• Title/Summary/Keyword: Clinical practice performance

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Deep Learning-Based Algorithm for the Detection and Characterization of MRI Safety of Cardiac Implantable Electronic Devices on Chest Radiographs

  • Ue-Hwan Kim;Moon Young Kim;Eun-Ah Park;Whal Lee;Woo-Hyun Lim;Hack-Lyoung Kim;Sohee Oh;Kwang Nam Jin
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1918-1928
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    • 2021
  • Objective: With the recent development of various MRI-conditional cardiac implantable electronic devices (CIEDs), the accurate identification and characterization of CIEDs have become critical when performing MRI in patients with CIEDs. We aimed to develop and evaluate a deep learning-based algorithm (DLA) that performs the detection and characterization of parameters, including MRI safety, of CIEDs on chest radiograph (CR) in a single step and compare its performance with other related algorithms that were recently developed. Materials and Methods: We developed a DLA (X-ray CIED identification [XCID]) using 9912 CRs of 958 patients with 968 CIEDs comprising 26 model groups from 4 manufacturers obtained between 2014 and 2019 from one hospital. The performance of XCID was tested with an external dataset consisting of 2122 CRs obtained from a different hospital and compared with the performance of two other related algorithms recently reported, including PacemakerID (PID) and Pacemaker identification with neural networks (PPMnn). Results: The overall accuracies of XCID for the manufacturer classification, model group identification, and MRI safety characterization using the internal test dataset were 99.7% (992/995), 97.2% (967/995), and 98.9% (984/995), respectively. These were 95.8% (2033/2122), 85.4% (1813/2122), and 92.2% (1956/2122), respectively, with the external test dataset. In the comparative study, the accuracy for the manufacturer classification was 95.0% (152/160) for XCID and 91.3% for PPMnn (146/160), which was significantly higher than that for PID (80.0%,128/160; p < 0.001 for both). XCID demonstrated a higher accuracy (88.1%; 141/160) than PPMnn (80.0%; 128/160) in identifying model groups (p < 0.001). Conclusion: The remarkable and consistent performance of XCID suggests its applicability for detection, manufacturer and model identification, as well as MRI safety characterization of CIED on CRs. Further studies are warranted to guarantee the safe use of XCID in clinical practice.

Application of Rasch Analysis to the Korean Berg Balance Scale (한국판 버그 균형척도 평가도구의 라쉬분석)

  • Lee, Jung-Ah;Yi, Chung-Hwi;Park, So-Yeon;Hwang, Su-Jin
    • Physical Therapy Korea
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    • v.13 no.3
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    • pp.49-56
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    • 2006
  • This study was designed to examine, using Rasch analysis, the rating scale performance of the Korean version of the Berg Balance Scale (BBS). The subjects were 95 elderly people at community dwelling. Subjects (19 men, 76 women) ranged in age from 65 to 91 years. Rasch analysis was then done by means of the Winsteps program to determine the validity and reliability of the Korean version of the BBS evaluation tools for elderly people. The results were as follows: Twenty-one elderly people were excluded for misfit persons. Three items were found to be misfits and the order of item difficulty of the remaining 11 items was arranged. Elderly people BBS ability is indicated by -.94~7.41 logit, and the transformation formula is score=(logit score+.94)/$(.94+7.41){\times}100$. This transformation formula can be applied to Korean elderly people for balance ability. In the order of difficulty of evaluation items, the most difficult item was "Standing on one foot" and the easiest item was "Standing to Sitting". In conclusion, the Korean version of BBS evaluation tool for the elderly people has been proved valid and will be useful in clinical practice and research in Korea.

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Evaluation and Application Effect of a Home Nasogastric Tube Feeding Simulation Module for Nursing Students: An Application of the NLN Jeffries Simulation Theory (간호학생을 위한 방문간호 비위관 관리교육 시뮬레이션 모듈 평가와 적용 효과: NLN Jeffries 시뮬레이션 이론 적용)

  • Baek, Hee Chong;Lee, Young Ran;Lee, Jong Eun;Lee, Jin Hwa;Kim, Hyung Seon
    • Research in Community and Public Health Nursing
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    • v.28 no.3
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    • pp.324-333
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    • 2017
  • Purpose: The purpose of this study was to develop a simulation module for teaching home health care and evaluate the applicability of the program to nursing students' practical training. Methods: The simulation module was developed based on the National League for Nursing Jeffries Simulation Theory. The theme of the developed scenario was teaching nasogastric tube feeding to the caregiver of patient with Parkinson disease. Participants were 61 nursing students who had learned tube feeding, and participated in the questionnaire survey after the simulation training. Results: The evaluation of simulation design showed the highest score on feedback/guided reflection, and was highly evaluated in the order of objectives/information, problem solving and fidelity. The educational practice of the simulation was highly evaluated in the order of active learning, high expectation and diversity of learning. The nursing students showed high satisfaction and self-confidence after the simulation education. Conclusion: We suggest that the developed simulation module can be applied to practical training for home health care. In the future, the change of self-efficacy, clinical judgment and performance ability of the students after the simulation education should be identified. Also, various simulation modules related to the community health nursing competencies should be continuously developed and verified.

