• Title/Summary/Keyword: Risk management factors

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CQI Activities for the Reduction of Clostridium difficile Associated Diarrhea in NCU of a University Hospital (일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동)

  • Park, Eun Suk;Chang, Kyung Hee;Youn, Young Ok;Lee, Jung Sin;Kim, Tae Gon;Yea, Han Seung;Kim, Sun Ho;Shin, Jeong Won;Lee, Kyungwon;Kim, June Myung
    • Quality Improvement in Health Care
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    • v.8 no.1
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    • pp.10-21
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    • 2001
  • Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

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Effect of Allergy Related Disease on Suicide Ideation among Adolescents in Korea (청소년 알레르기성 질환의 복합성과 중증도가 자살 생각에 미치는 영향)

  • Wang, Jin Woo;Kim, Eun Young;Park, Su Jin;Lee, Jun Hyup;Rhim, Kook Hwan
    • The Journal of Korean Society for School & Community Health Education
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    • v.17 no.3
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    • pp.11-25
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    • 2016
  • Background & Objectives: There were increasing evidence about the relationship between allergy related disease such as asthma, atopic dermatitis and allergic rhinitis and suicide ideation. However little was known about the concrete relatedness between severity and comorbidity of allergy related disease with suicide ideation. The objective of this study was to investigate the cases of the prevalence of suicide ideation among adolescents with allergy related disease such as asthma, atopic dermatitis and allergic rhinitis, and examine the association between allergy related disease and suicidal ideation among adolescents in South Korea. Methods: Data was based on Korean Youth Risk Behavior Web-based Survey(2014) which was a cross-sectional study containing 34,874 Korean middle and high school students who diagnosed with allergy related disease. We used the weights, strata and primary sampling unit information provided by the public use dataset to compute descriptive statistics and logistic regressions. Computations were done with SPSS version 20.0. Results: 19.9%, 15.6%, 13.8% of adolescents who suffered from one, two and three of allergy related diseases respectively reported having been thought of suicide ideation. Socio-demographic factors were adjusted as control variables. Students with greater severity of disease were more likely to have suicide ideation. Odds ratio for students who were absent one to three days from school because of allergies was 1.96(95% CI 1.51-2.46), and odds ratio for those who were absent more than four days from school was 3.60(95% CI 2.46-5.28). Conclusions: Given that adolescents' severity and comorbidity of allergy related disease were clearly associated with suicide ideation, suicide prevention programs for adolescents with allergy related disease should be improved by strategic approaches towards the severity and comorbidity of disease.

Blood Malignancies in Mazandaran Province of Iran

  • Tahmasby, Bahram;Marnani, Ahmad Barati;Maleki, Mohammadreza;Barouni, Mohsen;Mousavi, Seyyed Hamid;Naseriyan, Behjat;Nazarnezhad, Mirzaali;Alizadeh, Ali;Sabermahani, Asma
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1053-1056
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    • 2013
  • Background: Leukemia and lymphoma demonstrate significantly incidence rates throughout the world and particularly in Iran they cause serious mortality and diagnosis and treatment expenditures for both families and the health system. Combined they account for about 11 percent of cancers in Mazandaran province, ranking number 2 in prevalent cancers. The purpose of this study was to provide a first general and specific description of leukemia and lymphoma in Mazandaran province. Materials and Methods: In this descriptive retrospective study, entire patient's data were reviewed which had confirmed diagnosis of leukemia and lymphoma with valid laboratory or pathology reports in the period 2001-2008. The data were collected by Babol health research site related to Tehran University of Medical Science. Incidence rates based on age groups, gender, city of residence and type of malignancy were calculated and analyzed. Results: In Mazandaran province, 1,146 cases of leukemia and lymphoma were encountered, 5.9 in 100,000 persons on average annually. The highest incidence rates were obtained at age of 70 or above (26.4) and the lowest at age of 0-9 (2.3).The incidence rates in males and females were 7.1 and 4.8 respectively with a ratio of 1.5. The highest incidence rate was in Babol (7.3) and the lowest was calculated in Neka and Tonekabon equally (1.5). According to the type of malignancy, non Hodgkin lymphoma, with 2.5/100,000 have the most incidence rate and myeloid leukemia with 1.8 had the lowest. Conclusions: The obtained findings indicate clear differences in incidence rates based on age, gender, residence, and type of malignancy. Therefore it's suggested that in addition to promote data collecting programs, research projects should be programmed to define leukemia and lymphoma risk factors in this province.

