OBJECTIVE: Providing a risk assessment method for the implementation of radiotherapy to identify possible risks in the implementation of the treatment process, and proposing measures to reduce or prevent these risks. METHODS: A multidisciplinary expert evaluation team was developed and the radiotherapy treatment process flow was drawn. Through the expert team, the failure mode analysis is carried out in each step of the flow chart. The results were summarized and the (risk priority ordinal) score was obtained, and the quantitative evaluation results of the whole process risk were obtained. RESULTS: One hundred and six failure modes were obtained, risk assessment of (20%) high risk failure model are 22 and severity (≥ 8) high risk failure model are 27. The reasons for the failures were man-made errors or hardware and software failures. CONCLUSIONS Failure mode and effect analysis can be used to evaluate the risk assessment of radiotherapy, and it provides a new solution for risk control in radiotherapy field.
Healthcare Failure Mode and Effect Analysis ; Risk Assessment

BACKGROUND: In industrial countries, home care of community dwelling elderly people is rapidly growing. Frequent injuries in home caregivers result from slips, trips, and falls (STFs). The current study tests attentional cognitive failure to mediate the association between work stressors and STFs. METHODS: A sample of 125 home caregivers participated in a questionnaire study and reported work interruptions, unreasonable tasks, quality-threatening time pressure, conscientiousness, attentional cognitive failures, and STFs. RESULTS: In structural equation modeling, the mediation model was shown to fit empirical data. Indirect paths with attentional cognitive failures as the link between work stressors and STF were all significant in bootstrapping tests. An alternative accident-prone person model, that suggests individual differences in conscientiousness to predict attentional cognitive failures that predict more frequent work stressors and STFs, showed no significant paths between work conditions and STFs. CONCLUSION: To prevent occupational injury, work should be redesigned to reduce work interruptions, unreasonable tasks, and quality-threatening time pressure in home care.
Accidental Falls* ; Aged ; Caregivers ; Home Care Services* ; Humans ; Independent Living ; Individuality ; Negotiating ; Occupational Health ; Occupational Injuries

PURPOSE: The purpose of this study is to identify factors influencing activities-specific balance confidence in community-dwelling older adults. METHODS: This is secondary analysis of data from an intervention study for improving cognitive function. The data were collected from March 2 to September 30, 2017 at a senior center. Data of 131 older adults were included for this secondary analysis, and were analyzed by using t-test, ANOVA, and multiple regression. RESULTS: The mean score of activities-specific balance confidence is 65.08 out of a possible range of 0–100. The significant factors affecting activities-specific balance confidence among old adults include ‘more than 85 years old’, ‘waist circumference’, ‘depressive symptoms’, ‘activity restriction due to fear of falling’, and ‘self-rated health’ which explained 52.8% of the variance. CONCLUSION: The study results indicate that psychologic factors as well as physical condition should be considered for interventions to increase activities-specific balance confidence.
Accidental Falls ; Adult ; Cognition ; Humans ; Independent Living ; Postural Balance ; Senior Centers

Introduction: While the relationship between obesity and caloric intake is widely accepted, the role of glycemic index (GI) and glycemic load (GL) to body mass index (BMI) remains equivocal. This study seeks to determine the daily glycemic index (GI) and glycemic load (GL) of usual diet of rural-dwelling Filipinos, and their relationship with body mass index (BMI). Methods: This is a cross-sectional study reviewing the data of 139 adults from San Juan, Batangas. Average daily GI and GL were calculated from two-day food recall questionnaires. Spearman’s rank test was used to determine correlation of daily GI and GL with BMI; the mean BMI was compared among GI and GL tertiles using one-way ANOVA. Partial least squares regression was used to determine the contribution of food items to daily GI and GL. Results: No overall correlation was observed between daily GI or GL and BMI using Spearman’s rank. However, BMI was higher with increasing GI tertiles (p<0.0001) and GL tertiles (p=0.0108) among the males, but not females. Bread, coffeemix and sweets were major contributors to daily GI, while rice, bread/pastries and sweetened beverages were to daily GL. Leafy vegetables negatively contributed to both. Conclusion There is a positive relationship observed between daily GI and BMI, and daily GL and BMI among the men, but not women, in this population. Staple food with high GI like bread/pastries and sweetened beverages contributed most to both daily GI and GL, with the addition of rice for daily GL. Among Filipinos with marginal daily caloric intake, optimizing carbohydrate quality (low GI or GL) rather than limiting its quantity may be more appropriate. Future studies of prospective design and using objective methods of food intake reporting are recommended.
Glycemic Index ; Glycemic Load

BACKGROUND AND OBJECTIVE

In the Philippines, patients are constrained from accessing their own records, restricting their ability to freely choose who to seek care from. To address this, the study makes a case for the development of the health smart card in the Philippines, an integrative tool unique to each citizen carrying their lifetime medical record.

The prototype is developed using no-code programming technology and validated through a series of focus group discussions and stakeholder consultations with patients (n=4), healthcare administrators (n=4), and hospital personnel (n=13). It was then revised based on the collected insights and recommendations.

