• Title/Summary/Keyword: Risk management factors

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Evaluation of Peri-procedural Anticoagulation Drug Therapy undergoing Radiofrequency Ablation in Patients with Atrial Fibrillation (심방세동 환자의 고주파 도자절제술 전.후의 항응고약물요법 사용실태 분석)

  • Kim, Su-Hyun;An, Sung-Shim;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.159-164
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    • 2010
  • Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the $1^{st}$-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were $2.1{\pm}0.6$ in Group A and $2.2{\pm}0.7$ in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: 'omission in taking medication, stressfulness and headache, 'increased intake of high vitamin K foods', 'lifestyle change of increased physical activities', and 'increase of food-intakes'. To the contrary, 36 cases of increased INR were: 'reduce of food-intake', 'use of non-prescription drugs', 'reduction in physical activities', and 'excessive restriction on food-intake', consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation.

Breast Cancer Characteristics and Survival Differences between Maori, Pacific and other New Zealand Women Included in the Quality Audit Program of Breast Surgeons of Australia and New Zealand

  • Campbell, Ian;Scott, Nina;Seneviratne, Sanjeewa;Kollias, James;Walters, David;Taylor, Corey;Roder, David
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2465-2472
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    • 2015
  • Background: The Quality Audit (BQA) program of the Breast Surgeons of Australia and New Zealand (NZ) collects data on early female breast cancer and its treatment. BQA data covered approximately half all early breast cancers diagnosed in NZ during roll-out of the BQA program in 1998-2010. Coverage increased progressively to about 80% by 2008. This is the biggest NZ breast cancer database outside the NZ Cancer Registry and it includes cancer and clinical management data not collected by the Registry. We used these BQA data to compare socio-demographic and cancer characteristics and survivals by ethnicity. Materials and Methods: BQA data for 1998-2010 diagnoses were linked to NZ death records using the National Health Index (NHI) for linking. Live cases were followed up to December $31^{st}$ 2010. Socio-demographic and invasive cancer characteristics and disease-specific survivals were compared by ethnicity. Results: Five-year survivals were 87% for Maori, 84% for Pacific, 91% for other NZ cases and 90% overall. This compared with the 86% survival reported for all female breast cases covered by the NZ Cancer Registry which also included more advanced stages. Patterns of survival by clinical risk factors accorded with patterns expected from the scientific literature. Compared with Other cases, Maori and Pacific women were younger, came from more deprived areas, and had larger cancers with more ductal and fewer lobular histology types. Their cancers were also less likely to have a triple negative phenotype. More of the Pacific women had vascular invasion. Maori women were more likely to reside in areas more remote from regional cancer centres, whereas Pacific women generally lived closer to these centres than Other NZ cases. Conclusions: NZ BQA data indicate previously unreported differences in breast cancer biology by ethnicity. Maori and Pacific women had reduced breast cancer survival compared with Other NZ women, after adjusting for socio-demographic and cancer characteristics. The potential contributions to survival differences of variations in service access, timeliness and quality of care, need to be examined, along with effects of comorbidity and biological factors.

Factors Affecting Coffee Intake in Korean Adults (한국 성인의 커피 섭취량에 영향을 미치는 요인)

  • Kim, Myung-Gwan;Kim, Seung-Dae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.529-536
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    • 2020
  • This study aims to provide the basic data for coffee intake and health promotion by examining the conditions in which Korean adults consume the most coffee. The study used raw data from the second year of the 7th National Health and Nutrition Examination Survey (2017), and 3,325 subjects who were 19 years of age or older and who were not missing the required values. This number used as the average amount of coffee drank per day in the past year is at least one cup. In order to identify factors that affect coffee intake, the model included general characteristics such as gender, age, household income, education level, occupation, health behaviors such as smoking, drinking, high intensity and moderate intensity exercises, walking, physical activity during work and leisure, sleep time, stress and depression. The results showed that coffee intake was lower among women than men, coffee intake was higher for people 40-64 years than people 20-39 years old, physical occupations rather than non-physical occupations, smokers rather than non-smokers, and for high stress rather than low stress in life. Subjects with these factors are considered to be at risk of excessive caffeine intake from coffee. The risk group of this study should be studied for the effect of excessive consumption of coffee on personal health.

