• Title/Summary/Keyword: Risk Severity

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Risk Factors Associated with Clinical Insomnia in Chronic Low Back Pain: A Retrospective Analysis in a University Hospital in Korea

  • Kim, Shin Hyung;Sun, Jong Min;Yoon, Kyung Bong;Moon, Joo Hwa;An, Jong Rin;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.137-143
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    • 2015
  • Background: Insomnia is becoming increasingly recognized as a clinically important symptom in patients with chronic low back pain (CLBP). In this retrospective study, we have determined risk factors associated with clinical insomnia in CLBP patients in a university hospital in Korea. Methods: Data from four-hundred and eighty one CLBP patients was analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ${\geq}15$). Patients' demographics and pain-related factors were evaluated by logistic regression analysis to identify risk factors of clinical insomnia in CLBP. Results: It was found that 43% of patients reported mild to severe insomnia after the development of back pain. In addition, 20% of patients met the criteria for clinically significant insomnia (ISI score ${\geq}15$). In a stepwise multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain and neuropathic pain components, and high level of depression were strongly associated with clinical insomnia in CLBP. Among these factors, the presence of comorbid musculoskeletal pain other than back pain was the strongest determinant, with the highest odds ratio of 8.074 (95% CI 4.250 to 15.339) for predicting clinical insomnia. Conclusions: Insomnia should be addressed as an integral part of pain management in CLBP patients with these risk factors, especially in patients suffering from CLBP with comorbid musculoskeletal pain.

Risk Factors for Falls in the Elderly Population in Korea: An Analysis of the Third Korea National Health and Nutrition Examination Survey data (우리나라 65세 이상 노인들의 낙상사고 관련 요인 - 국민건강영양조사 결과를 이용하여)

  • Kim, Jong-Min;Lee, Myung-Sun
    • Korean Journal of Health Education and Promotion
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    • v.24 no.4
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    • pp.23-39
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    • 2007
  • Objective: The objective of this study is to identify the risk factors for falls among the Korean elderly population. Methods: We analyzed the data on 167 persons of 65 years of age or older who have experienced falls drawn from the Third Korea National Health and Nutrition Examination Survey. We conducted a cross-tabulation analysis and logistic regression analysis of the impact of the socio-demographic characteristics, health-related behavior, mobility, and morbidity upon the frequencies of falls. Results: Among the socio-demographic characteristics, gender(p<0.001), marital status(p<0.1), and the type of medical insurance(<0.1) were found to be statistically significant, Among the constraints on mobility, the severity of walking problems, (p<0.001) and depression(p<0.05) proved to be significant, As for variables related to health-related behavior, the level of routine physical activities (p<0.001) was found significant, Finally, rheumatism(p<0.1), osteoporosis(p<0.05), diabetes(p<0.1), urinary incontinence(p<0.01) were also significant. A logistic regression analysis of the incidence of falls revealed that urinary incontinence was the most important risk factor with an odds ratio of 2.7. Conclusion: Although a variety of factors affect the frequencies of falls in the elderly population, urinary incontinence proved to be the single most important risk factor. This finding implies that education for fall prevention is crucial for those with urinary incontinence.

PREVALENCE AND ASSOCIATED RISK FACTORS OF DENTAL EROSION IN 9- AND 10-YEAR-OLD CHILDREN IN BUSAN (부산시에 거주하는 9~10세 어린이의 치아침식증 유병률과 관련된 위험요소)

  • Yu, Seong Goo;Lee, Chang Han;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.1
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    • pp.11-20
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    • 2013
  • The prevalence and interest of dental erosion seems to be rising in children all over the world. Thus, This study was performed to investigate the prevalence and severity of dental erosion in the primary molars at terminal stage nearing exfoliation, and associated risk factors. An examination was performed on 788 children using modified Linkosalo & Markkanen system, and questionnaires were gained. Association between dental erosion and the risk factors were statistically analyzed with chi-squared test and logistic regression analysis at a significance level of p < 0.05. As a result, 213 children (27%) showed dental erosion, and the mandibular left first primary molar was the most influenced tooth. According to the analysis of risk factors, frequent intake of carbonated drinks and fruit juices showed significant development of erosion (p < 0.05), and using straw for drinking fruit juices showed significant a reduction of erosion (p < 0.05).

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.

