• Title/Summary/Keyword: Surveillance coverage

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Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women

  • Seo, Munseok;Langabeer, James
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.4
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    • pp.181-187
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    • 2018
  • Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

The Fault Tolerant Evaluation Model due to the Periodic Automatic Fault Detection Function of the Safety-critical I&C Systems in the Nuclear Power Plants (원전 안전필수 계측제어시스템의 주기적 자동고장검출기능에 따른 고장허용 평가모델)

  • Hur, Seop;Kim, Dong-Hoon;Choi, Jong-Gyun;Kim, Chang-Hwoi;Lee, Dong-Young
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.62 no.7
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    • pp.994-1002
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    • 2013
  • This study suggests a generalized availability and safety evaluation model to evaluate the influences to the system's fault tolerant capabilities depending on automatic fault detection function such as the automatic periodic testings. The conventional evaluation model of automatic fault detection function deals only with the self diagnostics, and supposes that the fault detection coverage of self diagnostics is always constant. But all of the fault detection methods could be degraded. For example, the periodic surveillance test has the potential human errors or test equipment errors, the self diagnostics has the potential degradation of built-in logics, and the automatic periodic testing has the potential degradation of automatic test facilities. The suggested evaluation models have incorporated the loss or erroneous behaviors of the automatic fault detection methods. The availability and the safety of each module of the safety grade platform have been evaluated as they were applied the automatic periodic test methodology and the fault tolerant evaluation models. The availability and safety of the safety grade platform were improved when applied the automatic periodic testing. Especially the fault tolerant capability of the processor module with a weak self-diagnostics and the process parameter input modules were dramatically improved compared to the conventional cases. In addition, as a result of the safety evaluation of the digital reactor protection system, the system safety of the digital parts was improved about 4 times compared to the conventional cases.

Epidemiological Investigation of a Measles Outbreak in a Preschool in Incheon, Korea, 2006 (2006년 인천의 한 유치원에서 발생한 홍역 유행 역학조사)

  • So, Jae-Sung;Go, Un-Yeong;Lee, Dong-Han;Park, Koang-Suk;Lee, Jong-Koo
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.3
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    • pp.153-158
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    • 2008
  • Objectives : This study describes a plan that was designed to prevent a measles outbreak that showed a changed outbreak pattern. This study is based on the epidemiological investigation of a measles outbreak in a preschool in Incheon, Korea, 2006. Methods : The subjects were 152 students at a preschool where a measles outbreak occurred. A questionnaire survey was conducted and serological testing for measles-specific IgM was preformed. Results : Of the fifteen confirmed, identified cases, eleven patients had been vaccinated with one dose, one patient had received two doses and three patients were unvaccinated. The three unvaccinated cases consisted of one 5-year-old child, one 3-year-old child and one 16-month-old infant. For the cases with one dose of the vaccination, there were 11 cases, which consisted of six 5-year-old children, two 4-year-old children, two 3-year-old children and one 2-year-old child. The case with two doses of the vaccination was one 4-year-old child. The attack rate of measles was 100% in the 0-dose group, 11.2% in the 1-dose group and 2.0% in the 2-dose group. The vaccine's efficacy was 88.8% in the 1-dose group and 98.0% in the 2-dose group. The vaccine effectiveness for the 2-dose group was higher than that of the 1-dose group. Conclusions : High coverage with a 2-dose vaccination should be maintained, and the vaccination should be given at the suitable time to prevent a measles outbreak with a changed outbreak pattern.

SPACEBORNE TOPS SAR SYSTEM MODELING AND PERFORMANCE ANALYSIS (TOPS 위성 SAR 모드 시스템 구현 및 성능 평가 연구)

  • Kang, Seo-Li;Song, Jeong-Hwan;Kim, Bum-Seung;Kim, Hyeon-Cheol;Lee, Woo-Kyung
    • Journal of Satellite, Information and Communications
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    • v.9 no.2
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    • pp.74-79
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    • 2014
  • Conventional ScanSAR mode has been adopted in Envisat or Radarsat and played an important role to acquire wide swath SAR images for environmental surveillance. However, it suffers from the undesirable scalloping effect caused by non-homogeneity of antenna pattern while the image resolution is sacrificed. In recent years, TOPS mode has been suggested and put into use to overcome the disadvantages of the conventional scanning mode. Although TOPS mode is able to produce wide-swath SAR image in a short time interval, it demands highly complicated system design knowledge. In this paper, we present the operation principle of TOPS mode and a full SAR simulation is performed to generate TOPS SAR raw data. Azimuth antenna pattern is modified during TOPS mode operation and it is shown that the undesired scalloping effect is suppressed in the generated SAR image.

