• 제목/요약/키워드: Risk-based screening level

검색결과 69건 처리시간 0.024초

노인요양시설 거주 노인을 위한 한국형 근거기반 연하장애 간호 프로토콜 개발 (Development of Evidence-based Dysphagia Nursing Care Protocol for Nursing Home Residents)

  • 방활란;박연환
    • 근관절건강학회지
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    • 제20권1호
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    • pp.31-42
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    • 2013
  • Purpose: The purpose of this study was to develop an evidence-based dysphagia nursing care protocol for nursing home (NH) residents in Korea. Methods: The protocol was developed based on international guidelines and literatures. After testing content validity by experts, the protocol was applied to the intervention group (n=35) for 4 weeks at one NH in December, 2011, whereas the control group (n=34) received routine care. Results: The protocol was composed of one-page algorithm and detailed guidelines. Algorithm pathway was organized in 3 parts, including screening dysphagia risk, grouping by dysphagia risk level, and assigning nursing care into each group. The nursing care included positioning, oral care, meal time care, diet modification, providing exercise and maneuver, and checking dysphagia signs and symptoms. The experts verified the content validity. Protocol was revised to fit NH practice after the participant observation. Clinical validity was established upon evaluating usefulness, appropriateness, and convenience of the protocol by NH nurses. Dysphagia risk of the intervention group was significantly decreased. Conclusion: Developed protocol will improve the quality of dysphagia care in nursing homes as it can serve as a consistent and integrated standard for nursing care of residents with dysphagia.

Financial and Economic Risk Prevention and Countermeasures Based on Big Data and Internet of Things

  • Songyan Liu;Pengfei Liu;Hecheng Wang
    • Journal of Information Processing Systems
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    • 제20권3호
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    • pp.391-398
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    • 2024
  • Given the further promotion of economic globalization, China's financial market has also expanded. However, at present, this market faces substantial risks. The main financial and economic risks in China are in the areas of policy, credit, exchange rates, accounting, and interest rates. The current status of China's financial market is as follows: insufficient attention from upper management; insufficient innovation in the development of the financial economy; and lack of a sound financial and economic risk protection system. To further understand the current situation of China's financial market, we conducted a questionnaire survey on the financial market and reached the following conclusions. A comprehensive enterprise questionnaire from the government's perspective, the enterprise's perspective and the individual's perspective showed that the following problems exist in the financial and economic risk prevention aspects of big data and Internet of Things in China. The political system at the country's grassroots level is not comprehensive enough. The legal regulatory system is not comprehensive enough, leading to serious incidents of loan fraud. The top management of enterprises does not pay enough attention to financial risk prevention. Therefore, we constructed a financial and economic risk prevention model based on big data and Internet of Things that has effective preventive capabilities for both enterprises and individuals. The concept reflected in the model is to obtain data through Internet of Things, use big data for screening, and then pass these data to the big data analysis system at the grassroots level for analysis. The data initially screened as big data are analyzed in depth, and we obtain the original data that can be used to make decisions. Finally, we put forward the corresponding opinions, and their main contents represent the following points: the key is to build a sound national financial and economic risk prevention and assessment system, the guarantee is to strengthen the supervision of national financial risks, and the purpose is to promote the marketization of financial interest rates.

Association between Diabetes Mellitus and Fatty Liver Based on Ultrasonography Screening in the World's Highest Cholangiocarcinoma Incidence Region, Northeast Thailand

