• Title/Summary/Keyword: Risk assessment program

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The effects of a personalized nutrition intervention program on food security, health and nutritional status of low-income older adults in Seoul city (서울시 일부 취약계층 노인에서 맞춤형 영양중재 프로그램에 따른 식품안정성 확보 및 건강·영양상태 개선 효과)

  • Lee, Yeyeon;Yang, Narae;Shin, Minjeong;Lee, Kyung-Eun;Yoo, Chang Hee;Kim, Kirang
    • Journal of Nutrition and Health
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    • v.53 no.4
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    • pp.416-430
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    • 2020
  • Purpose: This study was conducted to assess the effects of a personalized nutritional intervention program on food security and health and nutritional status of elderly people in the city of Seoul. Methods: A total of 372 elderly adults aged 65 years or above who resided in Seoul were enrolled in this study. Personalized supplementary food supply and nutritional education based on chronic disease status, disability and cooking ability were implemented for 4 months. To evaluate the effectiveness of the program, nutrient intake, food security status, anemia status, chronic disease management, and frailty status, and prevalence of malnutrition (Mini Nutritional Assessment) were examined. Results: After the program, all subjects displayed significantly increased nutrient intake. Before the intervention, all subjects were in a state of food insecurity; however, after the intervention, 37.1% of the subjects were food secure. Moreover, the rates of being at risk of malnutrition and malnutrition in subjects were decreased and instead rate of those who improved to normal increased to 29.8% from 0% of normal rate before the prevention. The rate of subjects without anemia increased from 18.7% to 28.5% after the intervention. In addition, the rate of subjects with intensive or periodic management of chronic diseases decreased, while those with occasional management of chronic diseases increased from 0% to 4.6%. Furthermore, the rates of being at risk of frailty and frailty were decreased and the normal rate increased from 0% to 9.7% instead. Age group-based analysis showed that elderly people over 80 years showed less improvement in the management of the chronic disease status and the frailty status. Conclusion: Personalized supplementary food supplies and nutritional education improved not only the nutritional status but also disease status in vulnerable older adults, and the effects were more significant in adults aged less than 80 years.

Evaluation of Gestational Age Median Value by Use of the Quad Test with Dimeric Inhibin A for Korea Pregnant Women (Inhibin-A를 추가한 Quad Test의 한국인 산모의 임신주수별 Median치에 대한 평가)

  • Yoo, Ja-Young;Choi, Sam-Kyu;Cho, Young-Suk;Hwang, Do-Young
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.1
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    • pp.56-60
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    • 2005
  • Human chorionic gonadotrophin (hCG) and unconjugated estriol (uE3) were added to AFP to make what is commonly known as the Triple test. The Triple test combines results from these three tests and has been a standard screening procedure for several years. Recent studies have demonstrated the usefulness of adding inhibin-A to Down's syndrome risk assessment. The Quad test adds dimeric Inhibin-A (DIA) to the three other markers and uses the same computer program to calculate risk factors. Testing was performed between 14 and 21 weeks of gestation. Sample size were 648 samples and period of study was from 1, July, 2004 to 30, September, 2004. Used analytical methods for AFP, hCG and uE3 were radioimmunoassay (RIA) and dimeric inhibin A was enzyme-linked immunosorbent assay (ELISA). Adding dimeric inhibin-A as a fourth marker to the standard triple test increases the detection rate from 62 % to 75 % with a false-positive rate of 5%. The DIA based Quad test has been shown to be the most effective second trimester screening test for Down's syndrome suitable for routine use. Increased DIA values are observed during normal pregnancy where a bimodal pattern response is seen. Values increase during the first trimester, decline after 14 weeks, and re-ascend between 17-25 weeks. Values for DIA may be additionally elevated during a Down's syndrome pregnancy. Dimeric inhibin A is a glycoprotein hormone made by the ovary and placenta. DIA levels are twice as high in Down's syndrome pregnancies. AFP, hCG, and uE3 levels vary with gestational age, and incorrect gestational dating will influence results. DIA levels do not vary substantially with gestational age, resulting in greater screening accuracy. Although the Quad test is an improvement over the Triple test, it is important to underscore the fact that a positive test on both should be done. Most women who initially screen positive will be found to be carrying normal babies when amniocentesis and definitive diagnostic chromosome analysis are done.

