• Title/Summary/Keyword: Systematic risk

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Delayed Treatment of Pulmonary Tuberculosis in a University Hospital (대학병원에서 발생하는 폐결핵 치료지연)

  • Kang, Shin Myung;Lee, Jun Gu;Chung, Jae Ho;Han, Chang Hoon;Byun, Min Kwang;Chung, Wou Youn;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.277-284
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    • 2006
  • Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

A Study on Therapeutic Compliance of Hypertensive Patients in a Rural Health Subcenter (일개 농촌지역 보건지소 고혈압 환자의 치료지속성)

  • Song, Min-Keun
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.155-164
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    • 2002
  • Hypertension is the most frequent disease of chronic circulatory diseases and major intermediate cause or risk of the cerebrovascular disease which is a leading cause of death in Korea. Therefore, management of hypertension is an important issue in Korean healthcare. Especially, therapeutic compliance of hypertensives is very important because the hypertensive patients should receive anti-hypertensive treatment as long as the condition exists. However, many patients drop out of treatment, which is a major problem that needs to be solved through a hypertension control program. This study was carried out to provide basic data and counter measule for the hypertension control program in the community which aimed to keep the patients receiving treatment continuously. In order to investigate compliance of hypertensive patients during three months follow-up and the rate of control of hypertension, the data were collected during February, 2001, by reviewing medical records of 295 hypertensive patients who had been registered to Gunnam-myeon health subcenter before November, 2000. The author also study the dropout reasons by interviewing 58 patients among 68 dropout patients. The results were as follows: 1. Among the 295 subjects, 108(36.6%) were male and 187(63.4%) were female. Statistically, female hypertensives had a higher mean age than male(64.6 vs 66.3, p<0.05). 2. The 54.9% of the patients took anti-hypertensive medicine continuously for the past three months. And 19.3% had drug intermittently, and 25.8% dropped out of treatment. 3. Among several variables, such as sex, age, health insurance, the time taken from a patient's village to the health subcenter, only the last one was found to be significantly related to therapeutic compliance in the contingency table analysis. 4. The dropout reasons by multiple response were as follows, 'no symptom or no problem' (23.9%), 'change to other hospitals'(19.4%), 'geographical barrier'(17.9%), 'change to a neighborhood drugstore' (14.9%), 'immobility'(7.5%), 'economic barrier'(6.0%), 'unsatisfactory services of the health subcenter'(4.4%). 5. The mean blood pressure of 295 subjects was $144.9{\pm}12.9/86.88{\pm}8.6mmHg$. 6. The 32.5% of the subjects were controlled below 140/90mmHg. Conclusions: In order to improve the low rates of treatment and control of hypertension in rural hypertensives, a more active and systematic hypertension control program, including out-reaching follow-up management, is required in rural area. Especially, for health education of hypertensive patients, emphasis should placed on correcting wrong attitude toward hypertension.

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A Study on Periodontal Disease and Tooth Loss in Metabolic Syndrome Patient (대사증후군 환자의 치주질환과 치아상실에 관한 연구)

  • Kang, Hyun-Joo
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.445-456
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    • 2015
  • The aim of this study was to identify an effective control method of metabolic syndrome (MS) and oral diseases by investigating relationship between of MS and periodontal disease, tooth loss of the adult men and woman. We analyzed and concluded as follows, using a nationwide representative sample, in 8,225 middle senior citizens based on raw data of the 5th National Nutrition Survey in 2010, 2012. The data were analyzed by descriptive statistics, chi-squared test, and logistic regression using SAS ver. 9.2 program. The results are as follows, for correlation of metabolic component to periodontal disease, it was found that in men, the periodontal disease odds ratio of the group with abnormal fasting blood glucose increased 1.27 fold (95% confidence interval [CI], 1.04~1.54), and in woman, the odds ratios of the group with abnormal high density lipoprotein cholesterol increased 1.45 fold (95% CI, 1.22~1.72) and the odds ratio of the group with abnormal obesity increased 1.44 fold (95% CI, 1.17~1.77). For correlation of MS to periodontal disease, it was found that the odds ratio of periodontal disease in the woman at-risk group increased 1.55 fold (95% CI, 1.19~2.01) and that of the group with MS increased 2.25 fold (95% CI, 1.68~3.02). For correlation of woman's metabolic component to missing teeth, it was found that the odds ratio of group with abnormal blood pressure increased 1.41 fold (95% CI, 1.10~1.82). For correlation of woman's MS to missing teeth, it was found that the odds ratio of missing teeth in the group with MS increased 1.48 fold (95% CI, 1.07~2.04). It is considered that a public health project comprising preventive and systematic disease management is necessary for controlling MS and oral disease. The findings of the study are expected to lay the foundation for the development of oral health promotion programs.