  • Thinkhamrop, Kavin;Khuntikeo, Narong;Phonjitt, Pichai;Chamadol, Nittaya;Thinkhamrop, Bandit;Moore, Malcolm Anthony;Promthet, Supannee
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3931-3936
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    • 2015
  • Fatty liver disease (FLD) can be a precondition for other liver pathology including cholangiocarcinoma (CCA). Diabetes mellitus (DM) has been suggested in some studies to be a risk factor for FLD as well as cancers, including cholangiocellular carcinoma; however, there are currently very few studies on FLD in DM subjects, although the rate of FLD continues to increase annually. To determine the association between DM and FLD ultrasonographic data were analyzed from the Cholangiocarcinoma Screening and Care Program (CASCAP), in northeast Thailand. DM was reported by the subjects based on the CASCAP health questionnaire. Factors that were associated with FLD were determined by prevalence, odds ratio (ORs) and its 95% confidence intervals (CIs) using multiple logistic regression. There were 45,263 subjects with a mean age of 53.46 (${\pm}9.25$) years. FLD was found in 36.3% of DM subjects but only in 20.7% of non-DM subjects. The association between DM and FLD was adjusted for all other factors including gender, age, education level, relatives diagnosed with CCA, smoking, alcohol consumption, and hepatitis B and C. The risk of DM in subjects having FLD was highly significant compared with the non-DM subjects (OR 2.13; 95%CI: 1.92 to 2.35; p-value < 0.001). Thus DM is significantly associated with FLD which in turn may facilitate the development of several diseases including CCA. DM should be taken into consideration in future ultrasonic investigations of FLD and CCA.

단계적 야생동식물 선량평가 코드 K-BIOTA의 특성 및 적용 (Characteristics of the Graded Wildlife Dose Assessment Code K-BIOTA and Its Application)

  • 금동권;전인;임광묵;최용호;김병호
    • Journal of Radiation Protection and Research
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    • 제40권4호
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    • pp.252-260
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    • 2015
  • 본 논문은 ICRP103 환경방호를 대비하여 국내에서 개발된 야생동식물 선량평가 코드 K-BIOTA의 기술적 배경 및 적용 사례를 기술한다. K-BIOTA는 스크리닝(screening) 선량평가(Level 1&2)와 부지 특성적 상세평가(Level 3)의 3단계의 단계적 평가방법을 적용한다. 스크리닝 단계평가는 상세평가의 필요성 여부를 판단하기 위한 예비적 평가 단계로 개별적인 생물종보다는 동식물을 그룹별로 구분하여 평가한다. Level 1 평가는 스크리닝 목적의 참조준위로부터 유도된 최대환경매체농도 값과 실제 환경매체농도 값의 비교로부터 위험도 지표(risk quotient)를 계산한다. Level 1 평가 결과 위험도 지표가 1보다 작으면 생태계의 건전성이 유지된다는 결론과 함께 평가를 종료하고, 1 보다 크면 동식물 그룹별로 평균적인 전이계수나 평형분배계수 값을 적용하여 조금 더 실제적인 Level 2 평가를 수행한다. 따라서 Level 2 평가가 Level 1 평가보다 덜 보수적이다. Level 2평가에서 위험도지표가 1 보다 작으면 생태계의 건전성이 유지된다는 결론을 내리고 평가를 종료하고, 1보다 크면 Level 3 평가를 수행한다, Level 3 평가는 부지 특성적 데이터를 고려하는 상세평가단계로, 동식물 그룹별 평가 대신 부지 대표적 동식물에 대한 개별적 선량평가를 수행하며, 대표적 동식물의 종류 및 크기, 거주인자, 전이계수, 평형분배계수에 대한 부지 특성적인 값을 사용한다. 또한 Level 3 평가 단계에서는 전이계수, 평형분배계수, 환경매체농도 (토양농도 또는 물의 농도)에 대한 개별 동식물의 피폭 선량률에 대한 불확실도 분석을 선택적으로 수행할 수 있다. 적용 가능한 확률밀도함수는 정규분포, 로그정규분포, 균일분포, 지수분포의 4가지이다. 국제원자력기구의 EMRAS II (Environmental Modeling for Radiation Safety) 모델 시나리오 비교 공동연구에 참가하여 K-BIOTA의 적용성을 검증하였다. 그 결과로 K-BIOTA는 다양한 오염 환경에서 거주하는 야생동식물의 방사선 영향을 평가하는데 유용함이 입증되었다.