The Relationships of Role-Conflict and Role-Overload, Coping Strategies, and Stress Response of Clerical Workers (사무직 근로자의 역할 관련 스트레스 요인과 대처전략, 스트레스 반응간의 관계)

  • Kim, Jeong Hee;Kim, Souk Young
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.1
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    • pp.56-67
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    • 1999
  • This study was designed to identify the relationships of role-conflict and role-overload, coping strategies, and stress response of clerical workers. The subjects were 115 clerical workers from two company. The instruments were the role-conflict and role-overload scale developed by Lee(1989), coping scale developed by Latack(1986), and the stress response scale developed by Chang(1993). Analysis of data was done by descriptive statistics, Cronbach's $\alpha$, Pearson correlation coefficietnt, ANOVA. The results of this study were summarized as follows ; 1. The average score for the level of stress response was $83.6({\pm}9.1)$. The high risk stress group was 86.1% of the clerical workers, the latent stress group members was 13.9%, and healthy group was 0%. The overall stress level was very high. 2. Considering the coping strategies by sociodemographic factors, the use of control coping strategies showed significant differences by work-time. The use of symptom management coping strategies showed significant differences by sex, age, married status, year of career, pay, and type of work. The organizational coping strategies showed significant differences by year of education and type of work. 3. The clerical workers who had worked below 44 hours per week complained significantly lower stress response(F=4.942, p<.05). 4. Above 65% of all respondents answered that they needed all of organizational level coping strategies. 5. The role-confilct positively related to escape and organizational level coping strategies(r=.562, r=.495, p<.05). The role-overload didn't related to individual level coping strategies, but positively related to organizational level coping strategies(r=.320, p<.05). 6. The control coping strategies and the escape coping strategies positively related to symptom management, organizational level coping strategies(r=.409, r=.324, r=.316, r=.339, p<.05). 7. The relationship between role-related stress and stress response revealed positive correlation(r=.482, r=.431, p<.05), and the relationship between stress response and control, symptom management coping strategies revealed negative cor-relation(r=-.3204, r=-.3146, p<.05). In conclusion, this study revealed that relationship of role related stress, coping strategies, stress response was statistically significant. The result of this study support that coping strategies vary across situation of stress. Based on survey results, future studies should consider coping strategies in specific stress situation and concept of symptom management coping strategy. Also organizational or training interventions could be developed and initiate to help to increase the use of adaptive coping strategies in light of individual and situational differences.

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Development of a Crew Resource Management Training Program for Reduction of Human Errors in APR-1400 Nuclear Power Plant (국내 원자력발전소 인적오류 저감을 위한 Crew Resource Management 교육훈련체계 개발)

  • Kim, Sa-Kil;Byun, Seong-Nam;Lee, Dhong-Hoon;Jeong, Choong-Heui
    • Journal of the Ergonomics Society of Korea
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    • v.28 no.1
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    • pp.37-51
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    • 2009
  • The nuclear power industry in the world has recognized the importance of integrating non-technical and team skills training with the technical training given to its control room operators to reduce human errors since the Three Mile Island and Chernobyl accidents. The Nuclear power plant (NPP) industry in Korea has been also making efforts to reduce the human errors which largely have contributed to 120 nuclear reactor trips from the year 2001 to 2006. The Crew Resource Management (CRM) training was one of the efforts to reduce the human errors in the nuclear power industry. The CRM was developed as a response to new insights into the causes of aircraft accidents which followed from the introduction of flight recorders and cockpit voice recorders into modern jet aircraft. The CRM first became widely used in the commercial airline industry, but military aviation, shipboard crews, medical and surgical teams, offshore oil crews, and other high-consequence, high-risk, time-critical industry teams soon followed. This study aims to develop a CRM training program that helps to improve plant performance by reducing the number of reactor trips caused by the operators' errors in Korean NPP. The program is; firstly, based on the work we conducted to develop a human factors training from the applications to the Nuclear Power Plant; secondly, based on a number of guidelines from the current practicable literature; thirdly, focused on team skills, such as leadership, situational awareness, teamwork, and communication, which have been widely known to be critical for improving the operational performance and reducing human errors in Korean NPPs; lastly, similar to the event-based training approach that many researchers have applied in other domains: aircraft, medical operations, railroads, and offshore oilrigs. We conducted an experiment to test effectiveness of the CRM training program in a condition of simulated control room also. We found that the program made the operators' attitudes and behaviors be improved positively from the experimental results. The more implications of the finding were discussed further in detail.

