• 제목/요약/키워드: risk-targeted

검색결과 235건 처리시간 0.023초

Tailored Dietary Counseling Using Self-Administered Diet History Questionnaire is Effective for Health Promotion : Japanese Experience

  • Satoshi Sasaki;Yoshiko Takahashi;Kim, Mi-Kyung
    • Journal of Community Nutrition
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    • 제5권2호
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    • pp.112-119
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    • 2003
  • Dietary counseling is undoubtedly important for prevention and treatment of chronic diseases. Several dietary counseling methods have been developed and used in Japan to promote healthier diets. However, in Japan, few studies have established effective counseling methods. We developed a computer-assisted tailored dietary counseling system with self-administered diet history questionnaire (DHQ) to assess nutrient intakes and the feedbacks for counseling. We examined the effectiveness of the system in three studies , two among mildly-hypercholesterolemic and one among healthy subjects. We observed significant changes in intakes of targeted nutrients in all three studies. We also observed favorable changes in the corresponding serum and urinary biomarkers in two studies, i.e., non-significant change in serum cholesterol, serum carotene and vitamin C, and a significant change in 24-hour urinary excretion of sodium. In addition, one of the studies observed a significant modified dietary habit for one-year after the intervention was completed. No unfavorable change was observed for non-targeted nutrients in all three studies. The dietary counseling system with DHQ was concluded to be effective among motivated high-risk and healthy subjects. The system's application to other diseases and populations such as children, adolescents, and elderly, should be examined further. (J Community Nutrition 5(2) : 112-119, 2003)

Cost-Effectiveness Analysis of HPV Vaccination: Comparing the General Population with Socially Vulnerable Individuals

  • Han, Kyu-Tae;Kim, Sun Jung;Lee, Seo Yoon;Park, Eun-Cheol
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8503-8508
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    • 2014
  • Background: After the WHO recommended HPV vaccination of the general population in 2009, government support of HPV vaccination programs was increased in many countries. However, this policy was not implemented in Korea due to perceived low cost-effectiveness. Thus, the aim of this study was to analyze the cost-utility of HPV vaccination programs targeted to high risk populations as compared to vaccination programs for the general population. Materials and Methods: Each study population was set to 100,000 people in a simulation study to determine the incremental cost-utility ratio (ICUR), then standard prevalence rates, cost, vaccination rates, vaccine efficacy, and the Quality-Adjusted Life-Years (QALYs) were applied to the analysis. In addition, sensitivity analysis was performed by assuming discounted vaccination cost. Results: In the socially vulnerable population, QALYs gained through HPV vaccination were higher than that of the general population (General population: 1,019, Socially vulnerable population: 5,582). The results of ICUR showed that the cost of HPV vaccination was higher for the general population than the socially vulnerable population. (General population: 52,279,255 KRW, Socially vulnerable population: 9,547,347 KRW). Compared with 24 million KRW/QALYs as the social threshold, vaccination of the general population was not cost-effective. In contrast, vaccination of the socially vulnerable population was strongly cost-effective. Conclusions: The results suggest the importance and necessity of government support of HPV vaccination programs targeted to socially vulnerable populations because a targeted approach is much more cost-effective. The implementation of government support for such vaccination programs is a critical strategy for decreasing the burden of HPV infection in Korea.

Clinical Observation of Whole Brain Radiotherapy Concomitant with Targeted Therapy for Brain Metastasis in Non-small Cell Lung Cancer Patients with Chemotherapy Failure

  • Cai, Yong;Wang, Ji-Ying;Liu, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권10호
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    • pp.5699-5703
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    • 2013
  • Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.

Assessment of Reproductive Health Risk of Polychlorinated Biphenyls by Monitoring the Expression of Claudius and Transepithelial Electrical Resistance in Mouse Sertoli Cells

  • Gye, Myung-Chan;Seiichiroh Ohsako;Lee, Ho-Joon
    • Journal of Microbiology and Biotechnology
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    • 제13권4호
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    • pp.495-500
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    • 2003
  • Tight junctions (TJ) between adjacent Sertoli cells in testis are important for the formation of the blood testis barrier (BTB). In an effort to verify the reproductive health risk of endocrine-active chemicals (EACs), changes in the transepithelial electrical resistance (TER) and the expression of TJ genes were examined by co-planar polychlorinated biphenyl (PCB) treatment in cultured mouse Sertoli cells. Although the increase in TER of Sertoli cells was accelerated by 10 nM co-planar PCB, it was downregulated by 100 nM co-planar PCB. The expression of claudin-1 was downregulated by co-planar PCB in a concentration-dependent manner. On the contrary, the expression of claudin-1 was increased in the Sertoli cells by 10 nM co-planar PCB treatment. These results suggest that the structure and function of TJ may be targeted by co-planar PCB in Sertoli cells. Assessment of the structure and function of TJ in Sertoli cells might be useful for screening the reproductive health risk of EACs.

