• 제목/요약/키워드: Early Assessment

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중독 중환자에서의 초기 영양상태평가와 예후와의 관계 (Assessment of early nutritional state in critical patients with intoxication and the effect of nutritional status on prognosis)

  • 고동완;최상천;민영기;이혁진;박은정
    • 대한임상독성학회지
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    • 제19권2호
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    • pp.93-99
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    • 2021
  • Purpose: Nutritional status and support in critically ill patients are important factors in determining patient recovery and prognosis. The aim of this study was to analyze the early nutritional status and the methods of nutritional support in critically ill patients with acute poisoning and to evaluate the effect of nutritional status on prognosis. Methods: A retrospective study was conducted in tertiary care teaching hospital from January 2018 to December 2020. in an emergency department of university hospital, 220 patients who were stayed more than 2 days of poisoning in intensive care unit were enrolled. Results: 155 (70.5%) of patients with acute poisoning had low-risk in nutritional risk screening (NRS). Patients with malignancy had higher NRS (low risk 5.2%, moderate risk 18.5%, high risk 13.2%, p=0.024). Patients of 91.4% supplied nutrition via oral route or enteral route. Parenteral route for starting method of nutritional support were higher in patients with acute poisoning of herbicide or pesticide (medicine 3.2%, herbicide 13.8%, pesticide 22.2%, p=0.000). In multivariate logistic regression analysis, herbicide or pesticide intoxication, higher risk in NRS and sequential organ failure assessment over 4.5 were affecting factor on poor recovery at discharge. Conclusion: NRS in patients intoxicated with herbicide or pesticide were higher than that in patients intoxicated with medicine intoxication. Enteral nutrition in patients intoxicated with herbicide or pesticide was less common. Initial NRS was correlated with recovery at discharge in patient with intoxication. It is expected to be helpful in finding patients with high-risk nutritional status in acute poisoning patients and establishing a treatment plan that can actively implement nutritional support.

교과기반(CEA) 프로그램학습성과 평가를 위한 전산시스템(Web-based) 개발 및 적용 (Development and Implementation the Program Outcomes Assessment System based on Web-based Course Embedded Assessment(CEA))

  • 이상주;조채영
    • 문화기술의 융합
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    • 제5권1호
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    • pp.67-75
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    • 2019
  • 본 연구는 교과기반 프로그램학습성과 평가를 위한 전산시스템 개발 및 적용 사례를 제시하여 프로그램학습성과 평가의 실효성을 높이기 위한 목적으로 실행되었다. 본 연구는 교과기반 프로그램학습성과 평가를 위한 전산시스템을 개발하고 개발된 전산시스템 적용사례를 제시하는 방법론적 연구이다. 본 연구의 목적을 달성하기 위해 먼저, 시스템 개발 생명주기에 따라 요구도 조사를 실시한 후 그 결과를 전산시스템 개발에 반영 하였다. 다음으로 개발된 전산시스템을 직접 적용해 본 교수들을 대상으로 평가를 실시하였다. 전산시스템 개발을 통해 졸업시점에 이른 학생들의 개인별, 성과별 프로그램학습성과가 달성되었는지에 대한 모니터 및 CQI 수행이 용이하게 되었으며, 미달성 프로그램학습성과 및 학생에 대한 원인분석과 개선방안을 모색하는 것이 가능하게 되었다.

New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic

  • Yoo, Seung Mi;Chung, Seol Hee;Jang, Won Mo;Kim, Kyoung Chang;Lee, Jin Yong;Kim, Sun Min
    • Journal of Preventive Medicine and Public Health
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    • 제54권1호
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    • pp.17-21
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    • 2021
  • In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.

영·유아기 타인양육이 학령전 어린이의 사회정서적 행동에 미치는 영향 (Effects of early nonparental care on preschoolers' socioemotional behaviors)

  • 박경자
    • 아동학회지
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    • 제13권2호
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    • pp.217-228
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    • 1992
  • The purpose of this study is to examine the effects of early full-time nonparental care during infancy/toddlerhood on children's socioemotional behaviors during the preschool period. Subjects for this study were 105 three- to five-year-olds from middle-class families in the U. S. A. Children were assigned to one of three groups according to their early care history. Children's social interactions with peers and caregivers during indoor free-play sessions in day care centers were observed for 20 minutes. The head teachers rated the children's social and emotional behaviors on two questionnaires. Mothers completed the Attachment Q-sort for attachment assessment for the preschoolers. In addition, mothers were asked to fill out a questionnaire on their parenting practices. Children who had received full-time nonparental care during infancy and/or toddlerhood were rated by their teachers as being more intellectually competent than children who did not receive full-time nonparental care during first three years of life. They were, however, rated by teachers and were observed by the researcher as being more aggressive than children with no full-time nonparental care. These children were observed to engage in less wandering/onlooking behaviors than children who had not had any full-time nonparental care. Children's attachment security scores and dependency scores did not differ as a function of early nonparental care histories. When the effects of early care patterns, sex of child, and current attachment security to mothers on aggressive behaviors of the preschoolers were examined by a hierarchical regression model, then any "pure" effects of nonparental care and of attachment security on child aggression were minimal after controlling for family background, child care center quality, and maternal childrearing practices. Strong buffering factors for the preschool children (family characteristics, parenting styles, and high quality nonparental care) mediated a possible risk factor of early nonparental care and promoted optimal outcomes for the children.