Association of a Combination between Actual Body Mass Index Status and Perceived Body Image with Anxiety and Depressive Condition in Korean Men and Women: The Fifth and Sixth Korea National Health and Nutrition Examination Survey (2010-2014) (우리나라 성인남녀의 비만 및 주관적 체형인식과 불안·우울과의 관련성: 국민건강영양조사(2010-2014년) 분석)

  • Lee, Hyomin;Chung, Woojin;Lim, Seungji;Han, Euna
    • Health Policy and Management
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    • v.28 no.1
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    • pp.3-14
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    • 2018
  • Background: Both objective body shape and perceived body image have been known to influence the mental health. The purpose of this study was to explore the relationship of a combination between actual body mass index (BMI) status and perceived body image with anxiety depressive condition (ADC) in Korean men and women. Methods: This cross-sectional study analyzed data of 26,239 subjects ${\geq}20$ years old from the National Health and Nutrition Examination Survey (2010-2014). This study performed a Rao-Scott chi-square and multivariate logistic regression analyses reflecting survey characteristics and used a variety of independent variables such as socio-demographics and health behavior factors. Results: With all independent variables considered, people with normal weight who perceived themselves as overweight were more likely associated with ADC than a referent group with normal weight who perceived themselves as normal weight, as shown for both men (odds ratio [OR], 1.52; confidence interval [CI], 1.07-2.15) and women (OR, 1.25; CI, 1.06-1.48). Meanwhile, compared to the referent group, men with underweight who perceived themselves as underweight showed a lower association with ADC (OR, 0.63; CI, 0.41-0.97), whereas women with underweight who perceived themselves as underweight showed its higher association (OR, 1.47; CI, 1.10-1.96). Conclusion: A certain group of people categorized as a combination between actual BMI status and perceived body image showed a relatively high likelihood of having ADC, and the gender difference in the likelihood of having the condition for a group was clear. Therefore, this study suggests the need to identify the group at a high risk of ADC on the basis of actual BMI status and perceived body image and to develop an appropriate mental health management program for the group.

The Application of Fuzzy Logic to Assess the Performance of Participants and Components of Building Information Modeling

