• Title/Summary/Keyword: guideline for risk management

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Korean Clinical Practice Guidelines for Aneurysmal Subarachnoid Hemorrhage

  • Cho, Won-Sang;Kim, Jeong Eun;Park, Sukh Que;Ko, Jun Kyeung;Kim, Dae-Won;Park, Jung Cheol;Yeon, Je Young;Chung, Seung Young;Chung, Joonho;Joo, Sung-Pil;Hwang, Gyojun;Kim, Deog Young;Chang, Won Hyuk;Choi, Kyu-Sun;Lee, Sung Ho;Sheen, Seung Hun;Kang, Hyun-Seung;Kim, Byung Moon;Bae, Hee-Joon;Wan, Chang;Park, Hyeon Seon
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.127-166
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    • 2018
  • Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, world-wide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.

Breast and Cervical Cancer Screening and Associated Factors among Older Adult Women in South Africa

  • Peltzer, Karl;Phaswana-Mafuya, Nancy
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2473-2476
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    • 2014
  • Background: Little is known about the cancer screening prevalence and correlates in older adults from different racial backgrounds. In the context of heightened efforts for prevention and early diagnosis, we collected information on screening for two major types of cancers: cervical and breast cancer in order to establish their prevalence estimates and correlates among older South African women who participated in the Study of Global Ageing and Adults Health (SAGE) in 2008. Materials and Methods: We conducted a national population-based cross-sectional study with a multi-stage stratified cluster sample of 3,840 individuals aged 50 years or older in South Africa in 2008. In this analysis, we only considered the female subsample of (n=2202). The measures used included socio-demographic characteristics, health variables, anthropometric and blood pressure measurements. Multivariable regression analysis was performed to assess the association of socio-demographic factors, health variables and cancer screening. Results: Overall, regarding cervical cancer screening, 24.3% ever had a Papanicolaou (PAP) smear test, and regarding breast cancer screening, 15.5% ever had a mammography. In multivariate logistic regression analysis, younger age, higher education, being from the White or Coloured population group, urban residence, greater wealth, and suffering from two or more chronic conditions were associated with cervical cancer screening, and higher education, being from the White or Indian/Asian population group, greater wealth, having a health insurance, and suffering from two or more chronic condtions were associated with breast cancer screening. Conclusions: Cancer screening coverage remains low among elderly women in South Africa in spite of the national guideline recommendations for regular screening in order to reduce the risk of dying from these cancers if not detected early. There is a need to improve accessibility and affordability of early cervical and breast cancer screening for all women to ensure effective prevention and management of cervical and breast cancer.

The Prevalence and Associated Factors of the Metabolic Syndrome in Pre-menopausal Housewives: An Analysis of the 2010~2015 Korean National Health and Nutrition Examination Survey (폐경 전 전업주부의 대사증후군 관련 요인: 2010~2015년 국민건강영양조사자료분석)

  • Kim, Chul-Gyu;Kim, Youngji
    • Research in Community and Public Health Nursing
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    • v.29 no.1
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    • pp.108-119
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    • 2018
  • Purpose: The purpose of this study is to estimate the prevalence of the metabolic syndrome in pre-menopausal housewives and to explore controllable and uncontrollable factors regarding metabolic syndrome. Methods: The study population of this cross-sectional survey was from the Korean Health and Nutrition Examination Survey (KHANES) 2010 through 2015, including the fifth and sixth population-based studies. The criteria for metabolic syndrome include waist circumference, blood pressure, fasting plasma glucose, triglyceride, high-density lipoprotein (HDL) based on Korean Clinical Practice Guideline for Metabolic Syndrome by the Korean Academy of Family Medicine 2015. Results: Among the 2,498 subjects, 247 subjects had metabolic syndrome and the prevalence was estimated to be 9.9%. The number of subjects who met the criterion of HDL was 936 (36.2%), which was the most prevalent among the criteria for metabolic syndrome. Statistically significant (p<.05) factors include age, livinghood benefit group, perceived health status, obesity, family history of DM, sleeping time, awareness of stress,leukocyte, and erythrocyte count. The odds ratio of obesity in the BMI ${\geq}25$ group was 12.59 times as high as that of the BMI <25 group (p<.001) for metabolic syndrome. Conclusion: The prevalence of metabolic syndrome in pre-menopausal housewives in the survey was not low, and it is necessary to develop and apply comprehensive health habit management programs to improve controllable factors including exercise and food intake.