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Risk of Lymph Node Metastases from Early Gastric Cancer in Relation to Depth of Invasion: Experience in a Single Institution

  • Wang, Zheng;Ma, Li;Zhang, Xing-Mao;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5371-5375
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    • 2014
  • Background: An accurate assessment of potential lymph node metastasis is important for the appropriate treatment of early gastric cancers. Therefore, this study analyzed predictive factors associated with lymph node metastasis and identified differences between mucosal and submucosal gastric cancers. Materials and Methods: A total of 518 early gastric cancer patients who underwent radical gastrectomy were reviewed in this study. Clinicopathological features were analyzed to identify predictive factors for lymph node metastasis. Results: The rate of lymph node metastasis in early gastric cancer was 15.3% overall, 3.3% for mucosal cancer, and 23.5% for submucosal cancer. Using univariate analysis, risk factors for lymph node metastasis were identified as tumor location, tumor size, depth of tumor invasion, histological type and lymphovascular invasion. Multivariate analysis revealed that tumor size >2 cm, submucosal invasion, undifferentiated tumors and lymphovascular invasion were independent risk factors for lymph node metastasis. When the carcinomas were confined to the mucosal layer, tumor size showed a significant correlation with lymph node metastasis. On the other hand, histological type and lymphovascular invasion were associated with lymph node metastasis in submucosal carcinomas. Conclusions: Tumor size >2 cm, submucosal tumor, undifferentiated tumor and lymphovascular invasion are predictive factors for lymph node metastasis in early gastric cancer. Risk factors are quite different depending on depth of tumor invasion. Endoscopic treatment might be possible in highly selective cases.

GOLPH3, a Good Prognostic Indicator in Early-stage NSCLC Related to Tumor Angiogenesis

  • Lu, Ming;Tian, Yu;Yue, Wei-Ming;Li, Lin;Li, Shu-Hai;Qi, Lei;Hu, Wen-Si;Gao, Cun;Si, Li-Bo;Tian, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5793-5798
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    • 2014
  • Background: Golgi phosphoprotein-3 (GOLPH3) is implicated in cancer development and progression. The aim of this study was to evaluate the prognostic significance of GOLPH3 protein and its association with tumor angiogenesis in patients with early-stage NSCLC. Materials and Methods: Immunohistochemistry was performed to determine GOLPH3 protein expression and allow assessment of intratumoral microvessel density (MVD) by counting CD-34 positive immunostained endothelial cells. Correlations of expression with MVD, clinicopathologic features and clinical prognosis were analyzed. Results: A notably higher level of GOLPH3 expression was found in early-stage NSCC tissues at the protein level. However, we do not find any correlation between GOLPH3 expression and clinicopathologic features (p>0.05), although higher MVD was positively associated with GOLPH3 overexpression (p<0.001). Expression of GOLPH3 was found to be an independent prognostic factor in early-stage NSCLC patients, those expressing high levels of GOLPH3 exhibiting a substantially lower 5-year overall survival than GOLPH3-negative patients (adjusted HR =1.899, 95% CI: 1.021-3.532, p=0.043). Conclusions: High expression of the GOLPH3 protein is common in early-stage NSCC, and is closely associated with tumor progression, increased tumor angiogenesis, and poor survival. We conclude a possibility of its use as a diagnostic and prognostic marker in early-stage NSCC patients.

