• 제목/요약/키워드: risk response

검색결과 1,643건 처리시간 0.026초

여자노인의 영양상태 평가 및 건강관리를 위한 Nutritional Risk Index (NRI) 비교 분석 (The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women)

  • 양은주
    • Journal of Nutrition and Health
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    • 제42권3호
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    • pp.234-245
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    • 2009
  • Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

Tobacco Smoke Exposure and Breast Cancer Risk in Thai Urban Females

  • Pimhanam, Chaisak;Sangrajrang, Suleeporn;Ekpanyaskul, Chatchai
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7407-7411
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    • 2014
  • The incidence of urban female breast cancer has been continuously increasing over the past decade with unknown etiology. One hypothesis for this increase is carcinogen exposure from tobacco. Therefore, the objective of this study was to investigate the risk of urban female breast cancer from tobacco smoke exposure. The matched case control study was conducted among Thai females, aged 17-76 years and living in Bangkok or its surrounding areas. A total of 444 pairs of cases and controls were recruited from the Thai National Cancer Institute. Cases were newly diagnosed and histologically confirmed as breast cancer while controls were selected from healthy women who visited a patient, matched by age ${\pm}5$ years. After obtaining informed consent, tobacco smoke exposure data and information on other potential risk factors were collected by interview. The analysis was performed by conditional logistic regression, and presented with odds ratio (ORs) and 95% confidence intervals(CI). From all subjects, 3.8% of cases and 3.4% of controls were active smokers while 11.0% of cases and 6.1% of controls were passive smokers. The highest to lowest sources of passive tobacco smoke were from spouses (40.8%), the workplace (36.8%) and public areas (26.3%), respectively. After adjusting for other potential risk factors or confounders, females with frequent low-dose passive smoke exposure (${\leq}7$ hours per week) from a spouse or workplace had adjusted odds ratio 3.77 (95%CI=1.11-12.82) and 4.02 (95%CI=1.04-15.50) higher risk of breast cancer compared with non-smokers, respectively. However, this study did not find any association of breast cancer risk in high dose passive tobacco smoke exposure, or a dose response relationship in cumulative passive tobacco smoke exposure per week, or in the active smoker group. In conclusion, passive smoke exposure may be one important risk factor of urban female breast cancer, particularly, from a spouse or workplace. This risk factor highlights the importance of avoiding tobacco smoke exposure as a key measure for breast cancer prevention and control.

Pathologic Risk Factors and Oncologic Outcomes in Early-stage Cervical Cancer Patients Treated by Radical Hysterectomy and Pelvic Lymphadenectomy at a Thai University Hospital: A 7 year Retrospective Review

  • Ruengkhachorn, Irene;Therasakvichya, Suwanit;Warnnissorn, Malee;Leelaphatanadit, Chairat;Sangkarat, Suthi;Srisombat, Jutatip
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5951-5956
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    • 2015
  • Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of$ 43.3{\pm}25.3$ months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Five-year and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.

사과 농가의 상대위험회피계수 추정 (Measuring the Relative Risk Aversion Coefficients of Apple Farmers)

  • 임청룡;여준호;김태균
    • 한국산학기술학회논문지
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    • 제16권2호
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    • pp.1036-1044
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    • 2015
  • 이 논문의 목적은 사과 생산자들의 위험에 대한 태도를 나타내는 상대위험회피계수를 추정하는 것이다. 이를 위해 실험적 접근방법을 이용하였으며, 두 가지 가상적인 상황을 만들어서 각각의 상황별로 두 단계의 설문을 실시하였다. 일정한 상대위험회피도를 가진 효용함수를 사용하였고, 상대위험회피계수는 로그정규분포를 따르는 것으로 가정하였다. 또한 가설적 편의를 줄이기 위해 서로 다른 문항에 대한 반복질문을 통해 자료를 수집하였다. 분석결과 사과 농가의 상대위험회피계수는 평균 10.915, 표준편차 7.516으로 나타났다. 각 구간별 설문응답에 대한 조건적인 상대위험회피계수 또한 측정되었다. 본 연구의 결과는 위험관리수단의 효과를 분석하는 시뮬레이션 모형의 파라미터로 쓰여 질 수 있다.

