• 제목/요약/키워드: Clinical value

검색결과 3,059건 처리시간 0.029초

임상실습을 경험한 방사선과 학생의 방사선사 이미지에 대한 주관성 연구 (A Q-Methodological Study on the Radiologist's Image of Radiology College Students Experienced Clinical Practice)

  • 김영란
    • 한국융합학회논문지
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    • 제11권7호
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    • pp.51-57
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    • 2020
  • 본 연구는 인간의 주관성 연구를 목적으로 하는 Q방법론을 적용하여 임상실습을 경험한 방사선과 학생의 방사선과 이미지에 대한 주관적 인식 유형과 그 유형의 특성을 살펴보고 이를 근거로 바람직한 방사선사의 이미지를 정립하기 위한 방사선과의 교육프로그램의 기초자료를 제공하고자 수행하였다. 8주동안 첫 임상실습을 경험한 3학년 방사선과 학생 30명을 P표본으로 편의표집 하였으며 33개의 Q표본을 9점 척도의 Q 분포도상에 강제 분포하도록 하였다. 수집된 자료는 QUANL PROGRAM에 의한 주인자분석법으로 처리하였다. 연구결과 아이겐 값(Eigen value)이 1.0이상으로 2개의 유형으로 분류되었다. 제 1유형은"환자중심형", 제 2유형은"조직중심형"이었다. 이 결과는 예비방사선사인 방사선과 학생의 직업가치관 유형별 향후 진로방향의 기초자료로 활용할 수 있다고 생각한다.

Evaluation of the role of ischemia modified albumin in neonatal hypoxic-ischemic encephalopathy

  • Talat, Mohamed A.;Saleh, Rabab M.;Shehab, Mohammed M.;Khalifa, Naglaa A.;Sakr, Maha Mahmoud Hamed;Elmesalamy, Walaa M.
    • Clinical and Experimental Pediatrics
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    • 제63권8호
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    • pp.329-334
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    • 2020
  • Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score ≥7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzyme-linked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.

주요 간호활동의 건강보험 수가 적절성에 관한 연구 (A Study on the Appropriateness of Health Insurance Fee in Main Nursing Practices)

  • 김윤미;김경숙;박미미;김인숙;김미영
    • 임상간호연구
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    • 제23권2호
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    • pp.236-247
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    • 2017
  • Purpose: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. Methods: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. Results: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. Conclusion: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

간호학생의 중환자실 임상실습 체험 연구 (The Study of the Nursing Students' Lived Experience of Clinical Practice at the Intensive Care Unit)

  • 박경숙;황윤영;최은희
    • 성인간호학회지
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    • 제15권3호
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    • pp.373-382
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    • 2003
  • Purpose: The purpose of this study is to investigate the perception of nursing students' on-site clinical experience at intensive care unit(ICU), which will help on developing fundamental tool to enhance the effect of their clinical practice. Method: Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 74 third-year nursing students who performed the clinical practice at an ICU in C university hospital. The students got the group interviews and kept the clinical diaries. Data was collected from series of group interviews and contents of the students clinical diaries. Result: Major concerns related to students clinical practice were found as follows : "being nervous about unfamiliar machines and situations", "being frustrated about the patients", "feeling of helplessness", "being stupefied from witnessing a death", "realizing the importance of health", "realizing individual patient's precious value through family's love", "realizing the importance of treating a patient as humanbein g", "realizing the differences between theory and practice", "modelizing two aspects of nursing: professional and personal", "readiness to become a capable nurse". Conclusion: We are able to obtain in-depth understandings about the nursing students lived experience of clinical practice at the ICU. Based upon this, there is a need to develop a better nursing intervention enhance the effectiveness of the nursing students clinical practice.

