Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.
The purpose of this study is to provide baseline information on the risk-taking health behavior of alcohol consumption in four ethnic groups, Caucasian, Chinese, Japanese, and Korean, residing in the State of Hawaii. Secondary data from the State-based Health Behavioral Risk Factor Surveillance System, designed by the Center for Disease Control, were used. The total sample analyzed for this study contained 6,068 persons. Univariate and logistic regression analysis were performed in order to determine sociodemographic profiles and the predictor variables to produce the findings of this study. The percentage distribution of six sociodemographic factors by race was very similar in all alcohol consumption factors, acute drinking, chronic drinking, and drinking and driving. In this study there were significant ethnic differences in alcohol consumption factors except drinking and driving.
Background: The Korea Risk Information Surveillance System (K-RISS) was developed to enable the early detection of food and drug safety-related issues. Its goal is to deliver real-time risk indicators generated from ongoing food and drug risk monitoring. However, the existing K-RISS system suffers under several limitations. Objectives: This study aims to augment K-RISS with more detailed indicators and establish a severity standard that takes into account structural changes in the daily time series of K-RISS values. Methods: First, a Delphi survey was conducted to derive the required weights. Second, a control chart, commonly used in statistical process controls, was utilized to detect outliers and establish caution, attention, and serious levels for K-RISS values. Furthermore, Bai and Perron's method was employed to determine structural changes in K-RISS time series. Results: The study incorporated 'closeness to life' and 'sustainability' indicators into K-RISS. It obtained the necessary weights through a survey of experts for integrating variables, combining indicators by data source, and aggregating sub K-RISS values. We defined caution, attention, and serious levels for both average and maximum values of daily K-RISS. Furthermore, when structural changes were detected, leading to significant variations in daily K-RISS values according to different periods, the study systematically verified these changes and derived respective severity levels for each period. Conclusions: This study enhances the existing K-RISS system and introduces more advanced indicators. K-RISS is now more comprehensively equipped to serve as a risk warning index. The study has paved the way for an objective determination of whether the food safety risk index surpasses predefined thresholds through the application of severity levels.
Purpose: To establish the concept of lung cancer hazard assessment theoretical models, evaluating the degree of lung cancer risk of Beijing for regional population lung cancer hazard assessment to provide a basis for technical support. Materials and Methods: ISO standards were used to classify stratified analysis for the entire population, life cycle, processes and socioeconomic management. Associated risk factors were evaluated as lung cancer hazard risk assessment first class indicators. Study design: Using the above materials, indicators were given the weight coefficients, building lung cancer risk assessment theoretical models. Regional data for Beijing were entered into the theoretical model to calculate the parameters of each indicator and evaluate the degree of local lung cancer risk. Results: Adopting the concept of lung cancer hazard assessment and theoretical models for regional populations, we established a lung cancer hazard risk assessment system, including 2 first indicators, 8 secondary indicators and 18 third indicators. All indicators were given weight coefficients and used as information sources. Score of hazard for lung cancer was 84.4 in Beijing. Conclusions: Comprehensively and systematically building a lung cancer risk assessment theoretical model for regional populations in conceivable, evaluating the degree of lung cancer risk of Beijing, providing technical support and scientific basis for interventions for prevention.
Objectives: In order to prepare measures to enhance construction workers' satisfaction with their working environment, the effects of working conditions and the mediating effects of safety and health information on workers' satisfaction with their working environment in the construction industry have been studied. The results of this study can be used as basic data for further studies in this field. Method: Data on 1,361 male construction workers from the 5th Korea Working Condition Survey (KWCS) were used for this study. The effects of working conditions were analyzed using SPSS 25.0 and the mediating effects of health and safety information were analyzed with SPSS PROCESS macro using the bootstrap method. Results: The safety and health management system and the self-determination of break time had a statistically significant positive effect on satisfaction with the working environment. Chemical and ergonomic risk factors had a statistically significant negative effect on satisfaction with the working environment. The provision of safety and health information, the mediating variable, had a statistically significant positive effect on satisfaction with the working environment. Therefore, it had a mediating effect between working conditions and satisfaction with the working environment. Conclusion: In order to enhance construction workers' satisfaction with their working environment, the above results suggest that the safety and health management system should be well established; self-determination of break times should be guaranteed; and chemical and ergonomic risk factors should be controlled. In addition, workers should be provided with necessary health and safety information related to their work. This study will be useful if these findings are used as basic data in further studies in related fields.
The aims of this study were to develop the suitable "system software" in chemical ranking and scoring (CRS) for the food hazardous chemicals associated with environmental emission and to suggest the priority lists of food contamination by environmental-origined pollutants. Study materials were selected with reference to the priority pollutants list for environment and food management from domestic and foreign research and the number of study materials is 103 pollutants (18 heavy metals, 10 PBTs, 10 EDs, and 65 organic compounds). The Food-CRS-Korea system consisted of the environmental fate model via multimedia, transfer environment to food model, and health risk assessment by contaminated food intake. We have established that health risks of excess cancer risks, hazard quotients (HQs) by chronic toxicity and HQs by reproductive toxicity convert to score, respectively. The creditable scoring system was designed to consider uncertainty of quantitative risk assessment based on VOI (Value-Of-Information). The predictability of the Food-CRS-Korea model was evaluated by comparing the presumable values and the measured ones of the environmental media and foodstuffs. The priority lists based on emissions with background-level-correction are 15 pollutants such as arsenic, cadmium, and etc. The priority lists based on environmental monitoring date are 17 pollutants including DEHP, TCDD, and so on. Consequently, we suggested the priority lists of 13 pollutants by considering the several emission and exposure scenarios. According to the Food-CRS-Korea system, arsenics, cadmium, chromes, DEHP, leads, and nickels have high health risk rates and reliable grades.
