• Title/Summary/Keyword: Risk management factors

Search Result 2,601, Processing Time 0.025 seconds

Surgical Repair of Ventricular Septal Defect after Myocardial Infarction: A Single Center Experience during 22 Years

  • Park, Sung Jun;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
    • /
    • v.46 no.6
    • /
    • pp.433-438
    • /
    • 2013
  • Background: Surgical repair of post-infarct ventricular septal defect (VSD) is considered one of the most challenging procedures having high surgical mortality. This study aimed to evaluate the outcomes of the surgical repair of post-infarct VSD. Methods: From May 1991 to July 2012, 34 patients (mean age, $67.1{\pm}7.9$ years) underwent surgical repair of post-infarct VSD. A retrospective review of clinical and surgical data was performed. Results: VSD repair involved the infarct exclusion technique using a patch in all patients. For coronary revascularization, 12 patients (35.3%) underwent concomitant coronary artery bypass graft, 3 patients (8.8%) underwent preoperative percutaneous coronary intervention, and 9 patients (26.5%) underwent both of these procedures. The early mortality rate was 20.6%. Six patients (17.6%) required reoperation due to residual shunt or newly developed VSD. During follow-up (median, 4.8 years; range, 0 to 18.4 years), late death occurred in nine patients. Overall, the 5-year and 10-year survival rates were $54.4%{\pm}8.8%$ and $44.3%{\pm}8.9%$, respectively. According to a Cox regression analysis, preoperative cardiogenic shock (p=0.069) and prolonged cardiopulmonary bypass time (p=0.008) were independent predictors of mortality. Conclusion: The early surgical outcome of post-infarct VSD was acceptable considering the high-risk nature of the disease. The long-term outcome, however, was still dismal, necessitating comprehensive optimal management through close follow-up.

The trend of prevalence of pain in Korea from 2005 to 2016

  • Cho, Sang-Hyeon;Kim, Yong-Min;Lee, Jae-Ho;Kim, Hyun-Soo;Song, Jae-Seok
    • The Korean Journal of Pain
    • /
    • v.33 no.4
    • /
    • pp.352-358
    • /
    • 2020
  • Background: Korean society is afflicted with rapid aging. Aging is a risk factor for pain, and pain can reduce patients' quality of life. Thus, adequate management and monitoring of changing trends accompanying the demographic shift are highly valuable. However, this study was conducted because no studies have investigated the recent changes in the prevalence of pain. Methods: The extent of the prevalence of pain was determined by questions related to quality of life based on the data derived from the Korea National Health and Nutrition Survey (KNHNS) from 2005 to 2016. The annual frequencies of the pain group and severe pain group were calculated using the survey questionnaire. Multiple logistic regression analysis was performed to determine possible differences in prevalence by year. Results: The prevalence of pain in all populations was 30.6% in 2005 and 18.9% in 2016. The average prevalence from 2005 to 2016 was 21.9%. A declining trend occurred over time with an odds ratio of 0.929 per year (95% CI: 0.921-0.938). The prevalence of severe pain was 2.35% in 2005 and 1.88% in 2016. Likewise, a decrease was observed over time, with an odds ratio of 0.920 per year at 95% CI 0.901-0.939. The decline in age-/sex-stratified analysis also showed a statistically significant trend in all groups. Conclusions: The prevalence of pain in Korean society, based on the KNHNS, has declined since 2005. Such a trend was observed in all ages and sexs, and was most significant in the elderly.

A Study on Stabilization of the Collapsed Slope due to Gyeongju Earthquake at Seokguram Access Road based on Geological Investigation (지질학적 조사를 바탕으로 한 경주지진으로 붕괴된 석굴암 진입도로 비탈면의 안정성 평가에 관한 연구)

  • Kim, Seung-Hyun;Lee, Kwang-Wu
    • Journal of the Korean Geosynthetics Society
    • /
    • v.18 no.4
    • /
    • pp.225-242
    • /
    • 2019
  • Rockfall failure at the access road to Seokguram were occurred due to the earthquake on September 12, 2016. A detailed investigation was carried out in order to find out the cause of the rockfall, to identify the risk of the entire sites, and to prepare proper countermeasure methods and mitigation. We checked for geological and topographical characteristics of overall slopes alongside the access road to Seokguram and made a face map. In addition, we analyzed topographical factors caused by the earthquake through calculating a degree of slope, degree of bearing, upslope contributing area, and wetness index with the use of shading relief map. As a result, we confirmed that the large rockfall occurred with a weak section. In this study, we also evaluated the overall slope stability of the entire access road to Seokguram in order to classify it into danger and caution zones depending on the risk of collapse.

