• Title/Summary/Keyword: Risk-based screening level

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Effects of Numerical Formats and Frequency ranges on Judgment of Risk and Inference in the Bayesian InferenceTask (숫자양식과 빈도범위가 베이스 추론 과제에서 위험판단과 추론에 미치는 영향)

  • Lee, Hyun-Ju;Lee, Young-Ai
    • Korean Journal of Cognitive Science
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    • v.20 no.3
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    • pp.335-355
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    • 2009
  • We examined risk judgment and the accuracy of inference based on two kinds of probabilities in a Bayesian inference task: the death probability from a disease (base rates) and the probability of having a disease with positive results in the screening test (posterior probabilities). Risk information were presented in either a probability or a frequency format. In Study 1, we found a numerical format effect for both base rate and posterior probability. Participants rated information as riskier and inferred more accurately in the frequency condition than in the probability condition for both base rate and posterior probability. However, there was no frequency range effect, which suggested that the ranges of frequency format did not influence risk ratings. In order to find out how the analytic thought system influences risk ratings, we compared the ratings of a computation condition and those of a no-computation condition and still found the numerical format effect in computation condition. In Study 2, we examined the numerical format effect and frequency range effect in a high and a low probability condition and found the numerical format effect at each probability level. This result suggests that people feel riskier in the frequency format than in the probability format regardless of the base rates and the posterior probability. We also found a frequency range effect only for the low base rate condition. Our results were discussed in terms of the dual process theories.

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Risk Factors of Hypothyroidism after Hemithyroidectomy for Benign Thyroid Disease in Korea (양성 갑상선 질환으로 편측 갑상선 절제술을 시행한 후 발생되는 갑상선 기능 저하증에 대한 위험인자)

  • Lee, Seok-Jae;Kim, Kyung-Tae;Cho, Byung-Han;Lim, Jae-Yol;Kim, Young-Mo
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.2
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    • pp.212-215
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    • 2010
  • Objectives:There are various reports for incidence and risk factors of hypothyroidism after hemithyroidectomy for benign thyroid disease. The reported incidence rate varies from 5.0 to 41.9%. Moreover, there are few reports about this in Korea. So, our objective is to identify the incidence and possible factors contributing to hypothyroidism after hemithyroidectomy in Korea. Subjectives and Methods:We reviewed medical records of patients who underwent hemithyroidectomy between 1999 and 2007 years. We enrolled 80 patients. The incidence of postoperative hypothyroidism was based on thyrotropin values and clinical symptoms. And all patients were evaluated for age, gender, serum thyrotropin(TSH) levels, serum free T4, weight of resected thyroid tissue and associated thyroiditis. Results:Nine of 80 patients(11.3%) became biochemically hypothyroid postoperatively. Six of 9 hypothyroid patients were diagnosed within 2 months of operation. The mean preoperative TSH level was $2.12{\pm}0.96mIU/L$ in hypothyroid and significantly different from $1.33{\pm}0.77mIU/L$ in euthyroid patients(p<0.05). There were no significant differences in age, gender, weight of resected thyroid tissue, preoperative free T4 and associated thyroiditis. Conclusion:A minority of patients became hypothyroid after hemithyroidectomy. Hypothyroidism following hemithyroidectomy occurred in patients with higher preoperative TSH levels.. The screening test for postoperative hypothyroidism should be performed from month to year after operation.

A neonate with hyperornithinemia-hyperammonemia-homocitrullinuria syndrome from a consanguineous Pakistani family