  • Wang, Bohan;Yang, Jin;Tan, Adrian;Tan, Fabian Hadipriono;Parke, Michael
    • Journal of Construction Engineering and Project Management
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    • v.8 no.4
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    • pp.1-24
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    • 2018
  • In the last decade, the use of Building Information Modeling (BIM) as a new technology has been applied with traditional Computer-aided design implementations in an increasing number of architecture, engineering, and construction projects and applications. Its employment alongside construction management, can be a valuable tool in helping move these activities and projects forward in a more efficient and time-effective manner. The traditional stakeholders, i.e., Owner, A/E and the Contractor are involved in this BIM system that is used in almost every activity of construction projects, such as design, cost estimate and scheduling. This article extracts major features of the application of BIM from perspective of participating BIM components, along with the different phrases, and applies to them a logistic analysis using a fuzzy performance tree, quantifying these phrases to judge the effectiveness of the BIM techniques employed. That is to say, these fuzzy performance trees with fuzzy logic concepts can properly translate the linguistic rating into numeric expressions, and are thus employed in evaluating the influence of BIM applications as a mathematical process. The rotational fuzzy models are used to represent the membership functions of the performance values and their corresponding weights. Illustrations of the use of this fuzzy BIM performance tree are presented in the study for the uninitiated users. The results of these processes are an evaluation of BIM project performance as highly positive. The quantification of the performance ratings for the individual factors is a significant contributor to this assessment, capable of parsing vernacular language into numerical data for a more accurate and precise use in performance analysis. It is hoped that fuzzy performance trees and fuzzy set analysis can be used as a tool for the quality and risk analysis for other construction techniques in the future. Baldwin's rotational models are used to represent the membership functions of the fuzzy sets. Three scenarios are presented using fuzzy MEAN, AND and OR gates from the lowest to intermediate levels of the tree, and fuzzy SUM gate to relate the intermediate level to the top component of the tree, i.e., BIM application final performance. The use of fuzzy MEAN for lower levels and fuzzy SUM gates to reach the top level suggests the most realistic and accurate results. The methodology (fuzzy performance tree) described in this paper is appropriate to implement in today's construction industry when limited objective data is presented and it is heavily relied on experts' subjective judgment.

A Study on the Development of integrated Process Safety Management System based on Artificial Intelligence (AI) (인공지능(AI) 기반 통합 공정안전관리 시스템 개발에 관한 연구)

  • KyungHyun Lee;RackJune Baek;WooSu Kim;HeeJeong Choi
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.1
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    • pp.403-409
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    • 2024
  • In this paper, the guidelines for the design of an Artificial Intelligence(AI) based Integrated Process Safety Management(PSM) system to enhance workplace safety using data from process safety reports submitted by hazardous and risky facility operators in accordance with the Occupational Safety and Health Act is proposed. The system composed of the proposed guidelines is to be implemented separately by individual facility operators and specialized process safety management agencies for single or multiple workplaces. It is structured with key components and stages, including data collection and preprocessing, expansion and segmentation, labeling, and the construction of training datasets. It enables the collection of process operation data and change approval data from various processes, allowing potential fault prediction and maintenance planning through the analysis of all data generated in workplace operations, thereby supporting decision-making during process operation. Moreover, it offers utility and effectiveness in time and cost savings, detection and prediction of various risk factors, including human errors, and continuous model improvement through the use of accurate and reliable training data and specialized datasets. Through this approach, it becomes possible to enhance workplace safety and prevent accidents.

A Study on the Effects of Meterological Factors on the Distribution of Agricultural Products: Focused on the Distribution of Chinese Cabbages (기상요인이 농산물 유통에 미치는 영향에 관한 연구: 배추 유통 사례를 중심으로)

  • Lee, Hyunjoung;Hong, Jinhwan
    • Journal of Distribution Research
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    • v.17 no.5
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    • pp.59-83
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    • 2012
  • Agriculture is a primary industry that influenced by the weather or meterological factors more than other industry. Global warming and worldwide climate changes, and unusual weather phenomena are fatal in agricultural industry and human life. Therefore, many previous studies have been made to find the relationship between weather and the productivity of agriculture. Meterological factors also influence on the distribution of agricultural product. For example, price of agricultural product is determined in the market, and also influenced by the weather of the market. However, there is only a few study was made to find this link. The objective of this study is to investigate the effects of meterological factors on the distribution of agricultural products, focusing on the distribution of chinese cabbages. Chinese cabbage is a main ingredient of Kimchi, and basic essential vegetable in Korean dinner table. However, the production of chinese cabbages is influenced by weather and very fluctuating so that the variation of its price is so unstable. Therefore, both consumers and farmers do not feel comfortable at the unstable price of chinese cabbages. In this study, we analyze the real transaction data of chinese cabbage in wholesale markets and meterological factors depending on the variety and geography. We collect and analyze data of meterological factors such as temperatures, humidity, cloudiness, rainfall, snowfall, wind speed, insolation, sunshine duration in producing and consuming region of chinese cabbages. The result of this study shows that the meterological factors such as temperature and humidity significantly influence on the volume and price of chinese cabbage transaction in wholesale market. Especially, the weather of consuming region has greater correlation effects on transaction than that of producing region in all types of chinese cabbages. Among the whole agricultural lifecycle of chinese cabbages, 'seeding - harvest - shipment - wholesale', meterological factors such as temperature and rainfall in shipment and wholesale period are significantly correlated with transaction volume and price of crops. Based on the result of correlation analysis, we make a regression analysis to verify the meterological factors' effects on the volume and price of chines cabbage transaction in wholesale market. The results of stepwise regression analysis are shown in