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자동화학 분석기 Toshiba 120 FR의 평가 (Evaluation of Autochemical Analyzer Toshiba 120 FR)

  • 박점기
    • 대한임상검사과학회지
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    • 제36권2호
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    • pp.98-109
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    • 2004
  • The lower limit of detection, precision, setting method of target value, reportable range determination, recovery, linearity, and comparison study with another equipment was evaluated for the Toshiba-120FR chemistry autoanalyzer which was newly introduced at the Daejeon Veteran Hospital in Dec. 2003. Nineteen kinds of test for AST, ALT, ALP, LDH, GGT, TP, ALB, GLU, T-cho, T-bil, TG, UA, CAL, IP, AMY, HDL-C, LDL-C, Cre and BUN were performed to evaluate the lower limit of detection, precision, setting method of target value, reportable range determination, recovery, linearity, and comparison study with other equipment according to the NCCLS guidelines(EP5-A, EP6-P, EP9-A). The Toshiba-120FR autochemical analyzer showed good precision for all tested items. The data concerning the lower limit of detection, precision(total CV 0.47%~3.65%), setting method of target value, reportable range determination, recovery(93%~111%), linearity($R^2=0.997{\sim}0.999$), and comparison study(r=0.977~0.999) with other equipment was acceptable for all tested items. The results of evaluation for the Toshiba-120FR autochemical analyzer showed that this equipment could be used as an alternative to other equipment.

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Sperm Penetration Assay의 임상적 타당성에 관한 연구 (Study on the Clinical Validity of Sperm Penetration Assay)

  • 방명걸;오선경;신창재;김정구;문신용;장윤석;이진용
    • Clinical and Experimental Reproductive Medicine
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    • 제20권1호
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    • pp.1-7
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    • 1993
  • The present study was designed to test the validity of the semen analysis(S/A) and the sperm penetration assay(SPA) as a prognostic indicator of male fertility in 123 patients undergoing in vitro fertilization(IVF). We attempted to correlate the traditional semen parameters or the extent of sperm penetration in SPA with the results of human IVF rate or cleavage rate. Poor correlation was found between the results of S/A and human IVF rate(sensitivity, 80.6% ;specificity, 46.7%; positive predictive value, 91.6%;negative predictive value, 25%). Conversely, good correlation was found between the results of SPA and human IVF rate(sensitivity, 100% ; specificity, 80% ;positive predictive value, 97.3% ;negative predictive value, 100%). Our results corroborate the conclusion that SPA can be a valuable tool as a prognostic indicator of male fertilizing ability.

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자외선 조사에 의한 피부 반응의 디지털 영상분석 (Analysis of Digital Images of Skin Reaction Induced By Ultraviolet Irradiation)

  • 이동엽;두영택;이정우
    • 대한임상전기생리학회지
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    • 제8권2호
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    • pp.39-43
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    • 2010
  • Purpose : The purpose of this study was to analyze skin reactions induced by ultraviolet irradiation using digital imagery. Methods : We recruited 15 women and ultraviolet irradiation was applied to their lumbar area. (The degree of inflammatory reaction was set on the basis of the third erythema dose. Image analysis was divided by Photoshop CS (8 bit RGB scale and gray scale). Then, images were processes using Image Pro Plus 4.5 program analyzing R, G, B, chromatic red value, luminance value and gray value. Results : As a result of analyzing changes in RGB scale, there were statistically significant differences in R, G, and chromatic red values. As a result of analyzing changes in gray scale, there were statistically significant differences in gray value. Analysis of changes in B and luminance values showed that there was no statistically significant difference. Conclusion : This study found that ultraviolet irradiation had influence on RGB and gray scale. These results suggest that changes to digital images on skin reaction by ultraviolet irradiation are related to erythema. In particular, these changes are related to R and gray values.

윤리적 딜레마 사례에 대한 간호사의 의사결정 분석 (Analysis of Decision-Making in Ethical Dilemma Cases among Clinical Nurses)