Effects of a Case-Based Sepsis Education Program for General Ward Nurses on Knowledge, Accuracy of Sepsis Assessment, and Self-efficacy

  • Kim, Bohyun;Jeong, Younhee
    • Journal of Korean Biological Nursing Science
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    • 제22권4호
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    • pp.260-270
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    • 2020
  • Purposes: Sepsis is a critical condition in which nurses should detect clinical manifestations and provide early intervention to prevent unwanted serious conditions in the patients. The initial occurrence and management of sepsis take place in general units, but there is a lack of knowledge in nurses. The purpose of this study was to examine the effects of a case-based sepsis education program and compare the case-based education program with and without smartphone applications. Methods: A quasi-experimental pre-test-post-test design with a control group was used. We provided a case-based education program with and without smartphone applications to the nurses and tested the effects of the program on knowledge, the accuracy of sepsis assessment, and self-efficacy as outcome variables. A total of 60 nurses in general units participated. To test differences in knowledge, the accuracy of sepsis assessment, and self-efficacy regarding sepsis between the groups over time, a mixed-design ANCOVA was used for parametric analysis, and generalized estimating equations (GEE) were used for nonparametric analysis. Results: There were significant differences in knowledge, the accuracy of sepsis assessment, and self-efficacy between the groups and within the groups over time. The intervention groups treated with the case-based education program showed improved outcome variables compared to the control group. There was no difference between case-based education with the smartphone application or without the application. Conclusions: The case-based education improved knowledge, the accuracy of sepsis assessment, and self-efficacy in the care of sepsis by nurses working in the general wards. The results suggest that the case-based education program for nurses was effective and eventually improved patient health outcomes.

우리나라의 남극 환경영향평가제도 정착을 위한 연구 (Introductive Study to the Antarctic Environmental Impact Assessment in Korea)

  • 최재용;최준규;최준영
    • Ocean and Polar Research
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    • 제26권2호
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    • pp.155-163
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    • 2004
  • The Protocol on Environmental Protection to the Antarctic Treaty was ratified in 1991. With the aim to ensure comprehensive protection of the Antarctic environment, it contains provisions on environmental protection and conservation of the Antarctic area, including provisions for Environmental Impact Assessment. Environmental Impact Assessment is a method used to predict environmental impacts at an early stage in project planning and design, and find ways to mitigate or prevent adverse impacts in order to maintain balance between development activities and environmental conservation. Internationally, the Environmental Impact Assessment (EIA) in the Antarctic is classified into three types - preliminary, Initial, and Comprehensive - based on the environmental impacts of the proposed activities. In case of the Preliminary Environmental Review (PER), proposed activity may proceed in accordance to the national procedures and drafting of an outline. However, Initial (IEE) and Comprehensive Environmental Evaluation (CEE) assess and verify the impacts of the proposed activity, and require methods or alternatives for mitigating or eliminating negative impacts on the environment. Although Korea's Act of 'Activities and Environmental Protection in Antarctica' also includes provisions on EIA for activities in Antarctica, there are obvious contrasts with the EIAs currently being conducted in Korea, in regards to deciding the level of EIA through screening and identifying key issues for assessment through scoping. In order to implement the proper EIA, more improved methods for drafting and reviewing the EIA to Antarctica in Korea are necessary.

신생아-학령전기 대상자의 맞춤형 방문건강관리 기록지 및 모형 개발 (Development of Health Assessment Tools and Tailored Home Visiting Nursing Service Model for Children in Poverty)

  • 김희자;유재순;김현숙;탁양주;방경숙;허보윤
    • 부모자녀건강학회지
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    • 제13권2호
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    • pp.63-77
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    • 2010
  • Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

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가상 환경 상의 헬리콥터 조종실 설계를 위한 정량적인 인간공학적 평가 방법 개발 (Development of Quantitative Ergonomic Assessment Method for Helicopter Cockpit Design in a Digital Environment)

  • 정기효;박장운;이원섭;강병길;엄주호;박세권;유희천
    • 대한인간공학회지
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    • 제29권2호
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    • pp.203-210
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    • 2010
  • For the development of a better product which fits to the target user population, physical workloads such as reach and visibility are evaluated using digital human simulation in the early stage of product development; however, ergonomic workload assessment mainly relies on visual observation of reach envelopes and view cones generated in a 3D graphic environment. The present study developed a quantitative assessment method of physical workload in a digital environment and applied to the evaluation of a Korean utility helicopter (KUH) cockpit design. The proposed assessment method quantified physical workloads for the target user population by applying a 3-step process and identified design features requiring improvement based on the quantified workload evaluation. The scores of physical workloads were quantified in terms of posture, reach, visibility, and clearance, and 5-point scales were defined for the evaluation measures by referring to existing studies. The postures of digital humanoids for a given task were estimated to have the minimal score of postural workload by finding all feasible postures that satisfy task constraints such as a contact between the tip of the index finger and a target point. The proposed assessment method was applied to evaluate the KUH cockpit design in the preliminary design stage and identified design features requiring improvement. The proposed assessment method can be utilized to ergonomic evaluation of product designs using digital human simulation.