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Effects of Integrated Palliative Care Intervention on Quality of Life in Terminal Cancer Patients: A Meta-analysis (통합적 완화 돌봄 중재가 말기암환자의 삶의 질에 미치는 효과: 메타분석)

  • Jo, Kae Hwa;Park, Ae Ran;Lee, Jin Ju
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.136-147
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    • 2015
  • Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.

Level of Awareness of Cervical and Breast Cancer Risk Factors and Safe Practices among College Teachers of Different States in India: Do Awareness Programmes Have an Impact on Adoption of Safe Practices?

  • Shankar, Abhishek;Rath, G.K.;Roy, Shubham;Malik, Abhidha;Bhandari, Ruchir;Kishor, Kunal;Barnwal, Keshav;Upadyaya, Sneha;Srivastava, Vivek;Singh, Rajan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.927-932
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    • 2015
  • Background: Breast and cervical cancers are the most common causes of cancer mortality among women in India, but actually they are largely preventable diseases. Although early detection is the only way to reduce morbidity and mortality, there are limited data on breast and cervical cancer knowledge, safe practices and attitudes of teachers in India. The purpose of this study is to assess the level of awareness and impact of awareness programs in adoption of safe practices in prevention and early detection. Materials and Methods: This assessment was part of a pink chain campaign on cancer awareness. During cancer awareness events in 2011 at various women colleges in different parts in India, a pre-test related to cervical cancer and breast cancer was followed by an awareness program. Post-tests using the same questionnaire were conducted at the end of the interactive session, at 6 months and 1 year. Results: A total of 156 out of 182 teachers participated in the study (overall response rate was 85.7 %). Mean age of the study population was 42.4 years (range- 28-59 yrs). There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of breast self examination (BSE) was significantly more frequent in comparison to CBE, mammography and the Pap test. Magazines and newspapers were sources for knowledge regarding screening tests for breast cancer in more than 60% of teachers where as more than 75% were educated by doctors regarding the Pap test. Post awareness at 6 months and 1 year, there was a significant change in alcohol and smoking habits. Major reasons for not doing screening test were found to be ignorance (50%), lethargic attitude (44.8%) and lack of time (34.6%). Conclusions: Level of knowledge of breast cancer risk factors, symptoms and screening methods was high as compared to cervical cancer. There was a significant increase in level of knowledge regarding cervical and breast cancer at 6 months and this was sustained at 1 year. Adoption of BSE was significantly greater in comparison to CBE, mammography and the Pap test. To inculcate safe practices in lifestyle of people, awareness programmes such as pink chain campaign should be conducted more widely and frequently.

A Study for the Appropriateness of the Different Reference Points in the Analysis of Working Posture

  • Kim, Day-Sung;Kim, Chol-Hong
    • Journal of the Ergonomics Society of Korea
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    • v.30 no.5
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    • pp.637-644
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    • 2011
  • Objective & Background: When applying various evaluation tools that analyze work posture risk through observation, accurate measurement of body flexion angle is very important. Method: This study investigated differences and appropriateness of 5 different existing reference points commonly used in the analysis of the work posture. Twenty five ergonomist and trained professionals were participated in this study. A Same flexion angle was utilized for the evaluation of risk assessment of musculoskeletal disorders using five different reference points to investigate the degree of difference between them. To investigate how different the observers' preferred flexion angle measuring methods were compared to the ISO 11226 Reference Posture, a virtual body model was constructed using the Poser 6.0 program. Six types of body flexion postures were constructed, and since neck flexion differs according to body angle, five types of neck flexion postures were constructed with the trunk bending $20^{\circ}$ forward, making up a total of 30 virtual flexion postures. Results: Results showed that the observers used personally preferred reference points instead of reference points recommend in the evaluation tools. Also the results revealed the their seems to be 6 types of flexion angle for the trunk and 11 types of measurement methods for the neck flexion angle in the form of personally preferred reference points. The results showed that a mean difference of $14^{\circ}$($4{\sim}23^{\circ}$) occurred in the trunk, and a mean difference of $20^{\circ}$($-8{\sim}51^{\circ}$) occurred in the neck. To increase accuracy when using the 5 evaluation tools in combination, the ISO 11226 standards, observers' preferred flexion posture standards, and common flexion posture standards of the evaluation tools were compared with the reference points of the 5 evaluation tools. Results showed considerable variance in angle difference for each evaluation tool. Conclusion: According to the results of this study, considering the angle difference between the flexion angle reference points of the evaluation tool and the reference points selected by the observers, it is concluded that instead of personally preferred reference points, the standardized reference points to enhance the accuracy and the objectivity. Application: The result of this study can be used as reference guide to develop the standardized reference point in the future.