Markov-based time-varying risk assessment of the subway station considering mainshock and aftershock hazards

  • Wei Che;Pengfei Chang;Mingyi Sun
    • Earthquakes and Structures
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    • v.24 no.4
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    • pp.303-316
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    • 2023
  • Rapid post-earthquake damage estimation of subway stations is particularly necessary to improve short-term crisis management and safety measures of urban subway systems after a destructive earthquake. The conventional Performance-Based Earthquake Engineering (PBEE) framework with constant earthquake occurrence rate is invalid to estimate the aftershock risk because of the time-varying rate of aftershocks and the uncertainty of mainshock-damaged state before the occurrence of aftershocks. This study presents a time-varying probabilistic seismic risk assessment framework for underground structures considering mainshock and aftershock hazards. A discrete non-omogeneous Markov process is adopted to quantify the time-varying nature of aftershock hazard and the uncertainties of structural damage states following mainshock. The time-varying seismic risk of a typical rectangular frame subway station is assessed under mainshock-only (MS) hazard and mainshock-aftershock (MSAS) hazard. The results show that the probabilities of exceeding same limit states over the service life under MSAS hazard are larger than the values under MS hazard. For the same probability of exceedance, the higher response demands are found when aftershocks are considered. As the severity of damage state for the station structure increases, the difference of the probability of exceedance increases when aftershocks are considered. PSDR=1.0% is used as the collapse prevention performance criteria for the subway station is reasonable for both the MS hazard and MSAS hazard. However, if the effect of aftershock hazard is neglected, it can significantly underestimate the response demands and the uncertainties of potential damage states for the subway station over the service life.

Effective Risk Communication Strategies for N-Nitrosamines in Rubber Balloons (고무풍선 중 니트로스아민류의 효과적 위해성 소통 전략에 관한 연구)

  • Hyunkyung Kim;Kiyoung Lee
    • Journal of Environmental Health Sciences
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    • v.49 no.4
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    • pp.228-235
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    • 2023
  • Background: As the public interest in chemical substances found in daily life has increased, environmental health education content has been developed and related studies have been conducted. However, there is still insufficient research on methodologies for environmental health education. Objectives: This study aimed to explore risk communication strategies by focusing on N-nitrosamines in rubber balloons. Methods: In this study, two different health messages were composed: a gain-framed message emphasizing the advantages of practicing the health behavior and a loss-framed message emphasizing the negative consequences of not practicing the health behavior. The effect of the message containing risk information was evaluated by measuring the health beliefs and health behavior potential for female caregivers. As the Environmental Health Act defines a child as "a person under the age of 13," a total of 131 women with children under the age of 13 were studied. Results: The age, awareness, and interest of the participants in the gain frame group and these in the loss frame group were similar. In terms of message framing effect, the gain-framed message was more effective in terms of health belief and potential health behavior than was the loss-framed message. As a result of an independent t-test, among the six variables of health belief model the message effect was statistically significant at the level of p<0.05 in three variables: perceived severity (t=2.287, df=129, p=0.024), self-efficacy (t=2.123, df=129, p=0.036), and health behavior potential (t=2.094, df=129, p=0.038). Conclusions: This study presented a direction for effective environmental health education by studying the effects of risk communication messages based on scientific evidence. It is necessary to extend the scope of environmental health education research by expanding research into various household products.

Automated Prioritization of Construction Project Requirements using Machine Learning and Fuzzy Logic System

  • Hassan, Fahad ul;Le, Tuyen;Le, Chau;Shrestha, K. Joseph
    • International conference on construction engineering and project management
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    • 2022.06a
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    • pp.304-311
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    • 2022
  • Construction inspection is a crucial stage that ensures that all contractual requirements of a construction project are verified. The construction inspection capabilities among state highway agencies have been greatly affected due to budget reduction. As a result, efficient inspection practices such as risk-based inspection are required to optimize the use of limited resources without compromising inspection quality. Automated prioritization of textual requirements according to their criticality would be extremely helpful since contractual requirements are typically presented in an unstructured natural language in voluminous text documents. The current study introduces a novel model for predicting the risk level of requirements using machine learning (ML) algorithms. The ML algorithms tested in this study included naïve Bayes, support vector machines, logistic regression, and random forest. The training data includes sequences of requirement texts which were labeled with risk levels (such as very low, low, medium, high, very high) using the fuzzy logic systems. The fuzzy model treats the three risk factors (severity, probability, detectability) as fuzzy input variables, and implements the fuzzy inference rules to determine the labels of requirements. The performance of the model was examined on labeled dataset created by fuzzy inference rules and three different membership functions. The developed requirement risk prediction model yielded a precision, recall, and f-score of 78.18%, 77.75%, and 75.82%, respectively. The proposed model is expected to provide construction inspectors with a means for the automated prioritization of voluminous requirements by their importance, thus help to maximize the effectiveness of inspection activities under resource constraints.