Sexual Behavior of Adolescents in Multicultural Families: An Analysis Using Data from the 15th Korea Youth Risk Behavior Survey 2019 (다문화가정 청소년의 성행태 실태 분석: 제15차(2019년) 청소년건강행태온라인조사 자료 이용)

  • Son, Yedong;Choi, Hye-Seon
    • Journal of Industrial Convergence
    • /
    • v.18 no.3
    • /
    • pp.73-82
    • /
    • 2020
  • The purpose of this study was to explore sexual behaviors among adolescents in multicultural families in Korea. The data were obtained from the 15th Korea Youth Risk Behavior Survey 2019. Complex-sample descriptive statistics and the chi-square test were used for data analysis in SPSS 25. Among adolescents in multicultural families, 8.2% reported having sexual experience. Condoms were the most commonly used contraceptive method, and most adolescents received sex education at school. Their likelihood of sexual experience differed according to grade, academic achievement, economic status, residential area, perceived stress, and drinking and smoking experience (p<.001). The results of this study suggest that sex education should be conducted with appropriate consideration of the important factors associated with adolescents in multicultural families.

Association of Sleep Disturbance, Fatigue, Job Stress and Exposure to Blood and Body Fluid in Shift-work Nurses (교대근무 간호사의 혈액과 체액 노출 경험과 수면장애, 피로, 직무스트레스와 상관성)

  • Ryu, Jae Geum;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
    • /
    • v.20 no.3
    • /
    • pp.187-195
    • /
    • 2018
  • Purpose: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. Methods: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. Results: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance ($ISI{\geq}15$), fatigue (FSS $score{\geq}4$), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS $score{\geq}4$). Conclusion: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

Assessment of vitamin $B_6$ status in Korean patients with newly diagnosed type 2 diabetes

  • Ahn, Hee-Jung;Min, Kyung-Wan;Cho, Youn-Ok
    • Nutrition Research and Practice
    • /
    • v.5 no.1
    • /
    • pp.34-39
    • /
    • 2011
  • The purpose of this study was to assess vitamin $B_6$ intake and status in Korean patients with newly diagnosed type 2 diabetes. Sixty-four patients with newly diagnosed type 2 diabetes and 8-11% glycated hemoglobin (A1C), along with 28 age-matched non-diabetic subjects, participated. Dietary vitamin $B_6$ intake was estimated by the 24 hour recall method and plasma pyridoxal 5'-phosphate (PLP) was measured. There was a significant difference in daily total calorie intake between the diabetic and non-diabetic groups ($1,917{\pm}376$ vs $2,093{\pm}311\;kcal$). There were no differences in intake of total vitamin $B_6$ ($2.51{\pm}0.91$ vs $2.53{\pm}0.81\;mg/d$) or vitamin $B_6$/1,000 kcal ($1.31{\pm}0.42$ vs $1.20{\pm}0.32\;mg$) between the diabetic and non-diabetic groups, and I intakes of total vitamin $B_6$ were above the Korean RDA in both groups ($180.0{\pm}57.9$ vs $179.0{\pm}65.4$). There was a higher percentage of diabetic subjects whose plasma PLP concentration was < 30 nmol/L compared to non-diabetic group. Plasma PLP levels tended to be lower in the diabetic subjects than in the non-diabetic subjects, although the difference was not statistically significant due to a large standard deviation ($80.0{\pm}61.2\;nmol/L$ vs $68.2{\pm}38.5\;nmol/L$). Nevertheless, plasma PLP levels should be monitored in pre-diabetic patients with diabetic risk factors as well as in newly diagnosed diabetic patients for long-term management of diabetes, even though this factor is not a major risk factor that contributes to the development of degenerative complications in certain patients.

Examining Factors Influencing the Intention to Use Mobile Payment: Focusing on Self-Construal (모바일 간편결제 이용의도에 미치는 영향요인에 관한 연구: 자기해석의 조절적 역할을 중심으로)

  • Lee, Jang-Suk;Sung, Dong-Kyu
    • Journal of Digital Convergence
    • /
    • v.16 no.4
    • /
    • pp.137-147
    • /
    • 2018
  • The purpose of this study was to examine the influence of variables of TAM, user characteristics variables, and perceived risk variables on the intention to use mobile payment. Through the combination of characteristics of mobile payment, this study also investigated the effect of various independent variables on the intention to use mobile payment including the moderating effect of self-construal. To verify hypotheses of this study, the hierarchical regression analysis based on responses from 188 undergraduate and graduate students was conducted. The significant findings of this study were as follows: TAM variables, user characteristics variables and perceived risk variables had positive influence on the intention to use mobile payment. Self-construal was found to moderate the effect of the perceived usefulness, perceived ease of use and subjective norm. This study may provide important implications for both academicians and practitioners.

A Prospective Cohort Study of Exercise and the Incidence of Type 2 Diabetes in Impaired Fasting Glucose Group (규칙적 운동과 제2형 당뇨병 발생에 관한 전향적 코호트 연구 -공복혈당장애군을 대상으로-)