  • 김현경
    • 간호행정학회지
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    • 제9권3호
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    • pp.459-480
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    • 2003
  • Purpose: This study was done to analyze the contents of nurses' ethical decision-making in four of hypothetical dilemma cases using the Cameron's Ethical Decision-Making Model of 'Value, Be, Do'. Method: Sixteen nurses who work at ICU at present or worked before, participated from April 10 to May 10 in 2002. The participants were interviewed three times each and for 40 minutes at once, with a structured questionnaire at their working places and locker rooms. The data was analyzed by a procedure of qualitative content analysis into three categories; what should I value, who should I be, what should I do. Result: 1) In consistency, most of subjects showed a unified voice in 'Value, Be, Do'. Exceptionally 8 subjects showed inconsistency such as 3 in active treatment to the incurable patients(case 1), 1 in treatment truth-telling to the terminally ill patients(case 2), 3 in conflict with uncooperative doctors(case 3), 3 in dying patients and euthanasia(case 4). Only one subject showed inconsistency in 3 dilemma cases. 2) Closing the interview procedure, the subjects evaluated Cameron's Model as it would help them build consistent value, carry right action, and cope to conflicts. Conclusion: On the basis of the results, it is recommended that nursing ethics should adopt the ethical decision-making model, and be applied to the curriculum of nursing colleges and continuing education program for clinical nurses.

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Storing information of stroke rehabilitation patients using blockchain technology: a software study

  • Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • 제39권2호
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    • pp.98-107
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    • 2022
  • Background: Stroke patients usually experience damage to multiple functions and a long rehabilitation period. Hence, there is a large volume of patient clinical information. It thus takes a long time for clinicians to identify the patient's information and essential pieces of information may be overlooked. To solve this, we stored the essential clinical information of stroke patients in a blockchain and implemented the blockchain technology using the Java programming language. Methods: We created a mini blockchain to store the medical information of patients using the Java programming language. Results: After generating a unique pair of public/private keys for identity verification, a patient's identity is verified by applying the Elliptic Curve Digital Signature Algorithm based on the generated keys. When the identity verification is complete, new medical data are stored in the transaction list and the generated transaction is verified. When verification is completed normally, the block hash value is derived using the transaction value and the hash value of the previous block. The hash value of the previous block is then stored in the generated block to interconnect the blocks. Conclusion: We demonstrated that blockchain can be used to store and deliver the patient information of stroke patients. It may be difficult to directly implement the code that we developed in the medical field, but it can serve as a starting point for the creation of a blockchain system to be used in the field.

다양한 골 이식재의 임상 효과에 대한 고찰 (A study of the clinical effects of various bone graft materials)

  • 이승범;연제영;채경준;정의원;김창성;이용근;조규성;채중규;김종관;최성호
    • Journal of Periodontal and Implant Science
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    • 제37권4호
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    • pp.719-732
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    • 2007
  • Purpose: Various bone graft materials are being used for periodontal tissue regeneration. Th materials are being developed continuously for ideal clinical effects. Therefore, it is necessary to identify the clinical characteristics of each bone graft material through comparing the various bone graft materials statistically and in doing so, proposing a more efficient bone graft material. In this study, the following results were attained through comparing the clinical effects among the bone graft materials, using the statistical method based on the clinical studies published at the department of periodontology of Yonsei hospital. Materials and Method: 6 selected studies of department of Periodontology at Yonsei University Hospital were based on clinical study of bone grafting in intrabony defects. It was compared the clinical parameters among the 6 clinical studies, using the statistical META analysis. Result: When comparing the probing depth reduction, there was a relatively great amount of decease when using the xenograft, Anorganic Bovine Derived Hydroxapatite Bone Matrix/Cell Binding Peptide(ABM/P-15: PepGen $P-15^{(R)}$) and the autogenous bone and absorbable membrane, d, 1-alctide/glycolide copolymer(GC: $Biomesh^{(R)}$). The allogfrafts showed a relatively low decrease in the probing depth and clinical attachment change. It also showed a slight decrease in the bone probing depth. The allografts showed various results according to different bone graft materials. When comparing the ABM/P-15 and bovine bone $powder(BBP^{(R)})$, ABM/P-15 showed a relatively high clinical attachment level and the bovine bone powder showed a relatively high clinical attachment level. The probing depth change and gingival recession change showed a lower value than the mean value between the two bone graft materials. The synthetic bone showed a relatively high decrease in clinical attachment level and periodontal probing depth change. There was a relatively larger amount of gingival recession when using Bioactive Glass(BG) but a relatively low bone regeneration effect was seen. Conclusion: Good restorative results of the periodontal tissue can be attained by applying the various bone graft materials being used today after identifying the accurate clinical effects.