  • Kim, Yoo-Mi;Lim, Han Hyuk;Gang, Mi Hyeon;Lee, Yong Wook;Kim, Sook Za;Kim, Gu-Hwan;Yoo, Han-Wook;Ko, Jung-Min;Chang, Meayoung
    • Journal of Genetic Medicine
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    • v.16 no.2
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    • pp.85-89
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    • 2019
  • Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare autosomal recessive urea cycle disorder. HHH is caused by a deficiency of the mitochondrial ornithine transporter protein, which is encoded by the solute carrier family 25, member 15 (SLC25A15) gene. Recently, government supported Korean newborn screening has been expanded to include a tandem mass spectrometry (MS/MS) measurement of ornithine level. We report a case of a neonate with HHH syndrome showing a normal MS/MS measurement of ornithine level. A female newborn was admitted to neonatal intensive unit due to familial history of HHH syndrome. Her parents were consanguineous Parkistani couple. The subject's older sister was diagnosed with HHH syndrome at age of 30 months based on altered mental status and liver dysfunction. Even though the subject displayed normal ammonia and ornithine levels based on MS/MS analysis, a molecular test confirmed the diagnosis of HHH syndrome. At 1 month of age, amino acid analysis of blood and urine showed high levels of ornithine and homocitrulline. After 11 months of follow up, she showed normal growth and development, whereas affected sister showed progressive cognitive impairment despite no further hyperammonemia after protein restriction and standard therapy. Our report is in agreement with a previous Canadian study, which showed that neonatal samples from HHH syndrome patients demonstrate normal ornithine levels despite having known mutations. Considering the delayed rise of ornithine in affected patients, genetic testing, and repetitive metabolic testing is needed to prevent patient loss in high risk patients.

Relationship between Arterial Stiffness and Physical Activity Level Assessed by International Physical Activity Questionnaire­short form (IPAQ­SF) in the Elderly (노인에서 동맥경화지표와 단문형 국제신체활동설문지(IPAQ­SF)로 평가한 신체활동수준과의 관계)

  • Lee, Hyun-Ju;Gwak, Ji-Yeon;Jun, Ha-Yeon;Kim, Eun-Kyung
    • Korean Journal of Community Nutrition
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    • v.25 no.3
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    • pp.236-245
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    • 2020
  • Objectives: Cardiovascular disease is a major cause of death in the elderly in Korea. Increased arterial stiffness is linked to risk of cardiovascular disease and mortality. The purpose of this study was to investigate the relationship between arterial stiffness and physical activity in the elderly. Methods: A total of 209 older adults (110 men and 99 women) participated in this study. Arterial stiffness of subjects such as brachial-ankle pulse wave velocity (baPWV) and ankle brachial pressure index (ABI) was measured using a non-invasive vascular screening device (VP-1000 Plus, Omron, Kyoto, Japan). The interviewed Korean version of the international physical activity questionnaire short form (IPAQ-SF) was used to evaluate subject's physical activity level and classify subjects as active or inactive group based on the time spent doing moderate to vigorous physical activity (MVPA). Results: The mean age of total subjects was 75.3 ± 5.6 years. There was no significant difference in sex distribution between the active group (39.7%) and inactive group (60.3%). The baPWV (1,758.1 ± 375.2 cm/sec) of the active group was significantly lower than that (1,969.7 ± 372.3 cm/sec) of the inactive group (P < 0.05). There was a significant inverse association between time spent in MVPA and baPWV (r = -0.245, P < 0.01). Conclusions: This study suggests that physical activity programs for older adults are needed to prevent arteriosclerosis.

A Study on Community Perceptions of Common Cancers, Determinants of Community Behaviour and Program Implementation in New Delhi, India

  • Seth, Tulika;Kotwal, Atul;Thakur, Rakesh Kumar;Ganguly, K.K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2781-2789
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    • 2012
  • Assessment of perceptions of the community, the determinants and development of their behavior regarding common malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer. However information on this important aspect is lacking in our country. Qualitative methods were here used to obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories of identified stakeholders. Most were unaware of the activities of the cancer control program. Even the providers were not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government, primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why many community members did not attend screening camps and other services reflect the determinants of community behavior, acting independently as well as in combination. The cancer control program was thought to be restricted only to some private facilities and overcrowded government tertiary care facilities where the visits were time consuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring and feedback were inadequately addressed by providers who were inadequately trained in many program activities. The program lacked effective planning, coordination and appropriate implementation at the grass roots level in Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of the existence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatment were common amongst community members as well as many of the providers. Thus the national cancer control program in our country needs further community participation and social mobilization. Accessibility, availability, acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoral coordination, training, supervision and monitoring of program activities, all need to be addressed to ensure the success of this important public health program.