Effects of Integrated Nursing Practice Simulation-based Training on Stress, Interest in Learning, and Problem-Solving Ability of Nursing Students (통합적 간호실무 시뮬레이션 기반 훈련이 간호대학생의 스트레스, 학습흥미, 문제해결능력에 미치는 영향)

  • Park, Sun-Nam;Chu, Min-Sun;Hwang, Yoon-Young;Kim, Sun-Hee;Lee, Sun-Kyoung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.4
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    • pp.424-432
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    • 2015
  • Purpose: In this study the time point of effects that repeat exposure to simulation-based nursing training has on stress, interest in learning, and problem-solving abilities were identified. Methods: Participants for this study were 75 nursing college students in Seoul. In a preliminary survey data were collected and measured for the general characteristics, stress, interest in learning, and problem-solving abilities of the students. Then, stress was assessed before performance of each of four-rounds of simulation training scenarios. After each simulation round, interest in learning and problem-solving abilities were assessed. Results: With respect to stress, no significant differences were found when comparing the results of the preliminary survey to those of each of the simulation-based training exercises. For the sub-items of interest in learning, interest in nursing knowledge and interest in clinical training significantly increased between the preliminary survey and the $4^{th}$ survey. Interest in lab training increased significantly at the $1^{st}$ survey. Problem solving abilities showed a significant increase from the preliminary at each of the survey points. Conclusion: Increasing the exposure of nursing students to simulation-based training enhances their interest in learning and problem-solving abilities. Therefore it is necessary to have education strategies that includes various simulation experiences for students.

Effects of Self-evaluation using Smartphone Recording on Nursing Students' Competency in Nursing Skills, Satisfaction, and Learning Motivations: Focusing on Foley Catheterization (자율실습교육에서 스마트폰 동영상을 활용한 자가평가 학습법이 간호술기 수행능력, 자율실습만족도, 학습동기에 미치는 효과: 유치도뇨를 중심으로)

  • Chang, Eunhwa;Park, Soohyun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.24 no.2
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    • pp.118-127
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    • 2017
  • Purpose: The purpose of this study was to identify effects of self-evaluation using smartphone recording on competency in nursing skills, satisfaction and learning motivations in nursing students'. The setting was the open laboratory hours. Methods: A quasi-experimental pre/post-test design was conducted in September 2015. The participants were 82 sophomore nursing students from one University. The experimental group did self-evaluation by watching recorded video clips of their performance. The control group did not have any self-evaluation. The primary outcomes were scores from the foley catheterization checklist, scores from a student satisfaction tool, and scores from a learning motivation tool. Data were analyzed using ${\chi}^2$ test, Fisher's exact test, independent t-test, and paired t-test. Results: There was a significant higher mean score in levels of satisfaction by students in the experimental group compared to the control group (t=2.26, p=.027). In addition, improvement in communication skills by the experimental group was significantly higher than improvement in the control group (t=3.96, p<.001). Conclusion: Findings show that self-evaluation using smartphone recordings has positive effects on increasing both communication skills and satisfaction with practice during open laboratory hours. These results indicate that, self-evaluation using smartphone recording is useful as a supplement to traditional open laboratory education.

An Analytic Study on Curriculum in Nursing Education (간호교육 과정에 관한 분석 연구)

  • 도복늠
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.81-94
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    • 1974
  • The trend in modern nursing is toward the performance of comprehensive nursing carp. Airer liberation of 1945, nursing education in Korea has made rapid progress. The System of nursing education in Korea has come to the professional school of nursing and collegiate program from high School level. Under these situations, the improvement on curriculum of nursing education is necessary. This paper is a basic study for improvement of curriculum in nursing education. 1. The aims of this study are; 1) to analyze and compare the objectives of nursing education in Korea and U.S.A 2) to analyze and compare the differences in curriculum of nursing education between Korea and U. S. A. 3) to find problems in nursing education of Korea 2. The curricula and bulletins from 2 colleges.9 departments, 12 professional schools and 18 attached schools of nursing in Korea and 9 attached schools of nursing and 17 colleges in U. S. A. were collected for this study. 3. The results of this study: 1) Most of Korean programs lack for the student to make understand respect the human in the statement of their objectives. 2) Most of Korean programs prepare their graduate to function as a contributing member of the-health team in the hospital and the community, while the graduate of the American attached schools is prepared to function in general staff nursing and team leadership positions in hospitals. 3) Most of Korean programs of nursing education hays low distribution of credits in supporting sciences. (especially sociology and psychology) 4) Too much proportion of time in attached schools and less and less proportion of time in professional schools is distributed in clinical practice area. 5) In our collegiate programs. too much proportion of time is distributed in adult nursing and less proportion of time in Psychiatric nursing. 6) Professional area on curriculum of attached schools is divided into many detailed subjects. 7) A large number of credits in total are distributed at the first year in attached schools.