The Effects of BizCool of Vocational High School on the Understanding of Enterprise Commencement and BizCool Outcomes (전문계 고교 창업교육(BizCool)이 창업인식 및 창업교육성과에 미치는 영향)

  • Cheon, Soo-Kyung;Jung, Hwa-Young
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.4 no.4
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    • pp.89-114
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    • 2009
  • BizCool is an entry-level business education program implemented with a purpose of enhancing the entrepreneurial disposition and capability of the youth through enterprise commencement education of vocational high school students and developing them into economic pillars of future to alleviate the labor shortage crisis of small and medium enterprises and revitalize enterprise commencement. In this study, the factors were deduced and a path analysis was conducted with the purpose of proposing a revitalization plan through an effectiveness analysis of enterprise commencement education for the youth. The result of the analysis revealed that BizCool has effects on the knowledge and understanding of enterprise commencement, and enterprise commencement knowledge also has effects on the understanding of enterprise commencement. In addition, it was found that the enterprise commencement knowledge and the understanding on enterprise commencement have effects on the intention of enterprise commence. In the result of verifying the hypothesis that the understanding of enterprise commencement according to the psychological characteristics of individuals will have a positive effect on the enterprise commencement intention, it was revealed that the risk resignation disposition and patience for ambiguity are having effects but accomplishment desire is not playing a moderating variable role. Through the above path analysis, a conclusion was obtained that the enterprise commencement education has effects on the outcome of enterprise commencement education through the understanding on enterprise commencement. Additionally, the nation needs to actively lead systematic enterprise commencement education within the policy of job creation upon realizing the need for enterprise commencement education of vocational high school, and a revitalization plan was proposed on the five kinds of a conversion of social perception on vocational high school, establishment of institutes specializing in BizCool and cultivation of BizCool specialists, development of various materials and expansion of BizCool program, field-centered lessons, revitalization of enterprise commencement club and personnel and resource support by companies.

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Psychosocial Characteristics and Factors Associated with Referral to Psychiatric Care in the Suicide Attempters Visiting Emergency Center (응급실에 내원한 자살 시도자들의 정신사회학적 특성과 정신건강의학과 진료 의뢰 관련 요인)

  • Kwon, Jung-Woo;Ko, Young-Hoon;Han, Chang-Su;Lee, Moon-Soo;Yoon, Ho-Kyung;Lee, Hongjae
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.106-113
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    • 2013
  • Objectives: The purpose of this study was to examine the characteristics and the psychosocial factors associated to the referral to psychiatric care in the suicide attempters visiting emergency center. Methods: We conducted a systematic chart review of 377 suicidal attempters visiting emergency center of the Korea University Ansan Hospital between January 2008 and December 2011. We gathered a data contain 20 items including psychosocial characteristics and factors related to suicide and factors related to psychiatric treatment. Multivariate logistic regression models were fitted to data to estimate the unique effects of sex, drunken status, companion, suicidal methods, place of suicide and current use of psychiatric medication on the referral to psychiatric care. Results: The female gender(OR=1.63, 95% CI=0.99-2.69), suicidal attempts at home(OR=3.40, 95% I= 1.21-9.56) and drunken state at visit(OR=2.34, 95% CI=1.10-5.01) are the factors that predict the risk of the non-referral of the patients to psychiatric intervention. Place of suicidal attempt was the most important factor do play a role in determining whether referral to psychiatric care will take place or not. Current use of psychiatric medication showed a trend toward significance(p=0.08, OR=1.67, 95% CI=0.95-2.95). Conclusions: These results suggest that when deciding whether to adapt or to refuse the referral to psychiatric care, the factors such as suicidal intent, lethality of suicide methods, familiar factors and alcohol may contribute onto the referral to psychiatric care. Additional research is required to investigate an association of these factors with referral to psychiatric care.