Assessment of the Knowledge and Attitude of Female Students towards Cervical Cancer Prevention at an International University in Japan

  • Ghotbi, Nader;Anai, Akane
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.897-900
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    • 2012
  • Cervical cancer resulting from prior infection with human papillomavirus (HPV) is a significant public health threat against young Japanese women. A national immunization plan to vaccinate 13~16 year old female students against HPV infection has been started in Japan since 2010, and may reach almost full coverage by the end of 2012. Older age females who may already be sexually active are not targeted by this plan but should follow safer sex practices as well as periodic screening of the cervix cytology to reduce their risk of developing cervical cancer. HPV vaccination alone does not offer full protection either, because only some HPV types are covered by the vaccines and the long-term efficacy of the vaccines has not been determined yet. Therefore, we did a survey at an international university in Japan to study the knowledge and attitude of female college students towards prevention of cervical cancer, to examine the age when they start sexual activity and other related attributes that may influence the risk of cervical cancer. We discuss the results of our survey and what they imply for the possible impact of an HPV immunization plan on the risk of cervical cancer in Japan, and conclude by an emphasis on the need to increase awareness among Japanese female adolescents and to enhance the cervical screening rates among older females who are already sexually active.

사회재난의 재난위해분석에 관한 연구 (A Study on Risk Analysis of Social Disaster)

  • 이관형;이원호;양원직
    • 한국방재안전학회논문집
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    • 제9권2호
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    • pp.15-21
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    • 2016
  • 국민안전처에서 발행하는 재난연감에 의하면 교통사고 화재 붕괴등 사회재난을 23가지로 분류하고 있다. 과거 재난은 주로 태풍 가뭄등 자연의 영향으로 발생한 반면 사회가 도시 중심으로 집중됨에 따라 사회재난의 종류와 빈도, 규모는 점점 증가하고 있는 추세이다. 그러나 이러한 사회재난이 가지고 있는 위해성이 어느 정도인지 객관적으로 판단할 수 있는 구체적인 기준과 평가방법이 없는 상태이다. 따라서 본 연구는 주요 사회재난 중 교통사고, 화재사고, 붕괴사고를 대상으로 최근 8년간 발생한 빈도, 인명피해규모, 재산피해규모에 관한 데이터를 활용하여 3차원 공간좌표상의 두 점간의 거리(유클리드거리)로써 재난위해지수를 산정하여 사회재난의 유형별 정량적인 평가가 가능하도록 하였다. 이 결과를 활용하여 주요 사회재난 유형별 위해성 순위를 정량적으로 평가할 수 있어 국가 재난관리체계 구축 시 기초자료로 활용될 수 있을 것으로 사료된다.

중년 남성에서 고정상혈압에 의한 고혈압발생 위험 규명을 위한 코호트내 환자-대조군 연구 (A Nested Case-Control Study on the High Normal Blood Pressure as a Risk Factor of Hypertension in Korean Middle-aged Men)

  • 안윤옥;배종면
    • Journal of Preventive Medicine and Public Health
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    • 제32권4호
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    • pp.513-525
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    • 1999
  • Objectives : High-normal blood pressure' is a factor influencing decision to initiate targeted intensive intervention strategy in westernized populations. JNC-VI offered the vigorous lifestyle modification for persons with 'high-normal blood pressure', who could be early detected. As a hypertension seems to be the result of multiple genetic factors operating in concert with associated environmental factors, it will be necessary to identify the high-normal blood pressure as a risk factor of hypertension for applying primary prevention strategy in Korean people. Methods : Although cohort study design might be adequate to recruit incidence cases, to keep time sequence of events, and to prevent information bias, nested case-control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population was the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from 1 Jan93 to 30Jun97. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. Results : As 75% of 247 incident cases had high-normal blood pressure, the crude odds ratio for hypertension was 2.04 (95% CI 1.47-2.83). Another statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity and history of quitting smoking. The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95% CI 1.31-2.56). Among high-normal blood pressure group, body mass index, weekly ethanol amounts, weekly physical activity, and dietary fiber except history of quitting smoking were still risk factors of hypertension. Conclusion : 'High-normal blood pressure' is a risk factor for hypertension in Korean middle-aged men, which represents that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is need.

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Association between Metabolic Syndrome and Physical Fitness in Postmenopausal Women

