• Title/Summary/Keyword: Systems epidemiology

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Work Conditions and Practices in Norwegian Fire Departments From 1950 Until Today: A Survey on Factors Potentially Influencing Carcinogen Exposure

  • Jakobsen, Jarle;Babigumira, Ronnie;Danielsen, Marie;Grimsrud, Tom K.;Olsen, Raymond;Rosting, Cecilie;Veierod, Marit B.;Kjaerheim, Kristina
    • Safety and Health at Work
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    • v.11 no.4
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    • pp.509-516
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    • 2020
  • Background: Meta-analyses have shown firefighters to be at an increased risk of several cancer types. Occupational carcinogen exposure may explain these increased risks. This study aims to describe Norwegian fire departments' work conditions from 1950 until today, focusing on factors relevant for potential occupational carcinogen exposure. Methods: With the help of a reference group, we developed a questionnaire on topics related to occupational exposure to carcinogens for the period 1950-2018. Selected Norwegian fire departments provided department-specific responses. Results: Sixteen departments, providing fire services for 48% of the Norwegian population as of 2019 and mainly consisting of professional firefighters, responded to our questionnaire. The introduction of synthetic firefighting foams, more regular live fire training, the introduction of chemical diving, and a higher number of diesel-driven fire service vehicles were identified as changes thought to increase exposure to occupational carcinogens. Changes thought to decrease exposure included the switch from negative to positive pressure self-contained breathing apparatuses, the use of self-contained breathing apparatuses during all phases of firefighting, the use of ventilating fans during firefighting, increased attention to flammable materials used during live fire training, increased attention to handling and cleaning of turnout gear and other equipment, and installment of exhaust removal systems in apparatus bays. Conclusion: Norwegian fire departments' work conditions have seen several changes since 1950, and this could influence firefighters' occupational carcinogen exposure. A peak of carcinogen exposure may have occurred in the 1970s and 1980s before recent changes have reduced exposure.

Automatic Access Management System Using Beacon (비콘을 활용한 자동화 출입관리 시스템)

  • Kim, Ho-Yoon;Kim, Hyo-Jong;Shin, Seung-Soo
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2021.05a
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    • pp.105-107
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    • 2021
  • With the prolonged COVID-19 worldwide, it is essential to create a list of visitors when using various facilities to prevent the spread of COVID-19 and to investigate epidemiology in the event of confirmed cases. In the beginning, there were many problems due to the leakage of personal information and false preparation by making a list of visitors with a handwritten list. To compensate for the problems of handwritten lists, the KI-Pass system based on QR codes is mainly managed. However, KI-Pass systems have the disadvantages of issuing QR codes and abusing personal information. In this paper, we propose an access management system using beacon. Beacon is an close-range wireless communication device and visitors when they are near the facility and automatically registers their personal information on the cloud server for access management. It is expected that this will be effective in preventing and responding to the spread of new infectious diseases in the future.

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Modeling Age-specific Cancer Incidences Using Logistic Growth Equations: Implications for Data Collection

  • Shen, Xing-Rong;Feng, Rui;Chai, Jing;Cheng, Jing;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9731-9737
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    • 2014
  • Large scale secular registry or surveillance systems have been accumulating vast data that allow mathematical modeling of cancer incidence and mortality rates. Most contemporary models in this regard use time series and APC (age-period-cohort) methods and focus primarily on predicting or analyzing cancer epidemiology with little attention being paid to implications for designing cancer registry, surveillance or evaluation initiatives. This research models age-specific cancer incidence rates using logistic growth equations and explores their performance under different scenarios of data completeness in the hope of deriving clues for reshaping relevant data collection. The study used China Cancer Registry Report 2012 as the data source. It employed 3-parameter logistic growth equations and modeled the age-specific incidence rates of all and the top 10 cancers presented in the registry report. The study performed 3 types of modeling, namely full age-span by fitting, multiple 5-year-segment fitting and single-segment fitting. Measurement of model performance adopted adjusted goodness of fit that combines sum of squred residuals and relative errors. Both model simulation and performance evalation utilized self-developed algorithms programed using C# languade and MS Visual Studio 2008. For models built upon full age-span data, predicted age-specific cancer incidence rates fitted very well with observed values for most (except cervical and breast) cancers with estimated goodness of fit (Rs) being over 0.96. When a given cancer is concerned, the R valuae of the logistic growth model derived using observed data from urban residents was greater than or at least equal to that of the same model built on data from rural people. For models based on multiple-5-year-segment data, the Rs remained fairly high (over 0.89) until 3-fourths of the data segments were excluded. For models using a fixed length single-segment of observed data, the older the age covered by the corresponding data segment, the higher the resulting Rs. Logistic growth models describe age-specific incidence rates perfectly for most cancers and may be used to inform data collection for purposes of monitoring and analyzing cancer epidemic. Helped by appropriate logistic growth equations, the work vomume of contemporary data collection, e.g., cancer registry and surveilance systems, may be reduced substantially.

