• 제목/요약/키워드: Risk Severity

검색결과 801건 처리시간 0.033초

신생아 괸리의 지역화 및 전원시스템 (Regionalization of neonatal care and neonatal transport system)

  • 신종범
    • Clinical and Experimental Pediatrics
    • /
    • 제50권1호
    • /
    • pp.1-6
    • /
    • 2007
  • In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.

Risk Factors Associated with Germinal Matrix-Intraventricular Hemorrhage in Preterm Neonates

  • Kim, Kwang-Ryeol;Jung, Sang-Won;Kim, Dong-Won
    • Journal of Korean Neurosurgical Society
    • /
    • 제56권4호
    • /
    • pp.334-337
    • /
    • 2014
  • Objective : The purpose of this study is to identify the risk factors associated with the development of germinal matrix-intraventricular hemorrhage (GM-IVH) and the relationship of the severity of disease and prematurity. Methods : A total of 168 premature neonates whose birth weight ${\leq}1500g$ or gestational age ${\leq}34$ weeks were examined by cranial ultrasound (CUS) for detection of GM-IVH among the babies admitted between January 2011 and December 2012 in our medical center neonatal intensive care unit. The babies were divided into two groups : GM-IVH and non-IVH. Clinical presentations, precipitating factors of the patients and maternal factors were analyzed. Results : In univariate analysis, gestational age, birth weight, delivery method, presence of premature rupture of membrane (PROM) and level of sodium and glucose were statistically meaningful factors (p<0.05). But only two factors, gestational age and presence of patent ductus arteriosus (PDA) were statistically meaningful in multivariate logistic regression (p<0.05). Delivery method [normal vaginal delivery (NVD) to Caeserean section] was borderline significant (p<0.10). Conclusion : Presence of PDA and gestational age were the important risk factors associated with development of GM-IVH.

줌카메라를 활용한 빗물받이 연결관의 도로함몰 리스크 분석 (Risk analysis of road cave-in of storm sewer lateral using zoom camera)

  • 한상종;황환국
    • 상하수도학회지
    • /
    • 제28권6호
    • /
    • pp.681-690
    • /
    • 2014
  • It is known that sewer problems are the major causes of road cave-in. The objective of this study is to analyze the risk of road cave-in due to storm sewer laterals. We investigated 174 storm sewer laterals using a zoom camera at O-dong area in Seoul. The causes of road cave-in were classified into five cases: breakage of rigid pipe, deformation of flexible pipe, out of pipeline alignment, changing pipe material or changing pipe diameter, and a poor linkage between lateral and sewer. In addition, all defects were sorted into five grades based on the severity rating at storm sewer laterals. In this study, the most fragile pipe materials were found to be concrete pipe and polyethylene pipe, which recorded 2.3 and 1.69 defect rates. With regard to the causes of road cave-in, deformation of flexible pipe has a large influence on road cave-in at present. On a long-term basis, the two causes, out of pipeline alignment and a poor linkage between lateral and sewer, could have more influence on road cave-in.

FMEA 기법 도입을 통한 병원 급식 품질 개선 사례 연구 - 배선서비스 품질 개선 및 환자만족도 중심으로 - (Case Study on Improvement of Hospital Foodservice by Introduction of FMEA Techniques - Focus on Food Delivery Service Quality and Customer Satisfaction -)

  • 김혜진;홍정임;허규진
    • 대한영양사협회학술지
    • /
    • 제21권1호
    • /
    • pp.25-36
    • /
    • 2015
  • In this study, we attempted to improve hospital food delivery service quality and customer satisfaction by using FMEA (Failure Mode and Effect Analysis), which is applied to the quality control of products in manufacturing plants. Subjective food delivery service quality improvement was judged based on a 5-point likert scale. Traditional FMEA uses an RPN (Risk priority number) to evaluate the risk level of a component or process. The RPN index was determined by calculating the product of severity, occurrence, and detection indexes. In our results, total RPN value (P<0.01) significantly decreased after FMEA introduction, whereas customer satisfaction (P<0.001) and food delivery service quality (P<0.001) significantly increased. Specifically, foodservice errors (P<0.01) and loss cost (P<0.01) were significantly improved by FMEA introduction. Taken together, we suggest that FMEA reduces critical activities and errors in foodservice delivery caused by simple priority selection.

