• Title/Summary/Keyword: Field clinical practice

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Telemedicine Software Application

  • UNGUREANU, Ovidiu Costica;POPESCU, Marius-Constantin;CIOBANU, Daniela;UNGUREANU, Elena;SARLA, Calin Gabriel;CIOBANU, Alina-Elena;TODINCA, Paul
    • International Journal of Computer Science & Network Security
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    • v.21 no.2
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    • pp.171-180
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    • 2021
  • Currently, hospitals and medical practices have a large amount of unstructured information, gathered in time at each ward or practice by physicians in a wide range of medical branches. The data requires processing in order to be able to extract relevant information, which can be used to improve the medical system. It is useful for a physician to have access to a patient's entire medical history when he or she is in an emergency situation, as relevant information can be found about the patient's problems such as: allergies to various medications, personal history, or hereditary collateral conditions etc. If the information exists in a structured form, the detection of diseases based on specific symptoms is much easier, faster and with a higher degree of accuracy. Thus, physicians may investigate certain pathological profiles and conduct cohort clinical trials, including comparing the profile of a particular patient with other similar profiles that already have a confirmed diagnosis. Involving information technology in this field will change so the time which the physicians should spend in front of the computer into a much more beneficial one, providing them with the possibility for more interaction with the patient while listening to the patient's needs. The expert system, described in the paper, is an application for medical diagnostic of the most frequently met conditions, based on logical programming and on the theory of probabilities. The system rationale is a search item in the field basic knowledge on the condition. The web application described in the paper is implemented for the ward of pathological anatomy of a hospital in Romania. It aims to ease the healthcare staff's work, to create a connection of communication at one click between the necessary wards and to reduce the time lost with bureaucratic proceedings. The software (made in PHP programming language, by writing directly in the source code) is developed in order to ease the healthcare staff's activity, being created in a simpler and as elegant way as possible.

A Study of Image Quality and Exposed Dose by Field Size Changing on CBCT (CBCT 촬영 시 조사야 조절에 따른 영상의 최적화 및 피폭선량에 관한 고찰)

  • Bang, Seung Jae;Kim, Young Yeon;Jeong, Il Seon;Kim, Jeong Soo;Kim, Young Gon
    • The Journal of Korean Society for Radiation Therapy
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    • v.25 no.2
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    • pp.175-180
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    • 2013
  • Purpose: Modern radiation therapy technique such as IGRT has become a routine clinical practice on LINAC for decrease patient's set-up error. CBCT can be used to adjust patient set-up error and treat patient more accurately. The Purpose of this study is to evaluate field size of CBCT for improving Image quality and suggest reference date of CBCT field size. Materials and Methods: Image date were acquired using KV CBCT and Catphan phantom (Half fan and full fan mode were scanned from 2 ~16 cm, at intervals of 2 cm). Field size were categorized by Small field size (2 cm, 4 cm), Medium field size (8 cm, 10 cm), Large field size (more than 14 cm) and evaluate. To estimated the CTDi using CTDi phantom and Ion chamber. Results: CT number linearity of Small and Large field size are greater than Medium field size. Spatial resolution are not significantly different without Small field size. But half fan mode is more different than full fan mode. In full fan, except Medium field size, all field size exceed recommendation for HU uniformity. But half pan has stability for all field except Small field size. CTDi makes radical sign function graph in Medium field size. Conclusion: The worst result was given by Small field size for Image quality and practically. Medium field size can be useful to prevent patient from radiation exposure and give better Image quality. So this study recommends that Medium field size (8~10 cm) is more suitable for CBCT.

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The Influence of Online Psychiatric Nursing Practicum including Virtual Simulation on Goal Commitment, Self-Efficacy, Critical Thinking Disposition and Problem-Solving Ability (가상 시뮬레이션을 포함한 온라인 정신간호학실습이 목표몰입, 자기효능감, 비판적 사고성향 및 문제해결능력에 미치는 영향)

  • Park, Keumok;Chung, Su Kyoung
    • Journal of Convergence for Information Technology
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    • v.11 no.10
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    • pp.60-67
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    • 2021
  • The purpose of this study is to investigate the effect of online psychiatric nursing practicum including virtual simulation on goal commitment, self-efficacy, critical thinking disposition, and problem solving ability of nursing students in the COVID-19 situation with difficult clinical practice. The subjects of this study were collected using an online questionnaire for third-year nursing students located in A city, and 31 students participated in the final. The results of this study showed that goal commitment and critical thinking disposition were improved in the post-test compared to the pre-test, but were not statistically significant. Self-efficacy (t=4.222, p<.001) and problem solving ability (t=6.807, p<.001) were signifincantly improved after than before online practicum. This findings indicate that online psychiatric nursing practicum including virtual simulation is effective in improving self-efficacy and problem solving ability. As it is difficult to perform nursing practice directly in the clinical field due to the recent COVID-19, it is expected that the limitations of online practicum can be overcome by utilizing various online contents including virtual simulations in online psychiatric nursing practicum.

