• Title/Summary/Keyword: high risk population

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Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study

  • Youngmin Kim;Byungchul Yu;Se-Beom Jeon;Seung Hwan Lee;Jayun Cho;Jihun Gwak;Youngeun Park;Kang Kook Choi;Min A Lee;Gil Jae Lee;Jungnam Lee
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.224-230
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    • 2023
  • Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

Verification of the Reliability and Validity of a Virtual Reality Cognitive Evaluation System Based on Motion Recognition Analysis Evaluation

  • Jeonghan Kwon;Subeen Kim;Jongduk Choi
    • Physical Therapy Korea
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    • v.30 no.4
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    • pp.306-313
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    • 2023
  • Background: As social problems due to the acceleration of the aging era and the increase in the elderly population are becoming serious, virtual reality (VR)-based healthcare is emerging as an approach for preventing and managing health issues. Objects: This study used validity and reliability analyses to examine the clinical efficacy that is, the clinical value and usability of a novel VR cognitive evaluation system index that we developed. Methods: We developed a VR cognitive evaluation system based on motion recognition analysis evaluation for individuals aged 65 to 85. After conducting the Korean version of the Mini-Mental State Exam (K-MMSE) cognitive evaluation, the evaluation score was verified through correlation analysis in the VR cognitive evaluation system. To verify the construct validity of the two groups, the Global Deterioration Scale (GDS) grades were categorized into a normal cognitive group (GDS grade 1) and a cognitive impairment group (GDS grades 2 and 3). The data were measured twice to determine the reliability between the two measurements and assess the stability and clinical value of the evaluation system. Results: Our evaluation system had a high correlation of 0.85 with the widely used K-MMSE cognitive evaluation. The system had strong criterion-related validity at the 95% confidence interval. Compared to the average score of GDS grade 1 in the VR cognitive evaluation system, the average score of GDS grades 2 and 3 in the VR cognitive evaluation system was statistically significantly lower while also having strong construct validity at the 95% confidence interval. To measure the reliability of the VR cognitive evaluation system, tests-retests were conducted using the intraclass correlation coefficient (3,1), which equaled 0.923 and was statistically significant. Conclusion: The VR cognitive evaluation system we developed is a valid and reliable clinical tool to distinguish between normal cognitive status and mild cognitive impairment.

Patterns of Health-related Quality of Life in Men Who Inject Drugs: A Survey in Southeast Iran

  • Marzieh Nojomi;Maysam Rezapour;Neda Soleimanvandi Azar;Mehdi Darabi;Mehran Asadi-Aliabadi
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.2
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    • pp.148-156
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    • 2024
  • Objectives: Understanding patterns of quality of life in people who inject drugs (PWID) can help healthcare providers plan and manage their health problems in a more focused manner. Therefore, the current study aimed to identify patterns of health-related quality of life in PWID in southeast Iran. Methods: This cross-sectional study was conducted in southeast Iran on men who had injected drugs at least once during the last year. We used convenience sampling in 2 drop-in centers and venue-based sampling at 85 venues. Demographic characteristics, high-risk behaviors, and health-related quality of life were evaluated using the 5-level EQ-5D version (EQ-5D-5L) questionnaire. Latent profile analysis was used to identify patterns of quality of life. Results: This study enrolled 398 PWID, who had a mean age of 34.1±11.4 years. About 47.9% reported a prison history in the last 10 years, 59.2% had injected drugs in the last month, and 31.6% had a history of sharing syringes. About 46.3% reported having 2 or more sexual partners in the last 6 months, and 14.7% had a history of sex with men. Out of the 5 EQ-5D-5L profiles, the fifth profile had the most people (36.6%). Most variations in quality of life were related to pain and discomfort. Conclusions: We showed that the pain and discomfort dimension of EQ-5D-5L had more variation in PWID. This finding will be useful for allocating appropriate interventions and resources to promote health-related quality of life in this population.

Prostate Cancer Screening in a Healthy Population Cohort in Eastern Nepal: an Explanatory Trial Study

  • Belbase, Narayan Prasad;Agrawal, Chandra Shekhar;Pokharel, Paras Kumar;Agrawal, Sudha;Lamsal, Madhab;Shakya, Vikal Chandra
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2835-2838
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    • 2013
  • Background: Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. Objective: To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. Materials and Methods: This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. Results: A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ${\leq}4.0$ ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% Conclusions: The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.