Objectives: This paper aims to discuss the current situation of and future directions for health promotion practice(HPP) and research in private sectors in Korea. Methods: Publications and web-site information of public health organizations, WHO-Health Promoting Hospitals member institutes, health/medical academic societies, and professional unities were collected and reviewed. Activities of Korea Association of Health Promotion(KAHP) were described in detail considering its leading role in health examination and promotion field in Korea. Results: The most common HPPs in private sectors were health education and public health campaigns for the prevention and management of diseases. Tailored health promotion programs for lifestyle changes and longitudinal follow-ups were the routine process for managing high risk groups at KAHP. Health promotion research in private sectors have focused on identifying health problems and behavioral determinants, and planning, implementing and evaluating health promotion programs. The most serious issues in HPPs of the private sectors were limited budget and manpower along with a lack of public recognition and a system-level support. Conclusion: To promote HPPs and research in private sectors, a system for financial sustainability should be introduced. They also need scientific evidence from research. 'Borderline medicine', a discipline specialized in management of high risk borderline group, could lead HPPs to sustainable private practices.
Objectives A hazard assessment of di(2-ethylhexyl) phthalate (DEHP), a commonly used workplace chemical, was conducted in order to protect the occupational health of workers. A literature review, consisting of both domestic and international references, examined the chemical management system, working environment, level of exposure, and possible associated risks. This information may be utilized in the future to determine appropriate exposure levels in working environments. Methods Hazard assessment was performed using chemical hazard information obtained from international agencies, such as Organization for Economic Cooperation and Development-generated Screening Information Data Set and International Program on Chemical Safety. Information was obtained from surveys conducted by the Minister of Employment and Labor ("Survey on the work environment") and by the Ministry of Environment ("Survey on the circulation amount of chemicals"). Risk was determined according to exposure in workplaces and chemical hazard. Results In 229 workplaces over the country, 831 tons of DEHP have been used as plasticizers, insecticides, and ink solvent. Calculated 50% lethal dose values ranged from 14.2 to 50 g/kg, as determined via acute toxicity testing in rodents. Chronic carcinogenicity tests revealed cases of lung and liver degeneration, shrinkage of the testes, and liver cancer. The no-observed-adverse-effect level and the lowest-observed-adverse-effect level were determined to be 28.9 g/kg and 146.6 g/kg, respectively. The working environment assessment revealed the maximum exposure level to be $0.990mg/m^3$, as compared to the threshold exposure level of $5mg/m^3$. The relative risk of chronic toxicity and reproductive toxicity were 0.264 and 0.330, respectively, while the risk of carcinogenicity was 1.3, which is higher than the accepted safety value of one. Conclusions DEHP was identified as a carcinogen, and may be dangerous even at concentrations lower than the occupational exposure limit. Therefore, we suggest management of working environments, with exposure levels below $5mg/m^3$ and all workers utilizing local exhaust ventilation and respiratory protection when handling DEHP.
한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
/
pp.325-329
/
2001
This paper tests existence of precautionary saving motive under health uncertainty, using household level panel data from Korea. For this purpose, this paper considers a dynamic health capital model with health uncertainty and derives testable equations for changes in consumption and medical expenditures. Under this framework, households who face future health uncertainty will exhibit precautionary behavior by depressing consumption or increasing investment in health. To test this hypothesis, the paper uses the conditional variance of health as the direct measure of health uncertainty, obtained by estimating a multinomial logit model. Empirical results using the Korean Household Panel Study (KHPS, 1993 - 1997) suggest that Korean elderly households follow the precautionary behavior to insure against future health risk.
This paper proposes Power System Health Index(PSHI) newly. The paper describes several kind of power system health indices based on two main categories, which are adequacy and security. In adequacy, four kinds of health indices of Frequency, Voltage, Reserve(Operating Reserve Power and Frequency Regulation Reserve Power) and Overload of lines and transformers are proposed. In security, four kinds of health indices of Voltage(154kV, 345kV and 765kV), Overload of lines and transformers, Power flow constraint among areas and SPS are proposed. All indices are mapped with three domains, which are indicated as Health, Margin and Risk, defined with expert interview. While domains of health, margin and risk is defined similar with the conventional well being analysis of power system. The criterion of the domains is proposed using an interview with expert operators and practical reliability codes in Korea. The several kinds of health index functions, which are linear ratio, piecewise linear ration and reverse ratio function etc. are developed in this paper. It will be expected that the developed health indices can help operators to control power system more successfully and also prevent power system from accident as like as black out in future because operator can make a decision immediately based on more easily visual information of system conditions from too much indices acquisition of complex power system.
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