    and
    . The type of chinese cabbages are categorized by 5 types, i.e. alpine, gimjang for winter, spring, summer, and winter crop, and all of the regression models are shown significant relationship. In addition, meterological factors in shipment and wholesale period are entered more in regression model than those in seeding and harvest period. This result implies that weather in consuming region is also important in the distribution of chinese cabbages. Based on the result of this study, we find several implications and recommendations for policy makers of agricultural product distribution. The goal of agricultural product distribution policy is to insure proper price and production cost for farmers and provide proper price and quality, and stable supply for consumers. Therefore, coping with the uncertainty of weather is very essential to make a fruitful effect of the policy. In reality, very big part of consumer price of chinese cabbage is made up of the margin of intermediaries, because they take the risk. In addition, policy makers make efforts for farmers to utilize AWIS (Agricultural Weather Information System). In order to do that, it should integrate the relevant information including distribution and marketing as well as production. Offering a consulting service to farmers about weather management is also expected to be a good option in agriculture and weather industry. Reflecting on the result of this study, the distribution authorities can offer the guideline for the timing and volume of harvest, and it is expected to contribute to the stable equilibrium of supply and demand of agricultural products.

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  • Impact of Corporate Entrepreneurship, Human Resource Innovation on the Firms' Innovation Activities and Nonfinancial Performance: A Exploratory Research of KOSDAQ Companies (사내기업가정신, 인적자원혁신성이 기업혁신활동과 비재무적 성과에 미치는 영향에 관한 탐색적 연구)

    • Hwangbo, Yun;Bae, Kun Seok
      • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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      • v.12 no.4
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      • pp.1-14
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      • 2017
    • New business management methods different from the past are necessary because of the rapid changes of the corporates' environment. KOSDAQ(Korean Securities Dealers Automated Quotation) companies should be expected the more affirmative business performance of companies by listing, but it is a well-known that they have problems of low business performance mostly. This paper aims to investigate the influential factors on enhancing corporate innovation and nonfinantial business performance, and to clarify practical measures and present a solution of KOSDAQ companies' problems through analysis of previous researches and an empirical research. This research present corporate entrepreneurship and human resources innovation as impact factors on the business performance to apply finely the path of technological innovation for the solution of the relevance investigation limit between the complexity of corporates' innovation paths and the firms' performance. And also knowledge management activities and external networks management or the firms have been adopted as a corporate innovation activities for free from quantitative measures, such as conventional research and development(R&D) activities by considering recent corporates' knowledge business operations. The results of the empirical analysis shows that significant impact factors on corporate innovation activities are the firms' propensities of competitive advantage initiative, risk taking and chief executive officer's innovation. These can be interpreted that the CEOs' innovation propensity should be enhanced for stimulating corporate's innovaton activities, which include the CEOs' interest in the development of new technology, the exploiting new businesses and their support of the innovation discipline for employees. In addition, it can be said that it is necessary to intensify more initiatives within those enterprise for enhancing the competitive advantage in the identical industry. The significant impact factors of corporate entrepreneurship and human resource innovation on the non-financial performance are resulted as the propensities of firms' competitive advantage initiative, CEOs' innovation and employees' innovaton. This shows that the higher propensities of firms' competitive advantage initiative, CEOs' innovation and employees' innovaton, the higher the cognitive degrees of business performance within each corporate, which include the members' awareness about firms' sales growth, market share growth, profit ratio growth, customers' preference and corporates' awareness.

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