A Study on the University Student's Consciousness about Sex and AIDS (대학생의 성 및 AIDS에 관한 의식 연구)

  • 강병우
    • Korean Journal of Health Education and Promotion
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    • v.11 no.1
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    • pp.43-56
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    • 1994
  • Although the officially confirmed incidence of the acquired immune deficiency syndrome(AIDS) has remained low thus far in Korea, the progression of the pandemic has been rapid, concerned about an eventual increase in transmission. Until a vaccine or cure is found, public information and education remain an important weapon against AIDS. For the year 2000, the current WHO projection is that there will be a cumulative total of 40 million HIV infections in man, woman and children, of which more than 90% will be in the developing countries. The incerased mortality among adults and children has raised concerns that AIDS may become so devastaing as to reverse positive population growth rates and wipe out entire population. In order to plan for the rising incidence of patient with AIDS, an assessment of AIDS-related cognition and behavior, attitude of the recognized high-risk groups is necessary. Considering that undergraduates have sexuality active and more oriented toward sexual concerns than other ages. Adolescents today are more sexually involved than in the past: The media, including films, music, and television, reinforce sexual concerns by preseating images of highly sexual adolescents. Incidence of both petting and sexual intercourse in higher and occurs at earlier ages, they are important reservoir of AIDS infection. Hence, it has become important to emymerats and describe the knowledge, attitude and behavior of them, I want.. This information will eventually guide the direction of change in public policies and education programs to meet the challenges of AIDS. The objective of this study were to identity Knowledge, Attitude, Experience of Sex and AIDS in Korea. The data were collected by survey at Korean Federation for AIDS Affairs, INC. and J university, K junior college. After October in 1993, surveyed with 507 student during their's college days in Seoul. The questionnaire was designed to provide information on sex and AIDS-related knowledge and attitudes and experience. AIDS-related knowledge was measured by using 26 questions on mode of transmission and AIDS-related attitudes were measured by 7 questions, AIDS-related experience was measured by 5 questions. There were the main dependent variables in our study, In conclusion, students during their university day need to develop AIDS-preventive education programs. Clearly, the many AIDS-prevention educational effort need to be guided by well trained health agents. Financial supports from all sectors (i.e., public and private) of our society are required to achieve that end. Further researches on AIDS-related Knowledge and Attitude and behaviors of undergraduates are needed for the development of comprehensive AIDS prevention programs.

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Mixed-effects zero-inflated Poisson regression for analyzing the spread of COVID-19 in Daejeon (혼합효과 영과잉 포아송 회귀모형을 이용한 대전광역시 코로나 발생 동향 분석)

  • Kim, Gwanghee;Lee, Eunjee
    • The Korean Journal of Applied Statistics
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    • v.34 no.3
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    • pp.375-388
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    • 2021
  • This paper aims to help prevent the spread of COVID-19 by analyzing confirmed cases of COVID-19 in Daejeon. A high volume of visitors, downtown areas, and psychological fatigue with prolonged social distancing were considered as risk factors associated with the spread of COVID-19. We considered the weekly confirmed cases in each administrative district as a response variable. Explanatory variables were the number of passengers getting off at a bus station in each administrative district and the elapsed time since the Korean government had imposed distancing in daily life. We employed a mixed-effects zero-inflated Poisson regression model because the number of cases was repeatedly measured with excess zero-count data. We conducted k-means clustering to identify three groups of administrative districts having different characteristics in terms of the number of bars, the population size, and the distance to the closest college. Considering that the number of confirmed cases might vary depending on districts' characteristics, the clustering information was incorporated as a categorical explanatory variable. We found that Covid-19 was more prevalent as population size increased and a district is downtown. As the number of passengers getting off at a downtown district increased, the confirmed cases significantly increased.

The Korea Cohort Consortium: The Future of Pooling Cohort Studies

  • Lee, Sangjun;Ko, Kwang-Pil;Lee, Jung Eun;Kim, Inah;Jee, Sun Ha;Shin, Aesun;Kweon, Sun-Seog;Shin, Min-Ho;Park, Sangmin;Ryu, Seungho;Yang, Sun Young;Choi, Seung Ho;Kim, Jeongseon;Yi, Sang-Wook;Kang, Daehee;Yoo, Keun-Young;Park, Sue K.
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.5
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    • pp.464-474
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    • 2022
  • Objectives: We introduced the cohort studies included in the Korean Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies. Methods: We mainly focused on the characteristics of individual cohort studies from the KCC. We developed "PROFAN", a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated. Results: The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102. Conclusions: We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.

Comparative analysis of ground settlement and tunnel displacement due to tunnel excavation considering topographic information based on GIS (GIS 기반 지형 정보를 고려한 터널 굴착에 따른 지반침하와 터널 변위 비교 분석)

  • Jae-Eun, Cho;Ye-Rim, Jung;Seong-Min, Song;Ji-Seok, Yun;Sang-Gui, Ha;Han-Kyu, Yoo
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.25 no.1
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    • pp.13-26
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    • 2023
  • Recently, as the development of underground spaces has become active due to rapid urbanization and population density, interest in the ground behavior according to the construction of underground spaces is increasing. In large cities with high population density and many buildings, ground subsidence has a great impact on structures and there may be a risk of collapse, so the analysis of ground behavior due to underground construction is essential. Previous studies have been conducted on the subsidence pattern of the surface and the deformation of the tunnel when constructing the tunnel, but analysis has rarely been conducted by using actual topographic information. Therefore, this study analyzed the difference in ground behavior between the actual topography and the flat topography. As a result, it was confirmed that ground settlement occurs at higher elevations, such as in mountainous topography, and when the numerical analysis is performed considering topographical information, the crown settlement of the tunnel is up to about approx. It showed a difference of 10 mm, and it was found that the sensitivity was less in the case of displacement of tunnel wall compared to the crown settlement and ground settlement. The numerical analysis considering the actual GIS-based topographic information presented in this study can be used to obtain more accurate surface subsidence data to understand the behavior of the upper structure due to tunnel excavation.