Hazard Factors Assessment for the Fishermen's Safety on the Vessel of Offshore Stow Nets on Anchor using Insurance Proceeds Payment of NFFC (수협 재해 보험급여를 이용한 근해안강망 어선원의 안전 위험 요소 평가)

  • LEE, Yoo-Won;CHO, Young-Bok;KIM, Sung-Ki;KIM, Seok-Jae;PARK, Tae-Geun;RYU, Kyong-Jin;KIM, Wook-Sung
    • Journal of Fisheries and Marine Sciences Education
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    • v.27 no.4
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    • pp.1129-1135
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    • 2015
  • The stow net is a stationary gear made from netting, usually in shape like trawl net without wings. The nets are fixed by means of anchors, placed according to the direction and strength of the current. And the commercial fishing is associated with high rate of fatal and non-fatal occupational injury. The hazard factors analysis for the fishermen's safety of offshore stow nets vessel was conducted to serve as a basic data for improving the healthy and safe working environment of fishermen using fishermen's occupational accidents of the national federation of fisheries cooperatives (NFFC) from 2012 to 2014 (n=1,144). As a result, the average occupational accident occurrence rate of this fishery was 206.9‰ in all industries 36.9 times the rate of that. In addition, average death and missing rate was found to have a very serious level management to 50.4‰ in all industries of death of 42.0 times. The accident occurred in 84.5 to 94.6% was happened at sea. The struck by object, slipping, contact with machinery, contact by object or gear and others occurred more frequently in order on the frequency of accident occurrence pattern. However, the occurrence rate of death and missing did not match the frequency of accident pattern. In other words, slipping occurred frequently higher while death and missing risk was not high. And the contact with fishing gear and fall in the waters was low while death and missing risk was high. The results are expected to contribute for identification and assessment of safety hazard occurred in offshore stow nets vessel.

Factors Associated with Early Death in Patients with Community-Acquired Pneumonia (지역사회획득폐렴에서 조기 사망과 관련된 인자)

  • Park, Hun-Pyo;Seo, Yong-Woo;Lee, Jeong-Eun;Kim, Young-Ho;Jang, Young-Yun;Park, Soon-Hyo;Seo, Chang-Kyun;Jeon, Young-June;Lee, Mi-Young;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.6
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    • pp.607-613
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    • 2005
  • Background : Early death is an important problem associated with the management of community-acquired pneumonia. However, there is little information on the risk factors associated with it. The aim of this study was to identify the factors associated with early death in community-acquired pneumonia patients. Methods : From January 1999 to July 2004, 1,487 adult patients with community-acquired pneumonia who were admitted to the pulmonary department via emergency center were examined. Early death was defined as those who died within 2 days of hospitalization. The clinical and laboratory aspects of the patients who died early (n = 30) were compared with those of an age and gender matched control population (n = 60). Results : In the early death group, respiratory rate, heart rate, and blood urea nitrogen (BUN) were significant higher (p < 0.05 for all), while the arterial pH, systolic pressure, and $PaO_2$ were significant lower (p < 0.05 for all) than the control. The independent factor significantly associated with early death was tachypnea (OR, 7.049). Conclusion : The importance of an early clinical assessment in emergency center with community-acquired pneumonia needs to be emphasized in order to recognize patients at risk of early death.

Analysis on Determinants of Acceptance Intention of New Agricultural Technology: Using Innovation Resistance Model (농업 신기술 도입의향에 대한 결정요인 분석: 혁신저항모델을 이용하여)

  • Kim, Woong;Kim, Hong-Ki;Yu, Young-Seok;Noh, Jaejong;Chae, Yong-Woo;Choi, Jong-San
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.190-199
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    • 2019
  • This study was conducted to expand the distribution of new technology efficiently by analyzing the structure relationship based on the innovation resistance model and partial least square structural equation model (PLS-SEM). This study selected innovative propensity, relative advantage, compatibility, complexity, trialability, risk, and extension service consisting of educational, technical, and funding services as factors affecting innovation resistance. This study constructed a questionnaire that measured 11 factors including acceptance intention of new technology using 33 indicators. Data was from April to October, 2017, targeting 180 farmers who did not join in projects to spread new technologies of the Rural Development Administration. Results showed the factors positively and significantly affecting innovation resistance include complexity and risk. Innovative propensity did not have any effect on innovation resistance. However, it positively affected acceptance intention of new technology. The service of the extension organizations had a negative effect on innovation resistance, but did not affect acceptance intention of new technology. This study suggests that extension services should promote activities such as education, consulting, publicity and pilot projects related with new technologies in order to minimize the antipathy toward new agricultural technologies.

Oral Health and Oral Health Behavior as Risk Factors for Depression (우울증에 대한 구강건강 및 관리행태 위험요인)

  • Lee, Kyung Hee
    • Science of Emotion and Sensibility
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    • v.24 no.3
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    • pp.17-26
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    • 2021
  • This study investigated the association between depression and oral health and the factors influencing depression in adults. Data on 13,199 people (male 5,793, female 7,406; age ≥19 years old) were extracted from the Korean National Health and Nutrition Examination Survey VIII (KNHANES VIII) (2016~2018) and analyzed using frequency, percentage, an x2 test, a T-test, and logistic regression analysis. Depression was defined as either a medical diagnosis or a score ≥10 on Patient Health Questionnaire-9. The probability of depression was found to be statistically different for general characteristics, such as gender, age, school grade, income, and drinking. The logistic regression analysis showed that the independent variables, general health awareness (OR=9.094, 95% CI 7.139~11.585) and oral health awareness (OR=1.936, 95% CI 1.465~2.560), were associated with depression, and speaking discomfort, chewing discomfort, oral pain (within 1 year), and prosthesis were found to increase depression probability. The depression probability was also was found to significantly increase by 1.81 times if brushing frequency was less that once a day, if people used dental floss (OR=1.42), and had to have an oral examination (OR=1.31). These results indicated that oral health and oral health behaviors are associated with the depression, with the influencing factors having oral health and behavior-related characteristics. Therefore, proper oral health and oral health risk factor behavior management programs should be developed to assist in reducing depression.