Impact Assessment of Sea_Level Rise based on Coastal Vulnerability Index (연안 취약성 지수를 활용한 해수면 상승 영향평가 방안 연구)

  • Lee, Haemi;Kang, Tae soon;Cho, Kwangwoo
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.27 no.5
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    • pp.304-314
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    • 2015
  • We have reviewed the current status of coastal vulnerability index(CVI) to be guided into an appropriate CVI development for Korean coast and applied a methodology into the east coast of Korea to quantify coastal vulnerability by future sea_level rise. The CVIs reviewed includes USGS CVI, sea_level rise CVI, compound CVI, and multi scale CVI. The USGS CVI, expressed into the external forcing of sea_level rise, wave and tide, and adaptive capacity of morphology, erosion and slope, is adopted here for CVI quantification. The range of CVI is 1.826~22.361 with a mean of 7.085 for present condition and increases into 2.887~30.619 with a mean of 12.361 for the year of 2100(1 m sea_level rise). The index "VERY HIGH" is currently 8.57% of the coast and occupies 35.56% in 2100. The pattern of CVI change by sea_level rise is different to different local areas, and Gangneung, Yangyang and Goseong show the highest increase. The land use pattern in the "VERY HIGH" index is dominated by both human system of housing complex, road, cropland, etc, and natural system of sand, wetland, forestry, etc., which suggests existing land utilization should be reframed in the era of climate change. Though CVI approach is highly efficient to deal with a large set of climate scenarios entailed in climate impact assessment due to uncertainties, we also propose three_level assessment for the application of CVI methodology in the site specific adaptation such as first screening assessment by CVI, second scoping assessment by impact model, and final risk quantification with the result of impact model.

The Normative Study of the Montreal Cognitive Assessment-Korea (MoCA-K) as Instrument for Screening of Mild Cognitive Impairment (MCI) (경도인지장애 선별검사로서 Montreal Cognitive Assessment-Korea (MoCA-K)의 규준 연구)

  • Kwak, Ho-Soung;Kim, Sun-Ho
    • Journal of The Korean Society of Integrative Medicine
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    • v.9 no.3
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    • pp.37-45
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    • 2021
  • Purpose : This study aimed to present normative data and cut-off points for older Korean adults completing the Montreal Cognitive Assessment - Korean (MoCA-K), which is used as a screening test for mild cognitive impairment in Korea. Methods : A total of 195 healthy adults ≥60 years were recruited. All participants completed the MoCA-K and the Korean - Mini-Mental State Examination (MMSE-K) to assess their cognitive function. Participants were divided into six groups based on their age: 60-64 years, 65~69 years, 70~74 years, 75~79 years, 80~84 years, and 85~89 years. Results : The results revealed that MoCA-K score decreased significantly with age (mean score ± standard deviation [SD]; 27.63±2.80 in subjects aged 60~64 years; 27.00±2.39 in subjects aged 65~69 years; 24.94±2.96 in subjects aged 70~74 years; 24.74±3.37 in subjects aged 75~79 years; 22.59±4.72 in subjects aged 80~84 years; and 18.83±5.38 in subjects aged 85~89 years; p<.001). Additionally, MoCA-K score also increased significantly with educational level (mean score±standard deviation [SD]; 19.95±4.78 in no formal education group; 24.95±2.22 in elementary school graduated group; 26.35±2.72 in middle school graduated group; 28.32±1.36 in high school graduated group; and 28.50±1.51 in more than college graduated group; p<.001). The optimal cut-off points were 24/25 for 60~69 years old group, 21/22 for 70~79 years old group, 17/18 for 80~84 years old group, and 13/14 for 85~89 years old group. The optimal cut-off points were 15/16 for individuals who were illiterate, 22/23 for individuals with 6 years of education, 22/24 for individuals with 9 years of education, and 26/27 for individuals with 12 or more years of education. Conclusions : This study presents normative data and cut-off points for the MoCA-K in older Korean adults. This data will facilitate more accurate detection and follow-up of the risk of mild cognitive impairment in this population, taking into consideration age and education. Future studies are required that should focus on the cut-off score on the level of education according to age.