Advanced medical devices and regulatory innovations in new health technology assessments (의료기기 발전과 신의료기술평가 규제혁신)

  • Lee, You Kyoung
    • Journal of the Korean Medical Association
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    • v.61 no.12
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    • pp.702-705
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    • 2018
  • Advances in technology lead to advances in medical devices, and these advances have the positive effect of creating opportunities for beneficial developments in healthcare, such as innovating traditional healthcare processes or expanding opportunities for diagnosing and treating diseases. Nonetheless, device developers, suppliers, users, insurers, and patients all face the challenge of balancing patient safety and health effectiveness with a reasonable profit. In Korea, the New Health Technology Assessment system aims to introduce safe and effective health technology, but this is only effective for the entry of devices onto the healthcare market. This system is not enough for creating a healthy ecosystem in which high-quality technologies and devices survive in the market and naturally exit from the market if not successful. The nation must not lag in the rapid development of medical devices, but the concomitant requirement for patient safety is like two rabbits moving in different directions. There is not enough time to resolve each source of uncertainty for both developers and users. The early adoption of health technologies, including medical devices, offers new opportunities for treatment and diagnosis, but also poses unexpected health risks. Thus, we need to design a plan to generate scientific evidence related to medical devices after they introduced into practice. Additionally, regarding the use of individual medical devices, we believe that the creation of a healthy ecosystem for medical devices by implementing medical device surveillance culture is a way to manage the opportunities and risks of the early introduction of innovative medical devices.

The Evolving Epidemiology of Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Strains Isolated from Adults in Crete, Greece, 2009-2016

  • Maraki, Sofia;Mavromanolaki, Viktoria Eirini;Stafylaki, Dimitra;Hamilos, George;Samonis, George
    • Infection and chemotherapy
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    • v.50 no.4
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    • pp.328-339
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    • 2018
  • Background: Pneumococcal disease is a major cause of morbidity and mortality worldwide, especially in patients with comorbidities and advanced age. This study evaluated trends in epidemiology of adult pneumococcal disease in Crete, Greece, by identifying serotype distribution and antimicrobial resistance of consecutive Streptococcus pneumoniae strains isolated from adults during an 8-year time period (2009-2016) and the indirect effect of the infant pneumococcal higher-valent conjugate vaccines 10-valent pneumococcal conjugate vaccine (PCV10) and 13-valent pneumococcal conjugate vaccine (PCV13). Materials and Methods: Antimicrobial susceptibility was performed by E-test and serotyping by Quellung reaction. Multidrug resistance (MDR) was defined as non-susceptibility to penicillin (PNSP) combined with resistance to ${\geq}2$ non-${\beta}$-lactam antimicrobials. Results: A total of 135 S. pneumoniae strains were isolated from adults during the study period. Twenty-one serotypes were identified with 17F, 15A, 3, 19A, and 11A, being the most common. The coverage rates of PCV10, and PCV13 were 17.8% and 37.8%, respectively. PCV13 serotypes decreased significantly from 68.4% in 2009 to 8.3% in 2016 (P = 0.002). The most important emerging non-PCV13 serotypes were 17F, 15A, and 11A, with 15A being strongly associated with antimicrobial resistance and MDR. Among all study isolates, penicillin-resistant and MDR strains represented 7.4% and 14.1%, respectively. Predominant PNSP serotypes were 19A (21.7%), 11A (17.4%), and 15A (17.4%). Erythromycin, clindamycin, tetracycline, trimethoprim-sulfamethoxazole, and levofloxacin resistant rates were 30.4%, 15.6%, 16.3%, 16.3%, and 1.5%, respectively. Conclusion: Although pneumococcal disease continues to be a health burden in adults in Crete, our study reveals a herd protection effect of the infant pneumococcal higher-valent conjugate vaccination. Surveillance of changes in serotype distribution and antimicrobial resistance among pneumococcal isolates are necessary to guide optimal prevention and treatment strategies.

Comparisons of Attitude on Media's Report for Avian Influenza between Poultry Breeder and Non-breeder (언론의 조류인플루엔자 보도에 대한 조류사육업자와 비사육업자의 태도 비교)

  • Oh, Gyung-Jae
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.58-66
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    • 2009
  • Objectives: Active participation of poultry breeder in surveillance system of Avian Influenza (AI) is very important. Therefore this study was conducted to present basis data for active report of AI that is affected by media's coverage in poultry breeder. Methods: Subjects were 88 persons, 28 who were poultry breeder at epidemic area of AI and 60 who were general person at non-epidemic area. Data were collected by the trained investigator from Jul. 1 to Aug. 31, 2008. Respondents were interviewed by means of a structured questionnaire. Results: The third-person effect among perceptions of influence in media's report on the AI was higher in breeder (32.1%) than in non-breeder (10.0%). However, Confidence to media report on the AI was lower in breeder than in non-breeder. Intention to report of the AI was 71.4% in breeder respectively, was 90.0% in non-breeder. There was statistically significant lower in breeder than non-breeder. The cause of avoidance of report was 'economic damage' for 87.5%, which acocounted for the majority of cases. Confidence to media report on the AI were positively correlated with concern on the AI and perception on seriousness of the AI, but negatively correlated with the third-person effect. Conclusions: These results showed that intention to report of the AI of breeder was susceptible to influenced by the third person effect and confidence in media's report on the AI. Therefore we should give a special attention to increase active report of poultry breeder during epidemic period of AI which is consideration of reasonable strategy of media's coverage, including mind and emotion state of poultry breeder.