Factors Prognostic for Survival in Japanese Patients Treated with Sunitinib as First-line Therapy for Metastatic Clear Cell Renal Cell Cancer

  • Kawai, Y;Osawa, T;Kobayashi, K;Inoue, R;Yamamoto, Y;Matsumoto, H;Nagao, K;Hara, T;Sakano, S;Nagamori, S;Matsuyama, H
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5687-5690
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    • 2015
  • Background: Factors predictive of survival have been identified in Western patients with metastatic clear cell renal cell carcinoma (mCCRCC) treated with sunitinib. Less is known, however, about factors predictive of survival in Japanese patients. This study evaluated factors prognostic of survival in Japanese patients with mCCRCC treated with first-line sunitinib. Materials and Methods: This retrospective study evaluated 46 consecutive Japanese mCCRCC patients treated with sunitinib as first line therapy. Clinical and biochemical markers associated with progression-free survival (PFS) were analyzed, with prognostic factors selected by uniand multivariate Cox regression analyses. Results: Univariate analysis showed that factors significantly associated with poor PFS included Memorial Sloan-Kettering Cancer Center poor risk scores, International Metastatic RCC Database Consortium poor risk and high (>0.5 mg/dl) serum C-reactive protein (CRP) concentrations (p<0.001 each). Multivariate analysis showed that high serum CRP was independently associated with poorer PFS (p=0.040). Six month disease control rate (complete response, partial response and stable disease) in response to sunitinib was significantly higher in patients with normal (${\leq}0.5mg/dl$) than elevated baseline CRP (p<0.001). Conclusions: CRP is a significant independent predictor of PFS for Japanese patients with mCCRCC treated with first-line sunitinib. Pretreatment CRP concentration may be a useful biomarker predicting response to sunitinib treatment.

Determination of seismic hazard and soil response of a critical region in Turkey considering far-field and near-field earthquake effect

  • Sonmezer, Yetis Bulent;Celiker, Murat
    • Geomechanics and Engineering
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    • 제20권2호
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    • pp.131-146
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    • 2020
  • Evaluation of earthquake impacts in settlements with a high risk of earthquake occurrence is important for the determination of site-specific dynamic soil parameters and earthquake-resistant structural planning. In this study, dynamic soil properties of Karliova (Bingol) city center, located near to the intersection point of the North Anatolian Fault Zone and the East Anatolian Fault Zone and therefore having a high earthquake risk, were investigated by one-dimensional equivalent linear site response analysis. From ground response analyses, peak ground acceleration, predominant site period, 0.2-sec and 1-sec spectral accelerations and soil amplification maps of the study area were obtained for both near-field and far-field earthquake effects. The average acceleration spectrum obtained from analysis, for a near-field earthquake scenario, was found to exceed the design spectra of the Turkish Earthquake Code and Eurocode 8. Yet, the average acceleration spectrum was found to remain below the respective design spectra of the two codes for the far-field earthquake scenario. According to both near- and far-field earthquake scenarios in the study area, the low-rise buildings with low modal vibration durations are expected to be exposed to high spectral acceleration values and high-rise buildings with high modal vibration durations will be exposed to lower spectral accelerations. While high amplification ratios are observed in the north of the study area for the near-distance earthquake scenario, high amplification ratios are observed in the south of the study area for the long-distance earthquake scenario.

자살의 생물학적 기전 (Biological Mechanism of Suicide)

  • 천은진
    • 생물치료정신의학
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    • 제24권3호
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    • pp.129-141
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    • 2018
  • Suicide is a behavior that is intended to cause death by itself and requires medical treatment, resulting in suicidal attempt or completion. Suicide causes loss of life, damages the body, costs a lot of medical expenses, and causes families to fall into sorrow and suffering therefore this suicide is a huge loss to family and society. There have been attempts to reduce and prevent suicide by understanding the mechanism of suicide. The mechanism of suicide can be thought of as psychological mechanism and biological mechanism. In the past, if we considered the psychological and biological mechanisms separately, the development of neuroscience now connects and integrates these two. Psychological factors affect biological factors and biological temperaments also affect perception or thinking about the situation and increase psychological vulnerability. Distant factors in suicidal behavior-such as childhood adversity and family and genetic predisposition-increase the lifetime risk of suicide. They alter the response to stress and other processes through changes in gene expression and regulation of emotional and behavioral characteristics. Distant factors affect the biological system and consequently changes in these systems can increase the risk of suicide. In other words, the distal factor does not directly induce suicidal behavior but rather acts indirectly through developmental or mediating factors. These mediating factors are impulsive aggressive and anxious trait, and chronic use of substances. The mechanism of this disorder is the abnormality of the serotonin system and the abnormality of the lipid level. Proximal factors are associated with the onset of suicide events and include changes in the major neurotransmitter systems, inflammatory changes, and dysfunction of glial cells in the brain. A series of studies, including a variety of research methods and postmortem and in-vivo imaging studies, show the impairment of the serotonergic neurotransmitter system and hypothalamic-pituitary-adrenal axis stress response system for suicidal behavior. These disorders lead to suicidal behavior due to difficulty in cognitive control of mood, pessimism, reactive aggression, abnormality in problem solving abilities, excessive response to negative social signals, severe emotional distress, and cognitive dysregulation of suicidal ideation.