A Study on Process Safety System Analysis for Application Process Safety Performance Indicators (공정안전성과지표 적용을 위한 공정안전시스템 분석방안 연구)

  • Ko, Byung Seok;Lim, Dong-Hui;Kim, Min-Seop;Seol, Ji Woo;Yoo, Byung Tae;Ko, Jae-Wook
    • Journal of the Korean Institute of Gas
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    • v.26 no.2
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    • pp.27-38
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    • 2022
  • In developed countries, the number of accidents has significantly decreased with the introduction of the process safety management system, but it has a regulatory nature and it is difficult to show the actual situation of workplace safety management. Many organizations recommend the use of process safety performance indicators to comprehensively monitor process safety status. In this study, for the application of process safety performance indicators, the related guidelines were compared and analyzed, and the method of using the process safety system of the workplace as an indicator was reviewed. In literature indicators, compliance with procedures is mainly checked, whereas in system-based indicators, procedures or inspections for a specific purpose of the safety system can be clearly identified, and the operation status can be measured and monitored. It can be seen that this characteristic is more advantageous in terms of the clarity of the supplements derived in operating safety management activities. Using this, it is possible to effectively show the level of safety management in the workplace.

Effectiveness of worksite-based dietary interventions on employees' obesity: a systematic review and meta-analysis

  • Park, Seong-Hi;Kim, So-Young
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.399-409
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    • 2019
  • BACKGROUND/OBJECTIVES: This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS: Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were "obesity," "nutrition therapy," and "worksite." The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS: A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of -4.37 (95% confidence interval (CI): -6.54 to -2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of -1.26 (95% CI: -1.98 to -0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of -5.57 (95% CI: -9.07 to -2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: -4.90 mmHg) and diastolic (WMD: -2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS: The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).

Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition

  • Su Young Kim;Min Seob Kwak;Soon Man Yoon;Yunho Jung;Jong Wook Kim;Sun-Jin Boo;Eun Hye Oh;Seong Ran Jeon;Seung-Joo Nam;Seon-Young Park;Soo-Kyung Park;Jaeyoung Chun;Dong Hoon Baek;Mi-Young Choi;Suyeon Park;Jeong-Sik Byeon;Hyung Kil Kim;Joo Young Cho;Moon Sung Lee;Oh Young Lee;Korean Society of Gastrointestinal Endoscopy;Korean Society of Gastroenterology;Korean Association for the Study of Intestinal Diseases
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.703-725
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    • 2022
  • Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Implementation of HACCP Model for Steamed Rice with Squid Served from Elementary School with Joint-Lunch Management System (공동관리 초등학교의 안전한 오징어덮밥 생산을 위한 HACCP적용)

  • 박금순;이인숙;금경운
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.2
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    • pp.365-372
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    • 2004
  • The purpose of this study was to implement HACCP system to foodservice of W and D elementary schools with joint-lunch management system in Kyungsan area. Steamed rice with squid was selected and Control Action, Monitoring Procedure and Control measure were identified based on HACCP flowchart to produce safe and healthy food. It was suggested that frozen squid must be thawed under the cold running city water and kept temperature below 1$0^{\circ}C$ and receiving/thawing procedure has to be done within 30 min. Raw vegetables must be washed under three-tube wash stand and whole prepreparation procedures should be done in 20 minutes. Clean and sanitize all the equipment and utensils before and after handling squid. Knives and cutting boards for vegetable and squid should be classified. Sauce for steamed rice with squid should be heated about 21 minutes to reach the temperature of 94$^{\circ}C$ before serving and internal temperature of food must be kept above 84.4$^{\circ}C$ during serving. The ideal temperature of kitchen should be remained 15∼18$^{\circ}C$. The underground water has to be excluded to minimize the risk of contamination in the foodservice facility and the prepreparation place must be separated with cooking place. Also, Personal hygiene Practice should be check in each stage. Further, additional research needs to be conducted to determine models for HACCP implementation for different menu.