The Effect of Metabolic Syndrome on Periodontal Disease in Korean Adults: Based on the Data from the 6th Korea National Health and Nutrition Examination Survey (2013∼2015)

  • Son, Jung-Hui;Bae, Soo-Myoung
    • Journal of dental hygiene science
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    • v.20 no.3
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    • pp.178-186
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    • 2020
  • Background: The purpose of this study was to evaluate the association between metabolic syndrome and periodontal disease in Korean adults. Methods: This study analyzed the screening data of 12,686 adults aged ≥19 years, including demographic characteristics, lifestyle habits, and each component of metabolic syndrome, obtained from the sixth Korea National Health and Nutrition Examination Survey database. Periodontal health status was measured by the community periodontal index. Subjects with three or more risk factors were considered as having metabolic syndrome. The Rao-Scott chi-square test was performed to assess the relationships between demographic characteristics, lifestyle habits, components of metabolic syndrome, and periodontal disease. Logistic regression analysis was performed based on the complex sample to evaluate the relationship between metabolic syndrome and periodontal disease. Results: The prevalence of periodontal disease was higher among the subjects with advancing age, lower average household income and education level, those working in production, residents of eup-myeon areas, in past or current smoker, those with excessive alcohol consumption habit in a week, and reduced brushing frequency and the use of oral care products (p<0.001). Each component of metabolic syndrome was associated with higher prevalence of periodontitis in the subjects with abnormal than in those with normal levels (p<0.001). The prevalence of periodontal disease in subjects with metabolic syndrome was approximately 1.443 times higher than that in normal subjects (odds ratio,1.443; p<0.001). Conclusion: This study confirmed the association between metabolic syndrome and periodontitis in Korean adults, and further studies will be needed to determine the causal relationship between the two conditions.

A Comparative Analysis of Smoking-Associated Factors in Wonju-si and Chuncheon-si: Based on the National Health Insurance Service-Health Screening Database (원주시와 춘천시 흡연 관련 요인 비교 분석: 국민건강보험공단 건강검진 DB 바탕으로)

  • Yun-Ji Jeong;Lee-Seo Seol;Hyung-Kyung Cho;Hyun-Ji Lee;Kwang-Soo Lee
    • Korea Journal of Hospital Management
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    • v.28 no.1
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    • pp.24-36
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    • 2023
  • Purposes: The purpose of this study was to analyze the factors associated with current smoking status in Wonju-si and Chuncheon-si, and to study the cause of difference in smoking rates between these two regions. Methodology: Data was from the National Health Insurance Service database from 2019 to 2020. Current smoking status was based on the response to the health examination questionnaire. Logistic regression analysis was conducted to identify factors associated with current smoking status. The study included 207,307 individuals from Wonju-si and 173,698 individuals from Chuncheon-si. Findings: The smoking rate of Wonju-si was 19.83%, and Chuncheon-si was 18.20%, showing a difference in the smoking rates between the two regions. Logistic regression analysis found that men, those aged 40-49, being a self-employed insured, a medical-aid beneficiary, having a lower income, working in construction, transport, storage, communication, or manufacturing industries, having a high-risk drinking level and being underweight were significantly associated with a higher likelihood of smoking(p<0.05). Additionally, having a chronic disease was associated with a lower likelihood of smoking in the case of Chuncheon-si(p<0.05). Practical Implication: This study found the differences of factors associated with smoking rates between the two regions and could provide implications for establishing intervention programs or policies that could contribute to lowering the smoking rate in areas with high smoking rates.

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A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System (모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구)

  • 이광옥
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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