Literature Review Nursing Intervention for Developmental Support on Preterm Infants (미숙아의 발달지지를 위한 간호중재에 관한 문헌연구)

  • Kim, Tae-Im;Sim, Mi-Kyung
    • Korean Parent-Child Health Journal
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    • v.4 no.1
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    • pp.35-55
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    • 2001
  • Recently attention has been focused on the effects of early intervention, or its lack, on both normal and preterm infants. Particularly numerous studies suggest that premature infants are not necessarily understimulated but instead are subjected to inappropriate stimulation. Developmental support and sensory stimulation have become clinical opportunities in which nursing practice can impact on the neurobehavioral outcome of premature infants. Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Increasingly, attention and concern in caring for low-birth-weight infants and premature infants has led clinicians in the field to explore the effects of a complex of interventions designed to create and maintain a developmentally supportive environment; to provide age-appropriate sensory input; and to protect the infant from inappropriate, excessive and stressful stimulation. The components of developmental care include modifications of the macro-environment to reduce NICU light and sound levels, care clustering, nonnutritive sucking, and containment strategies, such as flexed positioning or swaddling. Sensory stimulation of the premature infants is presented to standardize the modification of a developmental intervention based on physiologic and behavioral cues. The most appropriate type of stimuli are those that are sensitive to infant cues. Evaluation of infant physiological and behavioral responds to specific intervention stimuli may help to identify more appropriate interventions based on infants' cues. A critical question confronting the clinician is that of determining when the evidence supporting a change in practice is sufficient to justify making that change. There are acknowledged limitations in the current studies. Many of the studies examined had small sample sizes; used nonprobability sampling; and used a phase lag design, which introduces the possibility of threats to internal validity and limits the generalizability of the results. Although many issues regarding the effects of developmental interventions remain unresolved, the available research base documents significant benefits of developmental care for LBW infants in consistent outcomes, without significant adverse effects. Particularly, although the individual studies vary somewhat in the definition of specific outcomes measured, instrumentation used, time and method of data collection, and preparaion of the care providers, in all studies, infants receiving the full protocol of individualized developmentally supportive care had improvements in some aspect of four areas of infant functioning: level of respiratory or oxygen support, the establishment of oral feeding; length of hospital stay, and infant behavioral regulation. In summary, based on the available literature, individualized developmental intervention should be incorporated into standard practice in neonatal intensive care. And this implementation needs to be coupled with ongoing research to evaluate the impact of an individualized developmental care programs on the short- and long-tenn health outcomes of LBW infants.

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Study of Spectral Doppler Waveform Interpretation and Nomenclature in Peripheral Artery (말초 동맥 분광 도플러 파형 해석 및 명명법에 대한 고찰)

  • Ji, Myeong-Hoon;Seoung, Youl-Hun
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.649-660
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    • 2022
  • In 1959, Satomura used spectral Doppler ultrasound to express the velocity of red blood cells according to time change, and Kato defined a zero-base line that could tell the direction of blood flow, making it possible to know the direction of blood flow. This became the basis for the widely used classifications of Triphasic, Biphasic, and Monophasic. However, the above classification has limitations that confuse users with the meaning and timing of use in a clinical environment. As a result, the American Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU) A consensus document on Doppler waveform analysis was declared by the joint committee. This study tried to review this consensus and to suggest nomenclature and modifiers that can be used in the domestic vascular ultrasound clinical field. The joint committee formed by SVM and SVU recommended that the use of the triphasic waveform and the biphasic waveform be used as a multiphasic waveform rather than being used due to the ambiguity of interpretation. In addition, it was agreed to name the hybrid-type waveform, which is a monophasic and high-resistance waveform, which has always been a problem of interpretation in a clinical environment, as an intermediate resistive waveform. In addition, in order to increase the communication efficiency between the interpreter and the sonographer, waveform analysis was classified into a main descriptor and a modifier, and it was recommended to use a single nomenclature by unifying various synonyms. It is expected that this literature review will provide accurate arterial spectral Doppler waveform interpretation and an agreed-upon nomenclature to radiologists performing vascular ultrasound examination in clinical practice, and will be utilized as basic data that can contribute to the improvement of public health.