Molecular Epidemiology of Legionella pneumophila Isolated from Water Supply Systems in Seoul, Korea (서울시 수계시설에서 분리된 Legionella pneumophila의 분자역학적 특성)

  • Jeon, Su Jin;Jung, Ji Hun;Seung, Hyun Jung;Kim, Chang Kyu;Jin, Young Hee;Oh, Young Hee;Choi, Sung Min;Chae, Young Zoo
    • Journal of Environmental Health Sciences
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    • v.39 no.2
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    • pp.166-177
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    • 2013
  • Objectives: The genus Legionella is common in aquatic environments. Some species of Legionella are recognized as potential opportunistic pathogens for human, notably Legionella pneumophila that causes, Legionellosis. Thus, we investigated the contamination of Legionella pneumophila on water supply systems in Seoul, including cooling towers, public baths, hospitals and fountains. Methods: The existence of 16S rRNA and mip gene of L. pneumophila was confirmed in the genome of the isolated strains by PCR. Results: During the summer season of 2010 and 2011, Legionella pneumophila were detected from 163 samples (21.1%) out of 772 samples collected. Among the 163 strains of L. pneumophila, eighty one isolates belonged to serogroup 1 (57.4%), 23 isolates were serogroup 5 (16.3%), 21 isolates were serogroup 6 (14.9%), 8 isolates were serogroup 2 (5.79%), and 8 isolates were identified in serogroup 3 (5.7%). Through PFGE (pulsed-field gel electrophoresis) analysis using Sfi I, genetic types of L. pneumophila were classified into five (A to E) patterns by the band similarity with excess of 70% from public baths. Conclusions: The PFGE patterns of the serotypes showed a tendency for diversity of L. pneumophila. Our results suggest the existence of serological and genetic diversity among the L. pneumophila isolates.

CLINICAL CATEGORIES OF ADOLESCENT BORDERLINE STATE (청소년 경계선 상태의 임상적 분류)

  • Hong, Kang-E;Jeon, Seong-Ill;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.18-33
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    • 1995
  • The Purpose of this article is to identify the specific characteristics of borderline disorder in adolescence to conceptualize the borderline state as an adolescent process different from borderline personality disorder in adult, and to classify them according to it's unique clinical feature, porcess and outcome. The development of borderline disorder in adolescent, epidemiology, comorbid disorders and differential diagnosis, pre-existing sub-classification systems, and etiology in theories of psychodynamics, biological theories, experimental studies, and follow-up studies are reviewed. The authors conceptualize the adolescent borderline state include all clinical states generated by re-emergence of unresolved rapproachement conflicts in adolescent, and propose that there are four subgroups in adolescent borderline state. (1) Borderline state as an adolescent process. (2) Borderline state associated with psychotic disorders (3) Borderline state as an initial stnge of typical borderline personality disorder (4) Borderline state associated with organic problems. Conceptually, borderline state in adolescence is not a simple continuation of primary failure of separation-individuation but a struggle for mastering unresolved separation-individuation conflicts in adolesance i.e., the second separation-individuation state, and if it fails this time, the struggle might continue into adult life as borderline personality disorder.

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Distribution of Legionella species from water systems and genetic diversity of L. pneumophila serogroup 1 in Gyeonggi-do (경기도내 수계시설에서 분리된 레지오넬라균의 분포현황 및 Legionella pneumophila serogroup 1의 유전학적 다양성 연구)

