• 한국환경보건학회지
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• 제40권5호
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• pp.385-396
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• 2014

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.

• Journal of Preventive Medicine and Public Health
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• 제34권1호
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• pp.89-99
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• 2001

Objectives : To describe the characteristics of a mumps epidemic in Cheju-do, 1998 and to identify the risk factors associated with mumps infection. Methods : To estimate attack rate, previously collected data from the Nationally Notifiable Communicable Disease Reporting System and School Health Reporting System, temporarily administered by Division of Education. as well as additional surveillance data were used. In order to identify the clinical characteristics and risk factors associated with mumps, we conducted a questionnaire survey in 17 schools (9 elementary, 4 middle, and 4 high schools) among a population that included healthy students. Results : From March 3 to August 31, 2,195 cases of mumps were identified, and patients under 20 years of age accounted for 2,162 cases (attack rate 13.2, 95% CI 12.6-13.7/1,000). The attack rate for the population under 20 years of age was the highest in Nam county (44.7/1,000), nod in the 7-12 years old sub-group(>20.0/1,000). There was no sexual difference. 80.5% and 59.7% of patients presented periauricular and submandibular swelling respectively. Aseptic meningitis was a complication in 2.9% of cases, orchitis in 1.3%, epididymitis in 0.9% and oophoritis in 0.6% respectively. The overall MMR vaccination rate was 59.1% and it decreased in accordance with increasing age. In students aged 10 years old or below, household contact and MMR vaccination status was significantly associated with infection, and only among students with household contact, the risk of one dose MMR(OR=10.22, 95% CI 2.92-35.78) and non-vaccination (OR=11.62, 95% CI 1.96-68.96) was significantly greater when. compared with that of two dose vaccination. Among students aged 11 years old or above, household contact history was significantly associated and MMR vaccination status was not associated. Conclusions : Low vaccination rate and vaccine failure were thought to predispose the population for this large outbreak. To prevent sustained mumps outbreaks, a second MMR vaccination should be encouraged and catch up vaccinations should be given to elderly children who remain susceptible.

• Archives of Plastic Surgery
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• 제46권6호
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• pp.572-579
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• 2019

Background Even with satisfactory anastomosis technique and adequate experience of the surgeon, flap loss due to thrombosis can still occur due to the patient's underlying condition. Patients with hypercoagulability due to etiologies such as malignancy, hereditary conditions, and acquired thrombophilia are among those who could benefit from free flap procedures. This review aimed to evaluate the risk of free flap thrombosis in patients with hypercoagulability and to identify the most effective thromboprophylaxis regimen. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The PubMed, Embase, and Cochrane Library databases were explored. Types of free flaps, types of hypercoagulable states, thrombosis prevention protocols, thrombosis complication rates, and flap vitality outcomes were reviewed. Samples from the included studies were pooled to calculate the relative risk of free flap thrombosis complications in patients with hypercoagulability compared to those without hypercoagulability. Results In total, 885 articles underwent title, abstract, and full-text screening. Six articles met the inclusion criteria. The etiologies of hypercoagulability varied. The overall incidence of thrombosis and flap loss in hypercoagulable patients was 13% and 10.3%, respectively. The thrombosis risk was two times higher in hypercoagulable patients (P=0.074) than in controls. Thromboprophylaxis regimens were variable. Heparin was the most commonly used regimen. Conclusions Hypercoagulability did not significantly increase the risk of free flap thrombosis. The most effective thromboprophylaxis regimen could not be determined due to variation in the regimens. Further well-designed studies should be conducted to confirm this finding.

• 지역사회간호학회지
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• 제21권1호
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• pp.71-81
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• 2010

Purpose: This study was to examine the effects of a depression intervention and suicide prevention program in adolescents with high risk of suicide. Methods: This research was designed as a nonequivalent control group pretest-posttest study. The participants were adolescents with high risk of suicide in mental health screening examination. A total of 40 adolescents (experimental group=21, control group=19) were sampled from C-gun, Chungbuk Province. The experimental group participated in the depression intervention and suicide prevention program for eight sessions while the control group did not participate in the program. Data were collected with a self-reporting structured questionnaire from November to December, 2008. SPSS/Win 12.0 was used for data analyses including chi-square test, t-test, and paired t-test. Results: After this program, there was no statistically significant difference in depression (t=1.498, p=.142) between the two groups, but depression decreased in the experimental group. There was a statistically significant difference in suicide ideation (t=2.058, p=.047). Conclusion: To decrease depression and suicide ideation in adolescents with high risk of suicide, it is necessary to offer this program in a more intensive course and for a longer period. Also, family consultation programs and individual case treatment and consultation programs should be offered.

• 한국안전학회지
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• 제33권1호
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• pp.148-161
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• 2018

A traffic fatality by young people marked average annual decrease of 4.5% since 2011. Meanwhile, a traffic fatality by senior over 65 years old marked average annual increase of 7.9% for the last five years which means that the annual increase of traffic fatality by senior will be a serious problem. This study started questioning that senior drivers over 65 years old did not retain the same causal factor of fatal traffic accidents and thus extensively analyzed a risk of it by age group quantitatively, dividing the senior driver group into the early, middle and latter stages. Depending on the aging level, the risk of traffic fatality showed a wide difference in seven different types of traffic accidents generally, and happened to increase with latter and middle parts of the senior driver more than the early part. Therefore, this study proposes four policy suggestions: 1) The senior driver need to be offered customized driving educations and the improvement of road environment is also recommended. 2) Political assistance is needed to support and guide a safety related technology installation for the new or existing car. 3) Renewal of driving license and an aptitude test(physical examination, cognitive test) for drivers over 75 years old should take in a less than 3 years and an additional road test is needed as occasion demands. 4) Like the United States and Europe, development and extension of customized treatment guidebook for medical teams who examine senior drivers is needed and establishment of education and administration system that a supervisor of driving license renewal can impose safety restriction and American anonymity reporting system is considered to institutionalize in the medium to longer term.