중환자실 섬망예방을 위한 근거중심 간호중재 프로토콜 개발 (Development of an Evidence-Based Protocol for Preventing Delirium in Intensive Care Unit Patients)

  • 문경자;이선미
    • 임상간호연구
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    • 제16권3호
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    • pp.175-186
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    • 2010
  • Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

국내 전출력 원전 적용 화재 인간신뢰도분석 절차 개발 (Development of a Fire Human Reliability Analysis Procedure for Full Power Operation of the Korean Nuclear Power Plants)

  • 최선영;강대일
    • 한국안전학회지
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    • 제35권1호
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    • pp.87-96
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    • 2020
  • The purpose of this paper is to develop a fire HRA (Human Reliability Analysis) procedure for full power operation of domestic NPPs (Nuclear Power Plants). For the development of fire HRA procedure, the recent research results of NUREG-1921 in an effort to meet the requirements of the ASME/ANS PRA Standard were reviewed. The K-HRA method, a standard method for HRA of a domestic level 1 PSA (Probabilistic Safety Assessment) and fire related procedures in domestic NPPs were reviewed. Based on the review, a procedure for the fire HRA required for a domestic fire PSA based on the K-HRA method was developed. To this end, HRA issues such as new operator actions required in the event of a fire and complexity of fire situations were considered. Based on the four kinds of HFE (Human Failure Event) developed for a fire HRA in this research, a qualitative analysis such as feasibility evaluation was suggested. And also a quantitative analysis process which consists of screening analysis and detailed analysis was proposed. For the qualitative analysis, a screening analysis by NUREG-1921 was used. In this research, the screening criteria for the screening analysis was modified to reduce vague description and to reflect recent experimental results. For a detailed analysis, the K-HRA method and scoping analysis by NUREG-1921 were adopted. To apply K-HRA to fire HRA for quantification, efforts to modify PSFs (Performance Shaping Factors) of K-HRA to reflect fire situation and effects were made. For example, an absence of STA (Shift Technical Advisor) to command a fire brigade at a fire area is considered and the absence time should be reflected for a HEP (Human Error Probability) quantification. Based on the fire HRA procedure developed in this paper, a case study for HEP quantification such as a screening analysis and detailed analysis with the modified K-HRA was performed. It is expected that the HRA procedure suggested in this paper will be utilized for fire PSA for domestic NPPs as it is the first attempt to establish an HRA process considering fire effects.

토양생태계 위해성평가기법 비교연구: 토양생태준거치 산정을 중심으로 (Comparative study of Ecological Risk Assessment : Deriving Soil Ecological Criteria)

  • 이우미;김신웅;정승우;안윤주
    • 한국지하수토양환경학회지:지하수토양환경
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    • 제17권5호
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    • pp.1-9
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    • 2012
  • The purpose of ecological risk assessment in soil ecosystem is to protect ecological receptors and to provide a scheme of efficient management for soil contaminants. Developed countries have already prepared the methodologies of ecological risk assessment by considering their soil properties, land use, and ecological receptors. In this study, we compared the soil ecological risk assessment processes in the similarity and differences in methodology. Four countries, except for USA, adjusted the toxicological data for ecological risk assessment, based on their representative soil properties because the soil properties affect toxic effects to ecological receptors. The soil ecological risk assessment methodology of Netherlands and UK was based on 'Technical guidance document on risk assessment (TGD)' of European Chemical Bureau (ECB). Australia, USA, and Canada developed their autonomous methodology. In the Netherlands, UK, Australia, and Canada, they employed the species sensitivity distribution (SSD) approach if sufficient toxicity data are available. The USA determined the ecological soil screening level by obtaining the geometric mean of toxicological data for three species. Furthermore, all countries consider secondary poisoning in their soil ecological risk assessment. The latest risk assessment methodology of soil ecosystem that this study investigated can be used to explore what Korea needs to develop the Korean ecological risk assessment methodology of soil ecosystem in the future.

