation Tool) tools for three natural disasters and sixteen social disasters managed by the Seoul Metropolitan Government. The criteria for selecting 19 disaster types in Seoul are limited to disasters that occur frequently in the past and cause a lot of damage to people and property if they occur. We also considered disasters that are likely to occur in the future. According to the results of the QRE tools for disaster type in Seoul, the most dangerous type of disaster among the Seoul city disasters was "suicide accident" and "deterioration of air quality". Suicide risk is high and it is not easy to take measures against the economic and psychological problems of suicide. This corresponds to the Risk ratings(Likelihood ranking score & Severity rating) "M6". In contrast, disaster types with low risk during the disaster managed by the city of Seoul were analyzed as flooding, water leakage, and water pollution accidents. In the case of floods, there is a high likelihood of disaster such as localized heavy rains and typhoons. However, the city of Seoul has established a comprehensive plan to reduce floods and water every five years. This aspect is considered to be appropriate for disaster prevention preparedness and relatively low disaster risk was analyzed. This corresponds to the disaster Risk ratings(Likelihood ranking score & Severity rating) "VL1". Finally, the QRE tool provides the city's leaders and disaster managers with a quick reference to the risk of a disaster so that decisions can be made faster. In addition, the risk assessment using the QRE tool has helped many aspects such as systematic evaluation of resilience against the city's safety risks, basic data on future investment plans, and disaster response.

Highway Bridge Inspection Period Based on Risk Assessment (위험도평가에 의한 고속도로 교량의 점검주기)

  • Lee, Il-Keun;Kim, Dong-Hyawn
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.19 no.3
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    • pp.64-72
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    • 2015
  • Risk Based Inspection (RBI) Period was proposed for highway bridges in Korea. Hazard factors affecting bridge condition deterioration were found by analyzing condition data from Highway Bridge Management System (HBMS). Certain level of correlations between those factors and condition deterioration were found. They are used to evaluate hazard score. Summarizing several hazard factors, final hazard is classified as three level;high, moderate, low. Vulnerability is assessed only by the current state of bridge. Then, risk matrix is suggested for inspection periods. Inspection periods of the bridges with grade C, D, and E are maintained the same as before. But, those of grade A and B with moderate and high hazard score are elongated to maximum 6 years while the maximum inspection period is three years at present. By adjusting inspection period according to risk assessment, it was shown that 27% of average inspection manpower can be saved.

Psychosocial Assessment and Related Factors for Kidney Transplantation Candidates in South Korea: A Descriptive Correlational Study (한국 신장이식 대기자의 심리사회적 평가 및 영향 요인)

  • Chong, Hye Jin
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.249-258
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    • 2019
  • Purpose: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status. Methods: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT. Results: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk. Conclusion: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.

Community Based Cross-sectional Study on the Risk Factors of Dementia among the Elderly in a City (도시지역 노인의 치매 위험요인에 관한 단면연구)

  • Kim, Jung-Soon;Chun, Byung-Chul;Cho, Eu-Soo;Jeong, Ihn-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.4
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    • pp.313-321
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    • 2002
  • Objectives : To identify the risk factors of dementia among the elderly in a large city. Methods : A cross-sectional study was conducted in July 2001, with potential participants selected by stratified two stage cluster sampling of the elderly population of Keumgog dong, Busan. A total of 452 elderly people aged 65 years and over, underwent a two phase diagnostic procedure. Mini-mental State Examination-Korean (MMSE-K) and Samsung Dementia Questionnaire were used for the 1st stage, and the Clinical Dementia Rating Scale (CDR), the Bartel ADL, and IADL Index, the Korean Geriatric Depression Scale (KGDS), the Modified Hatchinski Ischemic Scale (MHIS), and other laboratory tests were used for the 2nd stage. Results : Of the 446 participants finally chosen, 45 were confirmed with dementia, and 363 as normal, with the rests not confirmed with dementia or as normal, were excluded from the analysis. According to the logistic regression analysis, the risk of dementia was significantly higher In: people aged 80 and above (OR=4.36, 95% CI=1.97-9.62), illiterate (OR=3.58, 95% CI=1.71-7.46), who had a history of strokes (OR=6.35, 95% CI=2.71-14.87), or who had 3 history of hyperlipidemia (OR=4.74, 95% CI=1.65-13.61), compared to their counterparts. Conclusions : These results suggest that efforts to prevent strokes and hyperlipidemia can significantly decrease the risk of dementia.