Earthquake risk assessment of concrete gravity dam by cumulative absolute velocity and response surface methodology

  • Cao, Anh-Tuan;Nahar, Tahmina Tasnim;Kim, Dookie;Choi, Byounghan
    • Earthquakes and Structures
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    • 제17권5호
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    • pp.511-519
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    • 2019
  • The concrete gravity dam is one of the most important parts of the nation's infrastructure. Besides the benefits, the dam also has some potentially catastrophic disasters related to the life of citizens directly. During the lifetime of service, some degradations in a dam may occur as consequences of operating conditions, environmental aspects and deterioration in materials from natural causes, especially from dynamic loads. Cumulative Absolute Velocity (CAV) plays a key role to assess the operational condition of a structure under seismic hazard. In previous researches, CAV is normally used in Nuclear Power Plant (NPP) fields, but there are no particular criteria or studies that have been made on dam structure. This paper presents a method to calculate the limitation of CAV for the Bohyeonsan Dam in Korea, where the critical Peak Ground Acceleration (PGA) is estimated from twelve sets of selected earthquakes based on High Confidence of Low Probability of Failure (HCLPF). HCLPF point denotes 5% damage probability with 95% confidence level in the fragility curve, and the corresponding PGA expresses the crucial acceleration of this dam. For determining the status of the dam, a 2D finite element model is simulated by ABAQUS. At first, the dam's parameters are optimized by the Minitab tool using the method of Central Composite Design (CCD) for increasing model reliability. Then the Response Surface Methodology (RSM) is used for updating the model and the optimization is implemented from the selected model parameters. Finally, the recorded response of the concrete gravity dam is compared against the results obtained from solving the numerical model for identifying the physical condition of the structure.

Serum vitamin D status and metabolic syndrome: a systematic review and dose-response meta-analysis

  • Lee, Kyueun;Kim, Jihye
    • Nutrition Research and Practice
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    • 제15권3호
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    • pp.329-345
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    • 2021
  • BACKGROUD/OBJECTIVES: Evidence has suggested an association between serum vitamin D and metabolic syndrome (MetS), but prospective studies are very limited. The objective was to assess the dose-response association between serum vitamin D concentration and MetS risk using a systematic review and meta-analysis of updated observational studies. MATERIALS/METHODS: Using MEDLINE, PubMed, and Embase, a systematic literature search was conducted through February 2020 and the references of relevant articles were reviewed. A random-effects model was used to estimate the summary odds ratio/relative risk and 95% confidence interval (CI). Heterogeneity among studies was evaluated with I2 statistic. In total, 23 observational studies (19 cross-sectional studies, and four cohort studies) were included in the meta-analysis. RESULTS: The pooled estimates (95% CI) for MetS per 25-nmol/L increment in serum vitamin D concentration were 0.80 (95% CI, 0.76-0.84; I2 = 53.5) in cross-sectional studies, and 0.85 (95% CI, 0.72-0.98; I2 = 85.8) in cohort studies. Similar results were observed, irrespectively of age of study population, study location, MetS criteria, and adjustment factors. There was no publication bias for the dose-response meta-analysis of serum vitamin D concentrations and MetS. CONCLUSIONS: Dose-response meta-analysis demonstrated that a 25-nmol/L increment in the serum vitamin D concentration was associated with 20% and 15% lower risks of MetS in cross-sectional studies and cohort studies, respectively.

흡연과 위암 발생의 관련성에 관한 지역사회 기반의 코호트 연구 (Cigarette Smoking and Gastric Cancer Risk in a Community-based Cohort Study in Korea)

  • 김연주;신애선;곽진;전재관;박수경;강대희;신해림;장성훈;유근영
    • Journal of Preventive Medicine and Public Health
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    • 제40권6호
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    • pp.467-474
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    • 2007
  • Objectives : Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. Methods : The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Career Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using Cox#s proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. Results : Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09-fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer ($P_{trend}<0.01$). Conclusions : This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.