개인정보 유출 방지를 위한 SRI(Security Risk Indicator) 기반 모니터링 시스템 개발 (A study on the development of SRI(Security Risk Indicator)-based monitoring system to prevent the leakage of personally identifiable information)

  • 박성주;임종인
    • 정보보호학회논문지
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    • 제22권3호
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    • pp.637-644
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    • 2012
  • 오늘날과 같은 정보화 사회에서는 정보가 기업의 핵심자산으로 인식되고 있으며, 특히 금융권에서는 고객의 개인정보 유출이 커다란 이슈로 대두되고 있다. 현재 상용화된 개인정보보호 기술은 전사적인 차원이 아닌 일부 기능으로 국한되거나 극히 일부분의 개인정보만 포함되는 경우가 많다. 따라서 전사적인 차원에서 개인정보 유출을 사전에 예방하기 위해서는 개인정보 유출의 징후를 지속적으로 모니터링 할 수 있는 체계에 대한 연구가 필요하다. 본 연구에서는 개인정보 접근에 대한 패턴분석 및 SRI(Security Risk Indicator)를 이용한 모니터링 체계 구축 방법론을 제안하였으며, 실제 금융권 기업에 적용하여 사례 연구를 수행하였다. 이를 통해 탐지된 개인정보 유출 시도는 탐지된 유형에 맞춰 체계화된 대응 방안을 수립할 수 있게 되었다.

당뇨병성 족부궤양의 재발과 연관된 위험인자: 심리사회적 위험인자를 포함한 후향적 연구 (The Risk Factors Associated with Foot Re-Ulceration in Diabetes: A Retrospective Study Including Psychosocial Risk Factors)

  • 전숙하;손무원;배서영
    • 대한족부족관절학회지
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    • 제16권2호
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    • pp.108-115
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    • 2012
  • Purpose: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. Materials and Methods: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. Results: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. Conclusion: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.

Endoscopic Findings in a Mass Screening Program for Gastric Cancer in a High Risk Region - Guilan Province of Iran

  • Mansour-Ghanaei, Fariborz;Sokhanvar, Homayoon;Joukar, Farahnaz;Shafaghi, Afshin;Yousefi-Mashhour, Mahmud;Valeshabad, Ali Kord;Fakhrieh, Saba;Aminian, Keyvan;Ghorbani, Kambiz;Taherzadeh, Zahra;Sheykhian, Mohammad Reza;Rajpout, Yaghoub;Mehrvarz, Alireza
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1407-1412
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    • 2012
  • Background & Objectives: Gastric cancer is a leading cause of cancer-related deaths in both sexes in Iran. This study was designed to assess upper GI endoscopic findings among people > 50 years targeted in a mass screening program in a hot-point region. Methods: Based on the pilot results in Guilan Cancer Registry study (GCRS), one of the high point regions for GC-Lashtenesha- was selected. The target population was called mainly using two methods: in rural regions, by house-house direct referral and in urban areas using public media. Upper GI endoscopy was performed by trained endoscopists. All participants underwent biopsies for rapid urea test (RUT) from the antrum and also further biopsies from five defined points of stomach for detection of precancerous lesions. In cases of visible gross lesions, more diagnostic biopsies were taken and submitted for histopathologic evaluation. Results: Of 1,394 initial participants, finally 1,382 persons (702 women, 680 men) with a mean age of $61.7{\pm}9.0$ years (range: 50-87 years) underwent upper GI endoscopy. H. pylori infection based on the RUT was positive in 66.6%. Gastric adenocarcinoma and squamous cell carcinoma of esophagus were detected in seven (0.5%) and one (0.07%) persons, respectively. A remarkable proportion of studied participants were found to have esophageal hiatal hernia (38.4%). Asymptomatic gastric masses found in 1.1% (15) of cases which were mostly located in antrum (33.3%), cardia (20.0%) and prepyloric area (20.0%). Gastric and duodenal ulcers were found in 5.9% (82) and 6.9% (96) of the screened population. Conclusion: Upper endoscopy screening is an effective technique for early detection of GC especially in high risk populations. Further studies are required to evaluate cost effectiveness, cost benefit and mortality and morbidity of this method among high and moderate risk population before recommending this method for the GC surveillance program at the national level.