2020 Korean Dietary Reference Intakes of selenium and a review of selenium database of foods by evaluating of selenium contents of the recommended menus (셀레늄의 2020 한국인 영양소 섭취기준 개정 및 권장식단의 셀레늄 함량 평가를 통한 식품의 셀레늄 데이터베이스 검토)

  • Choi, Kyungsuk;Lee, Okhee
    • Journal of Nutrition and Health
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    • v.55 no.4
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    • pp.430-440
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    • 2022
  • Selenium is an important trace mineral that plays an essential role in maintaining the body's immunity with oxidative stress defense and antioxidant activity, immunity, thyroid hormone control, defense against drug or heavy metal harm, and reducing the risk of chronic diseases. A selenium deficiency increases the risk of various chronic diseases, such as cancer, cardiovascular disease, diabetes, neurological disease, osteoarthritis, muscle necrosis and weakness, thyroid disease, and inflammatory diseases. This paper explains the criteria for establishing and revising selenium in the 2020 Dietary Reference Intake for Koreans (KDRIs) and reviews the current status of the selenium database and suggestions for setting the 2025 KDRIs in the future. In the 2020 KDRIs, the selenium intake with the maximum plasma selenoprotein P level was used as the criteria. The weight and coefficient of the variation were applied to the Chinese' reported values. Compared to 2015 KDRIs, there were some revisions in the selenium dietary reference intakes by gender and age according to the change in reference weight. To improve and revise selenium dietary reference intakes in the future, a selenium intervention study is needed to determine the maximum level of plasma selenoprotein P in Koreans. In addition, a revision of the selenium database of the nutritional assessment program (CAN-Pro 5.0) is needed. An analysis of the selenium content of foods should be expanded to assess the selenium intake accurately. In addition, research on the relationship between selenium intake and the biological indicators in the body is required for healthy people and subjects of special environments, such as patients and athletes with various oxidative stress.

Development of a Breast Cancer Awareness Scale for Thai Women: Moving towards a Validated Measure

  • Rakkapao, Nitchamon;Promthet, Supannee;Moore, Malcolm A;Hurst, Cameron P
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.851-856
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    • 2016
  • Background: Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. Objective: The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. Materials and Methods: This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. Results: A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index < 0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's ${\alpha}=0.86$). Conclusions: The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.

Identification of Introduced Gene and Its Expression and Gene Stability Assessment for Event Selection of Genetically Modified Plant toward Approval: Cucumber Mosaic Virus Resistant Hot Pepper (상업용 유전자 변형작물 이벤트 선발을 위한 도입유전자 확인, 발현 및 세대간 안정성 평가 : 오이모자이크바이러스 저항성 GM 고추)

  • Kang, Seung-Won;Han, Bal-Kum;Lee, Tae-Ho;Kim, Eun-Ji;Lee, Gung-Pyo
    • Horticultural Science & Technology
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    • v.30 no.2
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    • pp.192-200
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    • 2012
  • For the development of genetically modified plants, it is important to verify various factors which potentially affect the risk assessment as well as to establish an experimental program to produce scientific and reliable data. However, it is a time and cost consuming process to develop GM plants as well as to prepare scientific and convincible data for government's approval. Therefore, using the transgenic hot pepper tolerant to a new CMV pathotype, we attempted to suggest few methodological procedures, such as probe saturation for southern blot analysis and RT-PCR and ELISA for expression analysis, for identification and stability evaluation of inserted gene in genetically modified plant which are required for submission for approval. Ten partially overlapped probes covering full length of inserted gene were produced. We could identify that the inserted gene was stacked as a single copy as well as no partial element existed. Also, we could identify the stability of the inserted gene stacked in hot pepper using probe saturation. In the expression analysis with RT-PCR and ELISA, we also could provide the stable expression of transcript and proteins in leaves and placenta and pericarp of fruits of the CMV-resistant hot pepper.