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Assessment of Consumer's Food Safety Perceptions and Practices (소비자의 식품안전 인지도와 안전행동 평가)

  • Park, Ji-Yeon;Choi, Eun-Hui;Choi, Jung-Hwa;Shim, Sang-Kook;Park, Hyung-Soo;Park, Ki-Hwan;Moon, Hye-Kyung;Ryu, Kyung
    • Journal of Food Hygiene and Safety
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    • v.24 no.1
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    • pp.1-11
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    • 2009
  • Consumers are very concerned about food safety as the risk with food increased. This study was conducted to evaluate the perceptions and practices of consumers on food safety in order to collect some information for the development of consumer education program. Total 500 consumers were asked to answer for survey constituted with 6 questions of generic information, 4 of food safety perceptions and 8 of food safety practices from June to July, 2006. More than half of respondents (51.8%) were unsatisfied with the food safety management of government while the individual practices on food safety were satisfactory. Especially, most respondents (98.7%) checked the expiration date of food when they purchased and 97% of respondents were washed hands before food preparation. The higher food safety perception, the better food safety practices of consumers. These results suggest that the systematic and continuous educations on food safety hazards and the principles of sanitation management are necessary for safe food handling and perception on food safety.

Dietary maximum exposure assessment of vitamins and minerals from various sources in Korean adolescents (한국 청소년의 다양한 급원을 통한 비타민과 무기질 최대섭취량 평가)

  • Han, Ji Hye;Lee, Hyun Sook;Kim, Sun Hyo
    • Journal of Nutrition and Health
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    • v.46 no.5
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    • pp.447-460
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    • 2013
  • Dietary supplement use is prevalent and represents an important source of nutrition. This study was conducted in order to assess the dietary maximum exposure of vitamins and minerals from various sources including regular diet, vitamin mineral supplements for non-prescription drug (VMS-NPD), vitamin mineral supplements for health functional foods (VMS-HFF), and fortified foods (FF). A total of 1,407 adolescent boys and girls attending middle or high schools were chosen from various cities and rural communities in Korea. Users of vitamin and mineral supplements (n = 60, 15-18 years of age) were chosen from the above 1,407 students. Intake of vitamins and minerals from a regular diet and FF was assessed by both food record method and direct interview for three days of two weekdays and one weekend, and those from VMS-NPD and VMS-HFF were assessed by both questionnaire and direct interview, and compared with the recommended nutrient intake (RNI) and the tolerable upper intake level (UL) for Korean adolescents. Daily average exposure range of vitamins and minerals from a regular diet was 0.3 to 4.4 times of the RNI. Some subjects had an excessive exposure to the UL in the following areas: from regular diets, vitamin A (1.7%) and niacin (5.0%); from only VMS-NPD, vitamin C (9.1%) and iron (5.6%); and from only VMS-HFF, niacin (8.6%) > vitamin $B_6$ (7.5%) > folic acid (2.9%) > vitamin C (2.3%). Nutrients of daily total intake from regular diet, VMS-NPD, VMS-HFF, and FF higher than the UL included nicotinic acid for 33.3% of subjects, and, then, in order, vitamin C (26.6%) > vitamin A (13.3%), iron (13.3%) > zinc (11.7%) > calcium (5.0%) > vitamin E (1.7%), vitamin $B_6$ (1.7%). Thus, findings of this study showed that subjects may potentially be at risk due to overuse of supplements, even though most of them took enough vitamins and minerals from their regular diet. Therefore, we should encourage adolescents to have sound health care habits through systematic and educational aspects.