Findings report that the current facility-centric model utilizing paper records constrains patients’ access to their records due to long wait times, slow turnaround periods, constant intra- and inter-hospital transfers, and even charging of fees to acquire a copy of their own data. The health smart card alternative was widely accepted by the participants, particularly for its contribution to increasing data accessibility, patient empowerment, and advancing patient data ownership. Nevertheless, several considerations for the upscale implementation of the health smart card emerged, including creating an interoperable environment through harmonizing standards and capacity-building programs, and ensuring data security through robust cybersecurity measures. Issues on scalability and funding of the project were also raised, centering on the critical role of the government in stepping up as regulator and potential funder. Concerns over potential abuse, dataveillance, and the digital divide are tackled, highlighting the need to account for socioeconomic factors to ensure that no one is left behind in the implementation.

The study makes a case for the development and adoption of a health smart card to address the inaccessibility of records to patients. The study concludes by recommending the conduct of a pilot implementation to comprehensively demonstrate and analyze the features of the proposed scheme.

PURPOSE: The purpose of this study was to build a model to predict the fall prevention behavior of nurses in small and medium sized hospitals. METHODS: Participants were 382 nurses from 13 hospitals who responded to the structured self-reported questionnaire. The research model was based on previous study of fall prevention, theory of planned behavior, and the health belief model. RESULTS: The modified model generally showed higher levels than recommended level of model fit indices and acceptable explanation. Of 17 hypothetical paths, 14 were supported. Predicting variables explained 51.6% of fall prevention behavior. The fall prevention behavior of nurses showed a direct influence of fall prevention expectations, fall prevent threats, perceived behavioral control for fall prevention, and intention to prevent falls and an indirect of influence of patient safety culture, attitude toward fall prevention, and the subjective norm. CONCLUSION: Findings show a need to identify a range of barrier factors to increase the benefits of fall prevention behavior and enhance the perceived control of fall prevention so that nurses will be able to promote fall prevention behavior in hospitals. Also, it is critical to increase awareness of patient safety culture among nurses.
Accident Prevention ; Accidental Falls ; Health Behavior ; Humans ; Intention ; Nurses* ; Patient Safety ; Safety Management

The time-to-event index is a kind of common evaluation index. It measures the speed of intervention effect. It is different from other index in research design, source material filling, data checking and statistical analysis. To obtain the time-to-event index, investigators can fill in the table directly and statistical analyst can compute after clinical observation. When filling in the source material or data checking, it is should be noticed that the logical relation between the time-to-event index and the visiting point and between the time-to-event index and the correlative other indicator. When statistical analyzing, it is an important issue how to deal with the cases whose time-to-event index does not appear till the observation period ends. Understanding the difference clearly can make the time-to-event index evaluate the effect of the intervention truly and make the clinical observation results reliable.
Clinical Trials as Topic ; Female ; Humans ; Male ; Observational Studies as Topic ; Research ; Research Design

OBJECTIVE: To describe the longitudinal characteristics of unintentional fall accidents using a representative population-based sample of Korean adults. METHODS: We examined data from the Korean Community Health Survey from 2008 to 2013. Univariate analysis and multivariable logistic regression were used to identify the characteristics of fall accidents in adults. RESULTS: Between 2008 and 2013, the incidence rate of fall accidents requiring medical treatment increased from 1,248 to 3,423 per 100,000 people (p<0.001), while the proportion of indoor fall accidents decreased from 38.12% to 23.16% (p<0.001). Females had more annual fall accidents than males (p<0.001). The major reason for fall accidents was slippery floors (33.7% in 2011 and 36.3% in 2013). Between 2008 and 2010, variables associated with higher fall accident risk included specific months (August and September), old age, female gender, current drinker, current smoker, diabetes, osteoarthritis, osteoporosis, and depression. A high level of education and living with a partner were negatively associated with fall accident risk. In 2013, people experiencing more than 1 fall accident felt more fear of falling than those having no fall accidents (odds ratio [OR] for 1 fall, 2.12; 95% confidence interval [CI], 2.04–2.12; OR for more than 2 falls, 2.97; 95% CI, 2.83–3.10). CONCLUSION: The occurrence of fall accidents has consistently increased in Korea from 2008 to 2013. Future intervention studies are needed to reduce the increasing incidence rates of fall accidents in community dwelling adults.
Accidental Falls ; Adult* ; Depression ; Education ; Female ; Health Surveys* ; Humans ; Incidence ; Independent Living* ; Korea ; Life Style ; Logistic Models ; Male ; Osteoarthritis ; Osteoporosis

This paper proposes a falling detection system based on MPU6050 senor. The system consists of a MPU6050 sensor, a STM32 MCU and a set of Bluetooth 4.0 device: collecting and parsing the falling data, transferring the result to a smartphone, the smartphone: receiving the result, alarming the elder's family and hospital. This paper presentes a new judging algorithm based on the threshold of three-axis acceleration and angle deviation of body, in order to differentiate AF and normal daily activity. The result proves that the accuracy of the system is higher than 95%, which strongly highlight the robustness and reliability.
Acceleration ; Accidental Falls ; Activities of Daily Living ; Aged ; Algorithms ; Humans ; Reproducibility of Results ; Smartphone ; Software

Surveyed on 8 plant protective facilities and interviewed 500 agricultural households which used pesticide at 10 communes of 5 districts in Quang Tri province. The amount of used pesticide in agriculture was 12 tons/year, herbicide in which 51,7%; insecticide 48,2%. There were various and abundant types of pesticide supplied by many sources from the state and private sectors. The implementation of toxic safety, storage, utilization and treatment of pesticide waste in the community was limited which influenced on the environment and public health.
Pesticides ; Public Health ; Environment