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Discrimination of Parkinson's Disease from Essential Tremor using Acceleration based Tremor Analysis (가속도계를 이용한 진전현상의 분석을 통한 파킨슨병과 본태성 진전의 판별)

  • Lee, Hongji;Lee, Woongwoo;Jeon, Hyoseon;Kim, Sangkyong;Kim, Hanbyul;Jeon, Beom S.;Park, Kwangsuk
    • Journal of Biomedical Engineering Research
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    • v.36 no.4
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    • pp.103-108
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    • 2015
  • Discrimination of Parkinson's disease (PD) from Essential tremor (ET) is often misdiagnosed in clinical practice. Since tremor is time-varying signal, and dominant and harmonic frequencies are shown in tremor only with moderate or severe symptom, there are some limitations to use frequency related features. Moreover, patients with PD or ET can suffer from both resting tremor and postural tremor. In this study, 28 patients with PD and 17 patients with ET were enrolled. Tremor was measured with accelerations on the more affected hand during resting and postural conditions. The ratio of root mean square (RMS) of resting tremor to RMS of postural tremor, the mean coefficients of autocorrelation function (ACF), and the mean of differences of two adjacent coefficients of ACF at resting and postural were calculated and compared between PD and ET. The performance showed 98% accuracy with support vector machine and leave-one-out cross validation. In addition, the method accurately differentiated the patients with tremor-dominant PD from patients with ET, with 100% accuracy. Therefore, the developed algorithm can assist clinicians in diagnosing and categorizing patients with tremor, especially, patients with mild symptom or the early stage of a disease, for proper treatment.

Shape memory alloy (SMA)-based head and neck immobilizer for radiotherapy

  • Lee, Hyun-Taek;Kim, Sung-In;Park, Jong Min;Kim, Ho-Jin;Song, Dae-Seob;Kim, Hyung-Il;Wu, Hong-Gyun;Ahn, Sung-Hoon
    • Journal of Computational Design and Engineering
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    • v.2 no.3
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    • pp.176-182
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    • 2015
  • Head-and-neck cancer is often treated with intensive irradiation focused on the tumor, while delivering the minimum amount of irradiation to normal cells. Since a course of radiotherapy can take 5-6 weeks or more, the repeatability of the patient posture and the fastening method during treatment are important determinants of the success of radiotherapy. Many devices have been developed to minimize positional discrepancies, but all of the commercial devices used in clinical practice are operated manually and require customized fixtures for each patient. This is inefficient and the performance of the fixture device depends on the operator's skill. Therefore, this study developed an automated head-and-neck immobilizer that can be used during radiotherapy and evaluated the positioning reproducibility in a phantom experiment. To eliminate interference caused by the magnetic field from computed tomography hardware, Ni-Ti shape-memory alloy wires were used as the actuating elements of the fixtures. The resulting positional discrepancy was less than 5 mm for all positions, which is acceptable for radiotherapy.

Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • v.10 no.2
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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Effect of push-up plus exercise on shoulder stabilization muscle thickness in healthy adults in their twenties on various support surfaces (다양한 지지면에서 푸쉬업 플러스 운동이 20대 건강한 성인의 어깨 안정화 근육 두께에 미치는 영향)

  • Jeong, Jin Gyu;Park, Jae Cheol
    • Journal of Korean Physical Therapy Science
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    • v.29 no.3
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    • pp.48-55
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    • 2022
  • Background: The purpose of this study is to examine the effect of push-up plus exercise on the changes in the thickness of the trapezius trapezius, serratus anterior and pectoralis major muscles involved in shoulder stability in various support surfaces. Design: Randomized controlled trial. Methods: The thickness change of the shoulder stabilizing muscle was measured using an ultrasound device. Corresponding t-test was performed to confirm the change within the group before the experiment and after 5 weeks. And one-way ANOVA was used to confirm the change between groups after 5 weeks. As a post hoc test, the least significant difference test was performed, and the significance level was set to a=0.05. Results: Changes in the thickness of the trapezius muscle within the group were significantly different between UPEG and SPEG after 5 weeks (p<0.05), and there was a significant difference between groups after 5 weeks (p<0.05). Changes in the thickness of the serratus anterior and pectoralis major muscle within the group were significantly different after 5 weeks in PEG, UPEG and SPEG (p<0.05), and the changes between the groups were significantly different in the serratus anterior muscle after 5 weeks (p<0.05). Conclusion: From the results of this study, it was found that the push-up exercise on an unstable support surface was effective for strengthening the trapezius upper and serratus anterior. This study intends to suggest the possibility of application as basic data for a push-up plus exercise program in clinical practice.