Prevalence of Abnormal Cervical Cytology in HIV-Negative Women Participating in a Cervical Cancer Screening Program in Calmette Hospital, Cambodia

  • Hav, Monirath;Eav, Sokha;Heang, Nicole;Pich, Pintuna;Lim, Davy;Leang, Vitou;Korn, Aun;Lay, Sanine;Pluot, Michel;Kruy, Leangsim
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3101-3103
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    • 2016
  • Background: According to the most recent estimation of GLOBOCAN, Cambodia has the highest incidence and mortality rate of cervical cancer in Southeast Asia. A screen-and-treat strategy using visual inspection with acetic acid (VIA test) and cryotherapy has been implemented in Cambodia's national cervical cancer screening program since 2013. However, where resources are available, cervical cytology with or without high-risk HPV DNA testing is the preferred screening method used in this country. Aim: This study aims to calculate the prevalence of abnormal cervical cytology and explain the possible factors contributing to a reduced quality of cervical cytology among women participating in a hospital-based cervical cancer screening program in Cambodia. Materials and Methods: A descriptive study was conducted using information from the cytology and pathology database in the Department of Pathology of Calmette Hospital between January 2012 and December 2015. Prevalence of abnormal cervical cytology, based on the Bethesda 2001 classification, was calculated. Data on the adequacy of cytological specimens were analyzed in order to explain the factors contributing to a reduced quality of cervical cytology interpretation. Results: Among 6,207 women who participated in the cervical cancer screening program at Calmette Hospital during 2012 and 2015, 388 (6.25%) had abnormal cytology, which could be classified into Atypical Squamous Cells of Undetermined Significance (92 cases; 1.48%), Atypical Squamous Cells - Cannot Exclude High-Grade Intraepithelial Lesion (13 cases; 0.21%), Atypical Glandular Cells (11 cases; 0.18%), Low-Grade Squamous Intraepithelial Lesion (221 cases; 3.56%), High-Grade Squamous Intraepithelial Lesion (26 cases; 0.42%), and Squamous Cell Carcinoma (25 cases; 0.40%). Unsatisfactory smears made up 12.2% of the total cases. The most frequently identified factor leading to unsatisfactory smears was the absence of cells from the transformation zone. Conclusions: The present study showed an overall prevalence of abnormal cervical cytology of 6.25%, which is comparable to that in many large population-based studies in the Asia Pacific region. Nevertheless, the remarkably high rate of unsatisfactory smears in this study justifies further improvement in specimen sampling among Cambodian gynecologists.

Dietary Behaviors and Total Sugar Intake from Snacks of Female College Students according to Sweet Taste Perception (여대생의 단맛 인지도에 따른 식행동 및 간식류를 통한 당류 섭취량 평가)

  • Kim, Mi-Hyun;Bae, Yun-Jung;Yeon, Jee-Young
    • The Korean Journal of Food And Nutrition
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    • v.29 no.2
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    • pp.267-274
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    • 2016
  • Increasing sugar intake of population has become a nutritional issue in Korea. Sweet taste perception may be related to behaviors such as eating sweet food including high sugars and total sugar intake. This study aimed to evaluate objective and subjective sweet taste perception and the association among objective sweet taste perception, dietary behaviors related to eating sweet snack food including high sugar, and total sugar intake from the snacks. Participants were 261 healthy female college students (mean age: $21.0{\pm}1.6years$), who were divided into three subgroups based on oral sweet taste evaluation using a sweet taste assessment tool provided by Ministry of Food and Drug Safety: sweet-seeker group (n=139), medium sweet-seeker group (n=54), and unsweet-seeker group (n=68). There was no significant difference in weight and body mass index (BMI) among the three groups; however, the sweet-seeker group had significantly higher sweet taste preference than that of the other groups. Though more people in the sweet-seeker group thought they tended to eat sweet foods than the medium sweet-seeker and unsweet-seeker groups, over half of the sweet-seekers did not think they tended to eat sweet foods. The sweet-seeker group was more likely to eat sweet snacks such as breads, chocolate products, sugar-sweetened milk, and so on than the unsweet-seeker group. Total sugar intake from the selected sweet snacks was 44.4 g for the sweet-seeker group, 34.4 g for the medium sweet-seeker group, and 28.0 g for the unsweet-seeker group with a significant difference. These results indicated the absence of relationship between objective sweet taste perception and the obesity index; however, significant associations were detected among objective sweet taste perception, eating sweet snacks and total sugar intake from the snacks. We also found high disagreement between objective and subjective sweet taste perception of the subjects. The present study provided the novel insight that measuring objective sweet taste perception may be useful for assessing the risk of high sugar consumption and undesirable dietary behaviors.