Frequency of Candida Strains Isolated from Candidiasis Patients at A Tertiary Hospital over the Last 10 Years (최근 10년 동안 일개 상급종합병원의 칸디다혈증 환자에서 분리된 칸디다 균종의 빈도)

  • Hwang, Yu-Yean;Kang, On-Kyun;Park, Chang-Eun;Hong, Sung-No;Kim, Young-Kwon;Huh, Hee-Jae;Lee, Nam-Yong
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.2
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    • pp.110-118
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    • 2022
  • Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.

The value relevance of R&D expenditures according to the age of the replaced CEO (연구개발지출과 기업가치의 관계에 교체된 경영자의 나이가 미치는 영향)

  • Ha, Seok-tae;Kim, Eun-sil;Cho, Seong-pyo
    • Journal of Technology Innovation
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    • v.30 no.3
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    • pp.1-34
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    • 2022
  • This study examines the effect of CEO age on the value relevance of R&D which is the relationship between R&D expenditures and firm value. The value relevance of R&D expenditures is higher in companies with current older CEOs, while the relationship in companies with younger CEOs is lower than that of other companies. These results suggest that older CEOs tend to be conservative and make prudent R&D investment decisions. Because they make systematic investment decisions with rich experience, they are expected to have higher investment performance in the market. On the other hand, young CEOs choose risky investments in order to have their abilities highly evaluated in the labor market. The market places a high degree of risk on the R&D decision-making of young CEOs. Next, we analyze whether the age of the replaced CEOs affects the relationship between R&D expenditures and firm value. The result shows that the change of management increases the effect of R&D expenditure on firm value. However, in the case of being replaced by a younger CEO, this positive relationship becomes lower than that of other companies, showing results consistent with the case of the current younger CEO. The samples are analyzed by dividing them into conglomerates and non-conglomerates. In conglomerates, the age of the replaced CEOs does not affect the value relevance of R&D expenditures. Only non-conglomerates showed a negative (-) effect on the replaced younger CEOs. These results suggest that conglomerates maintain the stability of R&D management and performance so that the performance of R&D expenditures is not significantly affected by the age of the replaced CEOs. The reason is that mutual checks and support are coordinated within the group through decentralization of work and systematization of decision-making. This study shows evidence that the relationship between R&D expenditure and firm value according to the age of the replaced CEO is a phenomenon that only occurs in non-conglomerates. This phenomenon suggests that conglomerates are stably managing their R&D performance regardless of the change of CEOs or the characteristics of the CEOs.

A Development of Facility Web Program for Small and Medium-Sized PSM Workplaces (중·소규모 공정안전관리 사업장의 웹 전산시스템 개발)

  • Kim, Young Suk;Park, Dal Jae
    • Korean Chemical Engineering Research
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    • v.60 no.3
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    • pp.334-346
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    • 2022
  • There is a lack of knowledge and information on the understanding and application of the Process Safety Management (PSM) system, recognized as a major cause of industrial accidents in small-and medium-sized workplaces. Hence, it is necessary to prepare a protocol to secure the practical and continuous levels of implementation for PSM and eliminate human errors through tracking management. However, insufficient research has been conducted on this. Therefore, this study investigated and analyzed the various violations in the administrative measures, based on the regulations announced by the Ministry of Employment and Labor, in approximately 200 small-and medium-sized PSM workplaces with fewer than 300 employees across in korea. This study intended to contribute to the prevention of major industrial accidents by developing a facility maintenance web program that removed human errors in small-and medium-sized workplaces. The major results are summarized as follows. First, It accessed the web via a QR code on a smart device to check the equipment's specification search function, cause of failure, and photos for the convenience of accessing the program, which made it possible to make requests for the it inspection and maintenance in real time. Second, it linked the identification of the targets to be changed, risk assessment, worker training, and pre-operation inspection with the program, which allowed the administrator to track all the procedures from start to finish. Third, it made it possible to predict the life of the equipment and verify its reliability based on the data accumulated through the registration of the pictures for improvements, repairs, time required, cost, etc. after the work was completed. It is suggested that these research results will be helpful in the practical and systematic operation of small-and medium-sized PSM workplaces. In addition, it can be utilized in a useful manner for the development and dissemination of a facility maintenance web program when establishing future smart factories in small-and medium-sized PSM workplaces under the direction of the government.