  • Lee, Hyun-Kyung;Park, Yong-Bae;Hwang, Sun-Il;Kim, Young-Su;Park, Nan-Joo;Park, Kwang-Hee;Yoon, Mi-Hye
    • Korean Journal of Microbiology
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    • v.53 no.3
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    • pp.156-162
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    • 2017
  • Legionnaires' disease (LD) is a severe and potentially fatal pneumonia caused by colonization of human-made water system and subsequent aerosolization and inhalation of Legionella bacteria. A total of 147 Legionella strains was isolated from environmental water sources from public facilities in Gyeonggi-do, South Korea. The distribution of Legionella isolates was investigated according to facility type, and sample type. L. pneumophila was distributed broadly throughout Gyeonggi-do, accounting for 85.7% of the isolates, and L. pneumophila serogroup (sg) 1 predominated in all of the public facilities. L. wadsworthii predominated among non-L. pneumophila species. We performed comparative analyses of L. pneumophila sg 1 isolated from environment water of public facilities in Gyeonggi-do by pulsed field gel electrophoresis (PFGE) and sequence-based typing (SBT). Thirty-two isolates were classified into 22 types by PFGE and 9 sequence types (STs) by SBT and categorized into 3 groups. ST1 was the most prevalent sequence type and two STs obtained in this study had unique allelic profiles. The use of SBT data from different countries for epidemiology study of LD constitutes a technically uncomplicated and relatively easy method for strain subtyping, especially compared to other contemporary techniques.

Health-related Quality of Life of Patients With Diabetes Mellitus Measured With the Bahasa Indonesia Version of EQ-5D in Primary Care Settings in Indonesia

  • Muhammad Husen Prabowo;Ratih Puspita Febrinasari;Eti Poncorini Pamungkasari;Yodi Mahendradhata;Anni-Maria Pulkki-Brannstrom;Ari Probandari
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.5
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    • pp.467-474
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    • 2023
  • Objectives: Diabetes mellitus (DM) is a serious public health issue that places a heavy financial, social, and health-related burden on individuals, families, and healthcare systems. Self-reported health-related quality of life (HRQoL) is extensively used for monitoring the general population's health conditions and measuring the effectiveness of interventions. Therefore, this study investigated HRQoL and associated factors among patients with type 2 DM at a primary healthcare center in Indonesia. Methods: A cross-sectional study was conducted in Klaten District, Central Java, Indonesia, from May 2019 to July 2019. In total, 260 patients with DM registered with National Health Insurance were interviewed. HRQoL was measured with the EuroQol Group's validated Bahasa Indonesia version of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) with the Indonesian value set. Multivariate regression models were used to identify factors influencing HRQoL. Results: Data from 24 patients were excluded due to incomplete information. Most participants were men (60.6%), were aged above 50 years (91.5%), had less than a senior high school education (75.0%), and were unemployed (85.6%). The most frequent health problems were reported for the pain/discomfort dimension (64.0%) followed by anxiety (28.4%), mobility (17.8%), usual activities (10.6%), and self-care (6.8%). The average EuroQoL 5-Dimension (EQ-5D) index score was 0.86 (95% confidence interval [CI], 0.83 to 0.88). In the multivariate ordinal regression model, a higher education level (coefficient, 0.08; 95% CI, 0.02 to 0.14) was a significant predictor of the EQ-5D-5L utility score. Conclusions: Patients with diabetes had poorer EQ-5D-5L utility values than the general population. DM patients experienced pain/discomfort and anxiety. There was a substantial positive relationship between education level and HRQoL.

Targetoid Primary Liver Malignancy in Chronic Liver Disease: Prediction of Postoperative Survival Using Preoperative MRI Findings and Clinical Factors

  • So Hyun Park;Subin Heo;Bohyun Kim;Jungbok Lee;Ho Joong Choi;Pil Soo Sung;Joon-Il Choi
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.190-203
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    • 2023
  • Objective: We aimed to assess and validate the radiologic and clinical factors that were associated with recurrence and survival after curative surgery for heterogeneous targetoid primary liver malignancies in patients with chronic liver disease and to develop scoring systems for risk stratification. Materials and Methods: This multicenter retrospective study included 197 consecutive patients with chronic liver disease who had a single targetoid primary liver malignancy (142 hepatocellular carcinomas, 37 cholangiocarcinomas, 17 combined hepatocellular carcinoma-cholangiocarcinomas, and one neuroendocrine carcinoma) identified on preoperative gadoxetic acid-enhanced MRI and subsequently surgically removed between 2010 and 2017. Of these, 120 patients constituted the development cohort, and 77 patients from separate institution served as an external validation cohort. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were identified using a Cox proportional hazards analysis, and risk scores were developed. The discriminatory power of the risk scores in the external validation cohort was evaluated using the Harrell C-index. The Kaplan-Meier curves were used to estimate RFS and OS for the different risk-score groups. Results: In RFS model 1, which eliminated features exclusively accessible on the hepatobiliary phase (HBP), tumor size of 2-5 cm or > 5 cm, and thin-rim arterial phase hyperenhancement (APHE) were included. In RFS model 2, tumors with a size of > 5 cm, tumor in vein (TIV), and HBP hypointense nodules without APHE were included. The OS model included a tumor size of > 5 cm, thin-rim APHE, TIV, and tumor vascular involvement other than TIV. The risk scores of the models showed good discriminatory performance in the external validation set (C-index, 0.62-0.76). The scoring system categorized the patients into three risk groups: favorable, intermediate, and poor, each with a distinct survival outcome (all log-rank p < 0.05). Conclusion: Risk scores based on rim arterial enhancement pattern, tumor size, HBP findings, and radiologic vascular invasion status may help predict postoperative RFS and OS in patients with targetoid primary liver malignancies.