MAKING AGRICULTURAL INSURANCE IN INDIA FARMER-FRIENDLY AND CLIMATE RESILIENT

  • Kumar, K. Nirmal Ravi
    • Agribusiness and Information Management
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    • v.11 no.1
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    • pp.27-39
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    • 2019
  • Agricultural risks are exacerbated by a variety of factors ranging from climatevariability and change, frequent natural disasters, uncertainties in yields and prices, weakrural infrastructure, imperfect markets and lack of financial services including limited spanand design of risk mitigation instruments such as credit and insurance. Indian agriculture has little more than half (53%) of its area still rainfed and this makes it highly sensitive to vagaries of climate causing unstable output. Besides adverse climatic factors, there are man-made disasters such as fire, sale of spurious seeds, adulteration of pesticides and fertilizers etc., and all these severely affect farmers through loss in production and farm income, and are beyond the control of farmers. Hence, crop insurance' is considered to be the promising tool to insulate the farmers from risks faced by them and to sustain them in the agri-business. This paper critically evaluates the performance of recent crop insurance scheme viz., Pradhan Mantri Fasal Bhima Yojana (PMFBY) and its comparative performance with earlier agricultural insurance schemes implemented in the country. It is heartening that, the comparative performance of PMFBY with earlier schemes revealed that, the Government has definitely taken a leap forward in covering more number of farmers and bringing more area under crop insurance with the execution of this new scheme and on this front, it deserves the appreciation in fulfilling the objective for bringing more number of farmers under insurance cover. The use of mobile based technology, reduced number of Crop Cutting Experiments (CCEs) and smart CCEs, digitization of land record and linking them to farmers' account for faster assessment/settlement of claims are some of the steps that contributed for effective implementation of this new crop insurance scheme. However, inadequate claim payments, errors in loss/yield assessment, delayed claim payment, no direct linkage between insurance companies and farmers are the major shortcomings of this scheme. This calls for revamping the crop insurance program in India from time to time in tune with the dynamic changes in climatic factors on one hand and to provide a safety-net for farmers to mitigate losses arising from climatic shocks on the other. The future research avenues include: insuring the revenue of the farmer (Price × Yield) as in USA and more and more tenant farmers should be brought under insurance by doling out discounts for group coverage of farmers like in Philippines where 20 per cent discount in premium is given for a group of 5-10 farmers, 30 per cent for a group of 10-20 and 40 per cent for a group of >20 farmers.

U.S. Policy and Current Practices for Blending Low-Level Radioactive Waste for Disposal (저준위 방사성폐기물의 혼합 관련 미국의 정책과 실제 적용)

  • Kessel, David S.;Kim, Chang-Lak
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.14 no.3
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    • pp.235-243
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    • 2016
  • In the near future, many countries, including the Republic of Korea, will face a significant increase in low level radioactive waste (LLW) from nuclear power plant decommissioning. The purpose of this paper is to look at blending as a method for enhancing disposal options for low-level radioactive waste from the decommissioning of nuclear reactors. The 2007 U.S. Nuclear Regulatory Commission strategic assessment of the status of the U.S. LLW program identified the need to move to a risk-informed and performance-based regulatory approach for managing LLW. The strategic assessment identified blending waste of varying radionuclide concentrations as a potential means of enhancing options for LLW disposal. The NRC's position is that concentration averaging or blending can be performed in a way that does not diminish the overall safety of LLW disposal. The revised regulatory requirements for blending LLW are presented in the revised NRC Branch Technical Position for Concentration Averaging and Encapsulation (CA BTP 2015). The changes to the CA BTP that are the most significant for NPP operation, maintenance and decommissioning are reviewed in this paper and a potential application is identified for decommissioning waste in Korea. By far the largest volume of LLW from NPPs will come from decommissioning rather than operation. The large volumes in decommissioning present an opportunity for significant gains in disposal efficiency from blending and concentration averaging. The application of concentration averaging waste from a reactor bio-shield is also presented.