The Factors Influencing Value Awareness of Personalized Service and Intention to Use Smart Home: An Analysis of Differences between "Generation MZ" and "Generation X and Baby Boomers" (스마트홈 개인화 서비스에 대한 가치 인식 및 사용의도에의 영향 요인: "MZ세대"와 "X세대 및 베이비붐 세대" 간 차이 분석)

  • Sang-Keul Lee;Ae Ri Lee
    • Information Systems Review
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    • v.23 no.3
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    • pp.201-223
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    • 2021
  • Smart home is an advanced Internet of Things (IoT) service that enhances the convenience of human daily life and improves the quality of life at home. Recently, with the emergence of smart home products and services to which artificial intelligence (AI) technology is applied, interest in smart home is increasing. To gain a competitive edge in the smart home market, companies are providing "personalized service" to users, which is a key service that can promote smart home use. This study investigates the factors affecting the value awareness of personalized service and intention to use smart home. This research focuses on four-dimensional motivated innovativeness (cognitive, functional, hedonic, and social innovativeness) and privacy risk awareness as key factors that influence the value awareness of personalized service of smart home. In particular, this study conducts a comparative analysis between the generation MZ (young people in late teens to 30s), who are showing socially differentiated characteristics, and the generation X and baby boomers in 40s to 50s or older. Based on the analysis results, this study derives the distinctive characteristics of generation MZ that are different from the older generation, and provides academic and practical implications for expanding the use of smart home services.

The Impacts of Entrepreneurial Proclivity and Merchandising Strategy on Conventional Market and Its Policy Implications (한국 재래시장상인의 창업가정신과 상품화 전략이 시장이미지와 경영성과에 미치는 영향과 재래시장 정책에 대한 시사점)

  • Suh, Geun-Ha;Yoon, Sung-Wook;Suh, Chang-Soo
    • Journal of Distribution Science
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    • v.7 no.3
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    • pp.71-100
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    • 2009
  • The main purpose of this study is to define relevant factors that influence successful start-ups and management innovations of traditional markets from the point of market structures and relations. To do this, we devide an entrepreneurship of merchant into two factors, risk taking and managerial experience and choose product planning and its implementation to see merchandising of traditional markets. In this study we identify that several factors we chose are contributing to generating management performances through market promotional parameters. Also we confirm that image factors of traditional markets is consist of awareness and value of markets, and that these factors shows some sequential and continual patterns in the course of generating performances. In additions, it is identified that four independent factors have positive effects to star-up success; risk taking 0.29(t 2.61), managerial experience 0.04(t 1.79), merchandising implementation 0.374(t 2.61), market value 0.47(t 5.25), market awareness 0.22(t 2.30). This study can help merchants of traditional markets to make and change their market strategies, restructure their businesses and survive in the field. This also provide some ideas and guidances to relevant government agencies in formulating traditional market policies.

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Study of the Factors affecting Unmet Medical Needs in Patients with Cerebrovascular Diseases (뇌혈관질환자의 미 충족 의료에 미치는 영향요인 연구)

  • Lee, Jeong Wook
    • Journal of Digital Convergence
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    • v.16 no.9
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    • pp.279-291
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    • 2018
  • This study is designed to demonstrate risk factors of unmet medical care for people with cerebrovascular disease. To do this, statistical analysis was performed by using hierarchical logistic regression analysis with SPSS/WIN24.0 program using Korean Medical Panel data in 2014. In the final model of the hierarchical logistic regression analysis, which is based on Anderson's Model, adjusted for the factors of the predisposing and enabling factors, the explanatory variables affecting the unmet medical development are gender, economic activity, income level, the experience of lying in a sickbed, restriction on activity, subjective health condition, and the number of chronic diseases. Based on the results of this study, the practical and policy implications for the effective management and treatment of cerebrovascular disease should be included in the countermeasures for cerebrovascular disease, a strategy to reduce the unmet medical incidence of cerebrovascular disease, in order to meet the medical needs, the necessity of comprehensive measures considering various dimensions of variables and the influential variables of unmet medical emergence have been suggested for the necessity of making a detailed service manual that can improve accessibility to medical services.