Genome Type Analysis of Adenovirus Serotypes 1, 2 and 5 Isolated from Children with Lower Respiratory Tract Infections in Korea (하기도 감염 환아에서 분리된 Adenovirus 1, 2, 5 혈청형의 유전체형 분석)

  • Park, Ki-Won;Choi, Eun-Hwa;Choun, Ji-Tae;Lee, Hoan-Jong;Park, Ki-Ho
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.166-177
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    • 2005
  • Purpose : The purpose of this study was to examine the molecular epidemiology and genetic variability of adenovirus(Ad) serotypes Ad1, Ad2, and Ad5 over 14 years in Korea. Methods : A total of 382 adenoviral strains isolated from the nasopharyngeal aspirates of children with lower respiratory tract infections in Seoul, Korea from November 1990 to February 2003 were serotyped by neutralization assay with type-specific antisera. Viral DNAs were extracted from infected cell lysates by the modified Hirt procedure. Genome type(GT) was determined by DNA restriction analysis with 12 restriction enzymess(BamHI, BclI, BglI, BglII, BstEII, EcoRI, HindIII, HpaI, SalI, SmaI, XbaI, and XhoI). To evaluate the genetic relatedness, pairwise comigrating restriction fragments(PCRF) analysis was performed. Results : Of 382 strains, 33 strains(9%) were Ad1, 45 strains(12%) were Ad2, and 24 strains(6%) were Ad5. Eighteen GTs(Ad1p1-Ad1p7, Ad1a, Ad1b, Ad1b1-Ad1b3, Ad1c, Ad1d, Ad1e, Ad1e1, Ad1e2, Ad1f) among Ad1, 24(Ad2p1-Ad2p11, Ad2a, Ad2a1-Ad2a6, Ad2b, Ad2c, Ad2d, Ad2e, Ad2e1-Ad2e3) among Ad2, and 10(Ad5p1, Ad5p2, Ad5a, Ad5a1-Ad5a7) among Ad5 strains were identified. One or two strains of the vast majority of GTs were isolated during the study period while a few GTs were identified sporadically with more than 2 strains. It is notable that some GTs such as Ad1p5 and Ad5a1 appeared in cluster during a short period. In analysis of genetic relatedness, the degree of PCRFs(pairwise comigrating restriction fragments) for Ad1 varied from 79 to 99%, for Ad2, 82 to 99%, and for Ad5, 85 to 99%. Conclusion : This study established the comprehensive nomenclature systems of Ad1, Ad2, and Ad5. Diverse GTs identified in this study have crucial implications in the genomic diversity and epidemiological characteristics of Ad1, Ad2, and Ad5.

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Trends of Study and Classification of Reference on Occupational Health Management in Korea after Liberation (해방 이후 우리나라 산업보건관리에 관한 문헌분류 및 연구동향)

  • Ha, Eun-Hee;Park, Hye-Sook;Kim, Young-Bok;Song, Hyun-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.809-844
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    • 1995
  • The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (1) Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows ; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3 parts, that is , occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was sightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of Occupational Medicine(18.2%), Several Kinds of Medical Colloge Journal(17.0%), The Korean Journal Occupational Health(15.1%), The Korean Journal of Preventive Medicine(15.1%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(18.2%), occupational organization 3(9.1%) and occupational health delivery system 1 (3.0%). Of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was 185(71.1%), followed by women worker, white coiler workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (1) Study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.

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