Heuristics evaluation and development of the Caries Management by Risk Assessment (CAMBRA)-kids application for caries management of preschoolers (소아 우식관리를 위한 CAMBRA-kids 애플리케이션 개발 및 휴리스틱 평가)

  • Kang, Yu-Min;Lee, Su-Young
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.4
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    • pp.479-492
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    • 2019
  • Objectives: This study aimed to develop the CAMBRA-kids application for the systematic management of dental caries among preschoolers, activate the dental caries management system, and contribute to the dental caries management of preschoolers. Methods: The collected data were analyzed using R studio 1.2.1335 for Windows (RStudio Inc., Boston, MA, USA, 2018). Algorithm evaluation, heuristic evaluation and usability evaluation were analyzed using descriptive statistics. Results: Both expert evaluations of the application's algorithms were calculated as 100%, for proficiency and efficiency. The application worked well with the designed algorithms, the risk group level of participants was categorized appropriately, and the risk management method was guided properly according to the risk group level. Of the five problems presented in the heuristic evaluation, 'the lack of security' and 'the lack of information on oral health care' received 'high severity' scores. The usability evaluation of the application produces an overall score of 3.27. In the subscales (participation, functionality, aesthetics, and information) of the Mobile App Rating Scale (MARS), the 'participation' domain received the lowest score of 2.56 and the 'functional' domain received the highest score of 3.70. Conclusions: The CAMBRA-kids application is expected to be applied and used in the field of preschoolers' oral health care management, and to contribute to the prevention of dental caries of preschoolers by activating the dental caries management system using the application.

Assessment of Risk Factors for Postoperative Delirium in Older Adults Who Underwent Spinal Surgery and Identifying Associated Biomarkers Using Exosomal Protein

  • Baek, Wonhee;Lee, JuHee;Jang, Yeonsoo;Kim, Jeongmin;Shin, Dong Ah;Park, Hyunki;Koo, Bon-Nyeo;Lee, Hyangkyu
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.371-384
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    • 2023
  • Purpose: With an increase in the aging population, the number of patients with degenerative spinal diseases undergoing surgery has risen, as has the incidence of postoperative delirium. This study aimed to investigate the risk factors affecting postoperative delirium in older adults who had undergone spine surgery and to identify the associated biomarkers. Methods: This study is a prospective study. Data of 100 patients aged ≥ 70 years who underwent spinal surgery were analyzed. Demographic data, medical history, clinical characteristics, cognitive function, depression symptoms, functional status, frailty, and nutritional status were investigated to identify the risk factors for delirium. The Confusion Assessment Method, Delirium Rating Scale-R-98, and Nursing Delirium Scale were also used for diagnosing delirium. To discover the biomarkers, urine extracellular vesicles (EVs) were analyzed for tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light, and glial fibrillary acidic protein using digital immunoassay technology. Results: Nine patients were excluded, and data obtained from the remaining 91 were analyzed. Among them, 18 (19.8%) developed delirium. Differences were observed between participants with and without delirium in the contexts of a history of mental disorder and use of benzodiazepines (p = .005 and p = .026, respectively). Tau and UCH-L1-concentrations of urine EVs-were comparatively higher in participants with severe delirium than that in participants without delirium (p = .002 and p = .001, respectively). Conclusion: These findings can assist clinicians in accurately identifying the risk factors before surgery, classifying high-risk patients, and predicting and detecting delirium in older patients. Moreover, urine EV analysis revealed that postoperative delirium following spinal surgery is most likely associated with brain damage.