Therapeutic Plan for Traumatic Truncal Arterial Injury Associated with Truncal Organ Injury (체간부 장기 손상을 동반한 외상성 체간부 동맥 손상 환자의 치료 방침)

  • Jo, Choong Hyun;Jung, Yong Sik;Kim, Wook Hwan;Cho, Young Shin;Ahn, Jung Hwan;Min, Young Gi;Jung, Yoon Seok;Kim, Sung Hee;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.77-86
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    • 2009
  • Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

Risk Factors for Health and Environmental Disease in Gyeongju, Pohang, and Ulsan (경주, 포항, 울산지역 보건.환경성 질환 위해 인자)

  • Jung, Jong-Hyeon;Choi, Bong-Wook;Moon, Ki-Nai;Seok, Seong-Ja;Kim, Hyun-Gyu;Shon, Byung-Hyun
    • Journal of Environmental Health Sciences
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    • v.36 no.2
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    • pp.82-94
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    • 2010
  • This study was undertaken in an attempt to provide scientific grounds in explaining the causes of environmental and respiratory diseases resulting from air pollutants in Gyeongju and its neighboring areas. In relation to heavy metals, lead (Pb) was $0.0135{\sim}0.1744\;{\mu}g/m^3$ and high in order of Pohang, Ulsan, and Gyeongju while nickel (Ni) was $0.0023{\sim}0.0115\;{\mu}g/m^3$. The concentrations of heavy metals in the investigated areas did not exceed the environmental standards or Guideline Value of Korea or other countries. However, it is considered necessary to apply intensive control to some heavy metals including cadmium (Cd) that show a relatively high level of hazard. Based on the responses to the survey, measured personal interest in environmental pollution and the basic knowledge of the causes of the respiratory diseases was higher in those with a family history of allergic reactions to metals and bronchial asthma. The incidence of allergic disease was higher in those who are currently in poor health state. In addition, the general knowledge of environmental pollutants was higher in those with higher educational level and those with a higher interest in environmental pollution. Personal interest in environmental pollution was higher in those with higher basic knowledge of environmental pollutants. Therefore, it is necessary to increase the awareness through better education and campaigns on environmental pollution.

Sensitivity Analysis of Quasi-Governmental Agencies' Decisions for Cloud Computing Service (준 정부기관 클라우드 컴퓨팅 서비스 결정에 대한 민감도 분석)

  • Song, In Kuk
    • Journal of Internet Computing and Services
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    • v.16 no.1
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    • pp.91-100
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    • 2015
  • Recently many companies began to feel the pressures of cost savings due to the global recession, so they have been interested in the Cloud Computing. Cloud Computing is one of using method of IT resources through the network. Users can borrow softwares or hardwares instead of buying them. Many people expect remarkable growth in Cloud Computing industry because of it's effectiveness. But Cloud Computing industry is still at an early stage. Especially, people who in the public sector hesitate to adopt Cloud Computing Services due to security issues and their conservative views. Also, they just have limited understanding, so we need to investigate what they really know and understand. Researches about the Cloud Computing generally focus on technical issues, so we can hardly find researches reference for decision making in considering the services. The study aims to investigate diverse factors for agencies' adoption decisions, such as benefits, costs, and risk in developing the most ideal type of cloud computing service for them, and performs priority analyses by applying ANP (Analytic Network Process). The results identify that features pertaining to the risk properties were considered the most significant factors. According to this research, the usage of private cloud computing services may prove to be appropriate for public environment in Korea. The study will hopefully provide the guideline to many governmental agencies and service providers, and assist the related authorities with cloud computing policy in coming up with the relevant regulations.