Analysis of Infiltration Route using Optimal Path Finding Methods and Geospatial Information (지형공간정보 및 최적탐색기법을 이용한 최적침투경로 분석)

  • Bang, Soo Nam;Heo, Joon;Sohn, Hong Gyoo;Lee, Yong Woong
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.26 no.1D
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    • pp.195-202
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    • 2006
  • The infiltration route analysis is a military application using geospatial information technology. The result of the analysis would present vulnerable routes for potential enemy infiltration. In order to find the susceptible routes, optimal path search algorithms (Dijkstra's and $A^*$) were used to minimize the cost function, summation of detection probability. The cost function was produced by capability of TOD (Thermal Observation Device), results of viewshed analysis using DEM (Digital Elevation Model) and two related geospatial information coverages (obstacle and vegetation) extracted from VITD (Vector product Interim Terrain Data). With respect to 50m by 50m cells, the individual cost was computed and recorded, and then the optimal infiltration routes was found while minimizing summation of the costs on the routes. The proposed algorithm was experimented in Daejeon region in South Korea. The test results show that Dijkstra's and $A^*$ algorithms do not present significant differences, but A* algorithm shows a better efficiency. This application can be used for both infiltration and surveillance. Using simulation of moving TOD, the most vulnerable routes can be detected for infiltration purpose. On the other hands, it can be inversely used for selection of the best locations of TOD. This is an example of powerful geospatial solution for military application.

Characteristic Analysis of Wireless Channels to Construct Wireless Network Environment in Underground Utility Tunnels (지하공동구 내 무선 네트워크 환경구축을 위한 무선채널 특성 분석)

  • Byung-Jin Lee;Woo-Sug Jung
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.24 no.3
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    • pp.27-34
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    • 2024
  • The direct and indirect damages caused by fires in underground utility tunnels have a great impact on society as a whole, so efforts are needed to prevent and manage them in advance. To this end, research is ongoing to prevent disasters such as fire flooding by applying digital twin technology to underground utility tunnels. A network is required to transmit the sensed signals from each sensor to the platform. In essence, it is necessary to analyze the application of wireless networks in the underground utility tunnel environments because the tunnel lacks the reception range of external wireless communication systems. Within the underground utility tunnels, electromagnetic interference caused by transmission and distribution cables, and diffuse reflection of signals from internal structures, obstacles, and metallic pipes such as water pipes can cause distortion or size reduction of wireless signals. To ensure real-time connectivity for remote surveillance and monitoring tasks through sensing, it is necessary to measure and analyze the wireless coverage in underground utility tunnels. Therefore, in order to build a wireless network environment in the underground utility tunnels. this study minimized the shaded area and measured the actual cavity environment so that there is no problem in connecting to the wireless environment inside the underground utility tunnels. We analyzed the data transmission rate, signal strength, and signal-to-noise ratio for each section of the terrain of the underground utility tunnels. The obtained results provide an appropriate wireless planning approach for installing wireless networks in underground utility tunnels.

A Survey for Changed Control Policies of Hepatitis B in Republic of Korea (우리나라의 B형 간염 조절 정책의 변화에 대한 조사)

  • Han, Ji Yoon;Jung, Tae Woong;Koh, Dae Kyun;Kim, Jong Hyun
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.124-134
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    • 2011
  • Purpose : We have tried to search all concerning data on the policies of hepatitis B vaccination or surveillance of medical equipments that can transmit blood mediated diseases, including disposable syringe, in Republic of Korea, to propose references to other medical professionals. Methods : Data from domestic journals, government websites, computerized newspapers, etc. were reviewed. The data were arranged into four categories (governmental policies on hepatitis B control, hepatitis B mass immunization program in school, using process of hepatitis B vaccine, and policies on medical equipments surveillance, including disposable syringes, which is considered as source of blood mediated infection), and the periodic changes on each subjects in policies were reviewed. Results : Due to growing social concerns on hepatitis B in early 1980s, swift introduction and production of hepatitis B vaccine was made. After establishment of "5 year project for eradication of hepatitis B" in late 1983, number of vaccinated population jumped up to 6 million within 2 years (1984-85). However, since the immunization targets were mainly adult, not infant, this project was annulled in late 1985. Following this project, hepatitis B mass immunization program in school was carried out. In year 1995, hepatitis B vaccine was included in national immunization program. The use of disposable syringe was recommended from year 1980 but legislated in year 1985, finally. Conclusion : The mainstay in controlling hepatitis B in Republic of Korea was coordination of prompt introduction of vaccine, mass immunization, high vaccination coverage rate, or use of disposable syringes. However, since there is lack of official data available, it is urgent to arrange and computerize all government data related to infectious diseases.