  • Ku, Min-Ju;Shin, Kyung-A;Ko, Kwang-Jun;Oh, Jae-Keun
    • 대한의생명과학회지
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    • 제18권1호
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    • pp.63-70
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    • 2012
  • The research is performed in order to know the relationship between the metabolic syndrome and the physical fitness targeted for menopausal women (over 45 years). All subjects were divided into 4 groups; group without risk factors of metabolic syndrome (MS-0: n=74), group having one risk factor of metabolic syndrome (MS-1: n=68), group having two risk factors of metabolic syndrome (MS-2: n=44), and group having more than three risk factors of metabolic syndrome (MS ${\geq}$ 3: n=30). All groups' height, weight, body mass index and percent of body fat were measured. High density lipoprotein cholesterol (HDL), triglyceride, glucose and blood pressure (BP) levels were measured. Their cardiorespiratory ($VO_2max$) endurance, muscular strength, muscle endurance, and flexibility were measured. HDL, triglyceride, glucose and BP levels in MS-1, MS-2, and MS ${\geq}$ 3 group were significantly greater than those of MS-0 group. The endurance ($VO_2max$) in MS ${\geq}$ 3 group was higher than that of MS-0 group. Multiple regression with the risk factors of metabolic syndrome and the physical fitness showed a statistical significance in only $VO_2max$. We found that the risk factors of the metabolic syndrome adversely affect postmenopausal women's $VO_2max$ and that a decreased $VO_2max$ may have prognostic value for the prediction of metabolic syndrome.

패스워드의 정보시스템 보안효과에 영향을 미치는 요인에 관한 연구 (A Study on the Factors Affecting the Information Systems Security Effectiveness of Password)

  • 김종기;강다연
    • Asia pacific journal of information systems
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    • 제18권4호
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    • pp.1-26
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    • 2008
  • Rapid progress of information technology and widespread use of the personal computers have brought various conveniences in our life. But this also provoked a series of problems such as hacking, malicious programs, illegal exposure of personal information etc. Information security threats are becoming more and more serious due to enhanced connectivity of information systems. Nevertheless, users are not much aware of the severity of the problems. Using appropriate password is supposed to bring out security effects such as preventing misuses and banning illegal users. The purpose of this research is to empirically analyze a research model which includes a series of factors influencing the effectiveness of passwords. The research model incorporates the concept of risk based on information systems risk analysis framework as the core element affecting the selection of passwords by users. The perceived risk is a main factor that influences user's attitude on password security, security awareness, and intention of security behavior. To validate the research model this study relied on questionnaire survey targeted on evening class MBA students. The data was analyzed by AMOS 7.0 which is one of popular tools based on covariance-based structural equation modeling. According to the results of this study, while threat is not related to the risk, information assets and vulnerability are related to the user's awareness of risk. The relationships between the risk, users security awareness, password selection and security effectiveness are all significant. Password exposure may lead to intrusion by hackers, data exposure and destruction. The insignificant relationship between security threat and perceived risk can be explained by user's indetermination of risk exposed due to weak passwords. In other words, information systems users do not consider password exposure as a severe security threat as well as indirect loss caused by inappropriate password. Another plausible explanation is that severity of threat perceived by users may be influenced by individual difference of risk propensity. This study confirms that security vulnerability is positively related to security risk which in turn increases risk of information loss. As the security risk increases so does user's security awareness. Security policies also have positive impact on security awareness. Higher security awareness leads to selection of safer passwords. If users are aware of responsibility of security problems and how to respond to password exposure and to solve security problems of computers, users choose better passwords. All these antecedents influence the effectiveness of passwords. Several implications can be derived from this study. First, this study empirically investigated the effect of user's security awareness on security effectiveness from a point of view based on good password selection practice. Second, information security risk analysis framework is used as a core element of the research model in this study. Risk analysis framework has been used very widely in practice, but very few studies incorporated the framework in the research model and empirically investigated. Third, the research model proposed in this study also focuses on impact of security awareness of information systems users on effectiveness of password from cognitive aspect of information systems users.

Breast Cancer Knowledge and Screening Behaviour among Women with a Positive Family History: A Cross Sectional Study

  • Subramanian, Pathmawathi;Oranye, Nelson Ositadimma;Masri, Azimah Mohd;Taib, Nur Aishah;Ahmad, Nora
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권11호
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    • pp.6783-6790
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    • 2013
  • Background: Breast cancer is the commonest type of cancer among women, and in Malaysia 50-60% of the new cases are being detected at late stages. Do age, education level, income, ethnicity, relationship with breast cancer patients and knowledge of breast cancer risk factors influence breast screening practices? This study revealed interesting but significant differences. Objectives: To assess the knowledge of breast cancer risk factors and early detection measures among women in a high risk group. Materials and Methods: A cross sectional survey of one hundred and thirty one women relatives of breast cancer patients was carried out. Participants were selected through purposive sampling, during hospital visits. A self-administered questionnaire was used for data collection. Results: The majority of the respondents (71%) had poor knowledge of the risk factors for breast cancer. Income, relationship with a patient and practise of breast cancer screening predicted performance of mammography, $R^2$=0.467, F=12.568, p<0.0001. Conclusions: The finding shows inadequate knowledge of breast cancer risk factors and poor cancer screening practise among women with family history of breast cancer. Poor knowledge and practise of breast screening are likely to lead to late stage presentation of breast cancer disease. Some important predictors of breast cancer screening behaviour among women with positive family history of breast cancer were identified. An understanding of the strengths and significance of the association between these factors and breast screening behaviour is vital for developing more targeted breast health promotion.