• Nutrition Research and Practice
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• 제1권3호
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• pp.231-236
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• 2007

Underreporting patterns by the level of obesity have not been fully assessed yet. The purpose of this study was to examine the differential underreporting patterns on cardiovascular risk factor, macronutrient, and food group intakes by the level of Body Mass Index (BMI). We analyzed cross-sectional baseline nutritional survey data from the population-based longitudinal study, the Healthy Women Study (HWS) cohort. Study subjects included 538 healthy premenopausal women participating in the HWS. Nutrient and food group intakes were assessed by the one-day 24-hour dietary recall and a semi-quantitative food frequency questionnaire, respectively. The ratio of reported energy intake (EI) to estimated basal metabolic rate (BMR) was used as a measure of relative energy reporting status and categorized into tertiles. Overweight group ($BMI{\geq}25kg/m^2$) had a higher ratio of EI to BMR (EI/BMR) than normal weight group ($BMI<25kg/m^2$). Normal weight and overweight groups showed similar patterns in cardiovascular risk factors, nutrient intake, and food group intake by the EI/BMR. Fat and saturated fat intakes as a nutrient density were positively associated with the EI/BMR. Proportion of women who reported higher consumption (${\geq}4\;times/wk$) of sugar/candy, cream and red meat groups was greater in higher tertiles of the EI/BMR in both BMI groups. Our findings suggest similar patterns of underreporting of cardiovascular risk factors, and macronutrient and food group intakes in both normal and overweight women.

• International Journal of Advanced Culture Technology
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• 제7권2호
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• pp.28-33
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• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

• 산경연구논집
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• 제12권3호
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• pp.43-49
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• 2021

Purpose: This study attempted to examine the risk of stock price plunge according to the firm's management strategy. Prospector firms value innovation and have high uncertainties due to rapid growth. There is a possibility of lowering the quality of financial reporting in order to meet market expectations while withstanding the uncertainty of the results. In addition, managers of prospector firms enter into compensation contracts based on stock prices, thus creating an incentive to withhold negative information disclosure to the market. Prospector firms' information opacity and delays in disclosure of negative information are likely to cause a sharp decline in share prices in the future. Research design, data and methodology: This study performed logistic analysis of KOSPI listed firms from 2014 to 2017. The independent variable is the strategic index, and is calculated by considering the six characteristics (R&D investment, efficiency, growth potential, marketing, organizational stability, capital intensity) of the firm. The higher the total score, the more it is a firm that takes a prospector strategy, and the lower the total score, the more it is a firm that pursues a defender strategy. In the case of the dependent variable, a value of 1 was assigned when there was a week that experienced a sharp decline in stock prices, and 0 when it was not. Results: It was found that the more firms adopting the prospector strategy, the higher the risk of a sharp decline in the stock price. This is interpreted as the reason that firms pursuing a prospector strategy do not disclose negative information by being conscious of market investors while carrying out venture projects. In other words, compensation contracts based on uncertainty in the outcome of prospector firms and stock prices increase the opacity of information and are likely to cause a sharp decline in share prices. Conclusions: This study's analysis of the impact of management strategy on the stock price plunge suggests that investors need to consider the strategy that firms take in allocating resources. Firms need to be cautious in examining the impact of a particular strategy on the capital markets and implementing that strategy.

• 대한한방부인과학회지
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• 제34권3호
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• pp.137-156
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• 2021

Objectives: The purpose of this study is to assess the effect of taking herbal medicine for the postpartum lactation. Methods: We searched 9 databases for recent three years, that contained four english, two chinese, one japanese and two korean database from September 17, 2016 to December 31, 2020. Randomized controlled trials (RCTs) were eligible. Measurement of outcome included total curative effective rate, volume of lactation, volume of milk supplement, and serum prolactin concentration. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Total 725 of studies was screened, 11 RCTs were finally selected. Number of participants per study ranged from 60 to 257. The treatment group of taking a herbal medicine is effective for improving total curative effective rate, volume of lactation, volume of milk supplement, and serum prolactin concentration compared with control group. Because most of the studies had considerable heterogeneity in terms of type of intervention and comparison for outcome measurement, meta analysis for quantitative analysis was impossible. Conclusions: This studies showed that taking a herbal medicine is effective on increasing volume of lactation and speeding up the start of the first breastfeeding. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for breastfeeding and reduce the risk of bias.

• 항공우주의학회지
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• 제29권2호
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• pp.67-71
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• 2019

The health of licence holders (flight crew members and air traffic controllers) is recognized as an important element of aviation safety. The medical emergency symptoms that occur during the flight duty period without prior notice can interfere with human performance capabilities and threaten aviation safety. To prevent this, ICAO has been required to conduct a periodic medical assessment process of licence holders including routine analysis of in-flight incapacitation events and medical findings during medical to identify areas of increased medical risk and continuous reevaluation of the medical assessment process to concentrate on identified areas of increased medical risk. The supply and demand of licence holders have become a major issue due to the increase in air traffic around the world, and the pilot retirement age has been extended to 65 years. But, there is no significant change in the aviation medical assessments process. The follow up of the result of medical examination discovered through aviation medical examination is a very important part, but it has not been properly implemented, and the sick leaves and medical inflight incapacitation reporting system should be improved. The management of health risk factors for licence holders must be implemented to prevent aircraft accidents or aviation safety problems caused by health problems. In this paper, we propose the development plan and concrete improvement plan of the health risk management system of licence holders in Korea in terms of aviation safety.