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Prevalence and Risk Factors of Post-Stroke Depression (뇌졸중후우울증의 유병율 및 예측인자)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Kim, Joon-Tae;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Mood & Emotion
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    • v.9 no.2
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    • pp.57-63
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    • 2011
  • Objectives : This study aimed to investigate the prevalence and risk factors of depression within two weeks after stroke. Methods : A total of 362 stroke patients were recruited. Depression (major and minor depressive disorders) was diagnosed by applying DSM-IV criteria. Data on socio-demographic characteristics (age, gender, education, marital state, living state, religion, occupation, income, life event, and social support), stroke severity (NIHSS), disability (BI), stroke hemisphere and location, vascular risk and disease, and previous history of stroke and depression were obtained. Results : Depression was present in 90 (24.9%) patients: major depression 29 (8%) and minor depression 61 (16.9%) patients. In the univariate analyses, depression was associated with older age, higher number of stressful life event, poorer social support, severe disability, anterior stroke location, previous history of stroke and depression. In the multivariate analyses, depression was independently associated with higher number of stressful life events and poorer social support. Conclusion : Depression was common and was determined by premorbid levels of stress and social support in stroke patients at acute stage. More intensive psychiatric care and intervention is needed for the high risk group.

Cardiovascular Autonomic Neuropathy Predicts Higher HbA1c Variability in Subjects with Type 2 Diabetes Mellitus

  • Yang, Yeoree;Lee, Eun-Young;Cho, Jae-Hyoung;Park, Yong-Moon;Ko, Seung-Hyun;Yoon, Kun-Ho;Kang, Moo-Il;Cha, Bong-Yun;Lee, Seung-Hwan
    • Diabetes and Metabolism Journal
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    • v.42 no.6
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    • pp.496-512
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    • 2018
  • Background: This study aimed to investigate the association between the presence and severity of cardiovascular autonomic neuropathy (CAN) and development of long-term glucose fluctuation in subjects with type 2 diabetes mellitus. Methods: In this retrospective cohort study, subjects with type 2 diabetes mellitus who received cardiovascular autonomic reflex tests (CARTs) at baseline and at least 4-year of follow-up with ${\geq}6$ measures of glycosylated hemoglobin (HbA1c) were included. The severity of CAN was categorized as normal, early, or severe CAN according to the CARTs score. HbA1c variability was measured as the standard deviation (SD), coefficient of variation, and adjusted SD of serial HbA1c measurements. Results: A total of 681 subjects were analyzed (294 normal, 318 early, and 69 severe CAN). The HbA1c variability index values showed a positive relationship with the severity of CAN. Multivariable logistic regression analysis showed that CAN was significantly associated with the risk of developing higher HbA1c variability (SD) after adjusting for age, sex, body mass index, diabetes duration, mean HbA1c, heart rate, glomerular filtration rate, diabetic retinopathy, coronary artery disease, insulin use, and anti-hypertensive medication (early CAN: odds ratio [OR], 1.65; 95% confidence interval [CI], 1.12 to 2.43) (severe CAN: OR, 2.86; 95% CI, 1.47 to 5.56). This association was more prominent in subjects who had a longer duration of diabetes (>10 years) and lower mean HbA1c (<7%). Conclusion: CAN is an independent risk factor for future higher HbA1c variability in subjects with type 2 diabetes mellitus. Tailored therapy for stabilizing glucose fluctuation should be emphasized in subjects with CAN.

A Study on the Corporate Portfolio Risk Management for Multinational Construction Company (대형건설업체의 해외건설공사 포트폴리오 리스크 관리에 관한 연구)

  • Han Seung-Heon;Lee Young;Kim Hyung-Jin;Ock Jong-Ho
    • Korean Journal of Construction Engineering and Management
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    • v.2 no.2 s.6
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    • pp.68-80
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    • 2001
  • While opportunities for international construction firms have been growing with globalization, the risk of international construction projects is significantly increasing in severity and complexity. However, the traditional risk management approach in the construction industry has maintained a profit focus. In addition, this approach has not considered the overall risk at the corporate level, but rather has focused only on the risk of individuals at the project level. Corporate risk management should be implemented from the initial stages of new project selection. This paper suggests the Multi-criteria Integrated Systematic Analysis as a strategic decision-making tool for international construction contractors. The model integrates the multi-criteria of risk, return, and efficiency to choose the optimal set of new portfolios at the corporate level. This model also introduces the Value at Risk (VaR) concept to the international construction industry to present the total risk at the corporate level. To validate this model, this paper tested an experimental case study using the historical data of a global general contractor.

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