자동차 정면충돌에서 자동차 영구 변형량에 따른 승객 상해 추정 (Estimation of Injury Severity of Occupant based on the Vehicle Deformation at Frontal Crash Accident)

  • 김승기;최형연
    • 한국자동차공학회논문집
    • /
    • 제21권2호
    • /
    • pp.63-71
    • /
    • 2013
  • The estimation of occupant injury risk at crash accident is one of the most important assessments for the vehicle crashworthiness performance. The design of safety devices such as occupant restraining system also depend on the kinematics of occupant and its injury risk. The real world in-depth accident investigation provides detailed and realistic information of vehicle damage and occupant injury as well as the accident conditions. This paper introduces a statistical analysis of NASS/CDS database and domestic accident data to correlate speed change, vehicle damage extend, and occupant injury at frontal crash. The maximum crush extend shows a linear relationship with the effective impact speed. The injury risks of the occupant with and without restraining were also respectively quantified with the crush extend. This result can be effectively used for the emergent rescue of crash victims with automatic crash notification system.

심부전 환자의 빈혈과 사망률 및 재입원 간의 관계에 대한 통합적 고찰 (Anemia as a Risk Factor of Mortality and Rehospitalization in Patients with Heart Failure : An Integrative Review)

  • 손연정;김보환
    • 중환자간호학회지
    • /
    • 제12권1호
    • /
    • pp.94-108
    • /
    • 2019
  • Purpose : Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF. Method: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018. Results: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis. Conclusion: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.

한국 성인의 저작문제와 우울증의 연관성 (Association between chewing problems and depression in Korean adults)

  • 이은선;도경이
    • 한국치위생학회지
    • /
    • 제19권5호
    • /
    • pp.753-763
    • /
    • 2019
  • Objectives: To examine the association between chewing problems and depression in a representative sample of Korean adults. Methods: This study included 4,887 participants aged 19 years or older. Chewing problems were self-reported. Depression was measured using the PHQ-9 scale, which scored the frequency of symptoms over the last two weeks. Logistic regression analysis was used to estimate the odds ratio (OR) and 95% confidence intervals (CI). Results: There was a significant positive correlation between chewing problems and depression. Compared to those without chewing problems, participants with chewing problems had a 1.62 times higher risk of mild depression (OR=1.62; 95% CI:1.29-2.05), a 2.27 times higher risk of moderate depression (OR=2.27; 95% CI:1.52-3.38), and a 6.15 times higher risk of severe depression (OR=6.15; 95% CI:2.31-16.37). Conclusions: Results of this study indicate a significant association between chewing problems and depression. In addition, chewing problems were found to have a stronger relationship with higher severity levels of depression.

The impacts of exercise on pediatric obesity

  • Headid, Ronald J. III;Park, Song-Young
    • Clinical and Experimental Pediatrics
    • /
    • 제64권5호
    • /
    • pp.196-207
    • /
    • 2021
  • Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.

Adverse Effects of Air Pollution on Pulmonary Diseases

  • Ko, Ui Won;Kyung, Sun Young
    • Tuberculosis and Respiratory Diseases
    • /
    • 제85권4호
    • /
    • pp.313-319
    • /
    • 2022
  • Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.

심장동맥조영술 후 협착에 미치는 대사증후군의 영향인자 분석 (Analysis of the Influential Factors for Metabolic Syndrome on Stenosis after Coronary Angiography)

  • 김규희;지태정
    • 대한방사선기술학회지:방사선기술과학
    • /
    • 제45권1호
    • /
    • pp.19-29
    • /
    • 2022
  • The study is conducted with the subjects who have under gone coronary angiography to examine the influential factors for the severity of coronary stenosis. Four indicators related to hypertension, diabetes, dyslipidemia, obesity of metabolic syndrome were used as influential factors. As a result of the study, metabolic syndrome such as diabetes and dyslipidemia had 3.3 times and 7.7 times higher chance to lead to 1VD, respectively. In 2VD, diabetes showed 2.9 times higher risk, and dyslipidemia showed 8.5 times higher risk. In 3VD, diabetes was found to be 5 times higher and dyslipidemia was 17.5 times higher in risk. Therefore, it was confirmed that dyslipidemia showed the highest correlation among metabolic syndromes. According to this study, it was confirmed that dyslipidemia and diabetes were closely related to the influential factors for coronary artery stenosis.