  • Um, Hong-Dae;Lee, Duck-Chul;Lee, Sang-Yi;Kim, Yeon-Soo
    • Journal of Preventive Medicine and Public Health
    • /
    • v.41 no.1
    • /
    • pp.45-50
    • /
    • 2008
  • Objectives : To determine the relationship between exercise and the incidence of type 2 diabetes in an impaired fasting glucose group. Methods : This prospective cohort study was conducted in 19,440 men and 4,297 women, aged 30-69 years, with impaired fasting glucose at baseline who had undergone biennial medical evaluation through the National Health Insurance Corporation from 2000 to 2004. Impaired fasting glucose was defined as fasting glucose of 100 to 125 mg/dl and the subjects were divided into 3 groups depending on weekly exercise frequency. Multivariate logistic regression analysis was used to evaluate the association between the baseline exercise status and incidence of type 2 diabetes. Results : During the 4-year follow-up, a total of 3,239 men and 283 women developed type 2 diabetes, a cumulative incidence of 16.6% for men, and 6.5% for women. Also, 1,688 men (21.2%) and 127 women (15.2%) developed type 2 diabetes in the obese group. The adjusted relative risk (RR) of developing type 2 diabetes in non-exercising men was significantly higher than exercising men regularly (RR= 1.375, 95% CI=1.236-1.529)(p<0.0001), and the RR for non-exercising women was higher than exercising women regularly (RR=1.124, 95% CI=0.711-1.778). The RR for non-exercise men/women in the obese group was 1.571 (95% CI=1.351-1.827)(p<0.0001)/1.869 (95% CI=0.846-4.130). Conclusions : Regular exercise is effective in preventing type 2 diabetes in people with impaired fasting glucose, and particularly in obese people. People with risk factors for diabetes should participate in a regular exercise program.

BRCA1 Gene Mutations and Influence of Chemotherapy on Autophagy and Apoptotic Mechanisms in Egyptian Breast Cancer Patients

  • Abdel-Mohsen, Mohamed Ahmed;Ahmed, Omiama Ali;El-Kerm, Yasser Mostafa
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.3
    • /
    • pp.1285-1292
    • /
    • 2016
  • Background: It is well established that mutations in the BRCA1 gene are a major risk factor for breast cancer. Induction of cancer cell death and inhibition of survival are the main principles of cancer therapy. In this context, autophagy may have dual roles in cancer, acting on the one hand as a tumor suppressor and on the other as a mechanism of cell survival that can promote the growth of established tumors. Therefore, understanding the role of autophagy in cancer treatment is critical. Moreover, defects in apoptosis, programmed cell death, may lead to increased resistance to chemotherapy. Purpose: The aim of the present study was to detect BRCA1 gene mutations in order to throw more light on their roles as risk factors for breast cancer in Egypt. Secondly the role of autophagy and apoptosis in determining response to a fluorouracil, doxorubicin, cyclophosphamide (FAC) regimen was investigated. Materials and Methods: Forty-five female breast cancer cases and thirty apparently healthy females were enrolled in the present study. Serum levels of autophagic biomarkers, Beclin 1 and LC3 as well as the serum levels of apoptosis biomarkers Bcl-2 and Caspase-3 were measured before and after chemotherapy. Results: BRCA1 mutations were found in 5 (16.7%) and 44 (99.8%) of the controls and cancer patients, the most frequent being 5382insC followed by C61G and 185 delAG. The results revealed that chemotherapy caused elevation in serum concentration levels of the autophagic biomarkers (Beclin 1 and LC3). This elevation was associated with a significant decrease in serum concentration levels of Bcl-2 and significant increase in caspase-3 concentration levels (apoptotic markers). Conclusions: The results of the present study indicate a very high level of BRCA mutations in breast cancer cases in Egypt and point to involvement of autophagic and apoptotic machinery activation in response to FAC chemotherapy.

Cancer Registration in Basrah-Southern Iraq: Validation by Household Survey

  • Hussain, Riyadh Abdul-Ameer;Habib, Omran S
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.sup3
    • /
    • pp.197-200
    • /
    • 2016
  • On an international scale, the burden of cancer in absolute numbers continues to increase, mainly due to aging of population in many countries, the overall growth of the world population, changing lifestyle with increasing cancer-causing behavior, like cigarette smoking, changing dietary habits and sedentary life. Cancer is the second-leading cause of death and disability in the world, after only heart disease. Recently, increasing incidence and mortality of cancer have also become evident in the developing world. In Iraq and particularly in Basrah in the southern part of the country, the burden has definitely increased and deserves extensive research. The present paper is part of an extensive household survey carried out in Basrah in 2013. Among the objectives was to validate official cancer registration in the governorate. The cross-sectional survey had a retrospective component to inquire about the incidence of cancer and cancer-related deaths during the three years preceding the date of inquiry (2010-2012). A convenient sample of 6,999 households with 40,688 inhabitants using multistage cluster sampling was surveyed involving all urban and rural areas of Basrah. The official cancer registration activities in Basrah seemed to have attained a high level of registration coverage (70-80%) but the gap, represented by missed cases, is still high enough to criticize the system. Most of the missing cases were either not notified by treating facilities or they were diagnosed and treated outside Basrah. Using a set of parameters, the pattern of cancer was consistent based on data of the household survey and data of the cancer registry but a gap still existed in the coverage of incident cancer and mortality by cancer registration. Integrated serious steps are required to contain the risk of cancer and its burden on the patient through improving the registration process, improving early detection, diagnostic and management capabilities and encouraging scientific research to explore the hidden risk factors and possible causes of low registration coverage. Periodic household surveys seemed feasible and essential to support routine registration.