A study on the current status and development of the new health technology assessment of Korean medicine field (한의 신의료기술 평가 활성화 방안 제언)

  • Park, Minjung;Jung, Youjin;Son, Soo Kyung;Kwon, Soohyun;Kim, Nankwen;Kim, Jong Woo;Park, Dong Ah;Chung, Seok-Hee
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.59-75
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    • 2019
  • Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

A Study of Huh-Im(許任)'s ChimGuKyungHumBang(『鍼灸經驗方』) (허임(許任) 『鍼灸經驗方』 연구(硏究))

  • Park, Mun-Hyun
    • The Journal of Korean Medical History
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    • v.15 no.1
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    • pp.63-146
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    • 2002
  • Huh-Im(許任, 1570~1647) was an acupuncture doctor of Chosun(朝鮮) era through the late 16th century and early 17th century. Even though he was a person of low birth, he participated in the loyal medication through three loyal generations, Sunjo(宣祖), Kwanghaegun(光海君) and Injo(仁祖). He was recognized of his services and became an official, 'Dangsanggwan'(堂上官) and Kyunggi(京畿) district official several times. In the early Chosun era, acupuncture medicine was focused. During the late 16th century, Imjin(壬辰) war aroused more needs about acupuncture medicine, and acupuncture doctors showed remarkable work. Under these circumstances, Huh-Im(許任)'s fame spread throughout the country. Huh-Im(許任) wrote ChimGuKyungHumBang("鍼灸經驗方") in 1644 based on his lifetime clinical acupuncture & moxibustion experience. It was the first specialized book of acupuncture in Chosun era. This event took place 30 years after DongEuiBoGam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") was published. But it was not influenced much by DongEuiBoGam - Acupuncture Chapter("東醫寶 鑑-鍼灸篇") in the form or contents. ChimGuKyungHumBang("鍼灸經驗方") and Huh-Jun(許浚)'s DongEuiBo- Gam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") were the fruits of the middle Chosun, and they are complementary to each other in theory and practice. The chief distinctions of ChimGuKyungHumBang("鍼灸經驗方") are in it's compact and practical edition and a lot of his clinical acupuncture prescriptions mentioned in the book. Huh-Im(許任) not only accepted the existing books such as NaeKyung("內經"), DongInSuHyulChimGuDoKyung and Shin- Eung Kyung("神應經") with his point of view and clinical experience, but also showed creative operation of studies. Indicating incorrect acupuncture points(訛穴), acupuncture remedy based on the visceral pathogenesis(臟腑病機) and the channel pathogenesis, research on new acupuncture points, sorting out plenty of outer meridian acupuncture points(經外奇穴), creating supplementary and purging acupuncture method(鍼補瀉法) which is a change of hand treatment of KiHyoYangBang("奇效良方"), operating variety of acupuncture and moxibustion treatments, and application of acupuncture treatments on surgery field such as intumescences and emergency cases are the examples. Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") influenced on the folk remedy books(民間經驗方書) in the late Chosun era. Compact and practical characteristics of the book let acupuncture treatment be freindly to the people. It can be confirmed in JeungBoSanRimKyungJe-Emergency Chapter("增補山林經濟-救急篇") or the formation of SaAmChimBob(舍巖鍼法). ChimGuKyungHumBang("鍼灸經驗方") was introduced to Japan in 18th century and published twice. ChimGuJibSung("鍼灸集成"), known as an acupuncture medical book of late Qing dynasty(淸末, 1874), is confirmed to be an plagiarization of DongEuiBoGam-Acupuncture Chapter("東醫寶鑑-鍼灸篇") and ChimGuKyungHum- Bang("鍼灸經驗方") of 17th century Chosun. Confusions and errors arouse from mistaken editional trend of ChimGuJIbSung("鍼灸集成") which had not disclosed it's original author and the title of the book must be reformed. In this way, fruits of acupuncture of the middle Chosun era including Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") will take a right place in acupuncture medicine history.

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Toxicity of Eun-bi San Pharmacopuncture Injection inthe Muscle of Rats

  • Lee, Jongcheol;Jeong, Hohyun;Cha, Eunhye;Park, Manyong;Choi, Sungyoul;Yook, Taehan;Song, InJa;Kim, Sungchul
    • Journal of Pharmacopuncture
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    • v.18 no.1
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    • pp.63-71
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    • 2015
  • Objectives: This study was carried out to analyze the single-dose toxicity of Eun-Bi San pharmacopuncture injected into the muscle of Sprague-Dawley (SD) rats. Methods: All experiments were performed at Biotoxtech, an institution certified to conduct non-clinical studies under the Good Laboratory Practice (GLP) regulations. Six week old SD rats reared by ORIENTBIO were chosen for this pilot study. The reason SD rats were chosen is that they have been widely used in safety tests in the field of medicine, so the results can be easily compared with many other databases. The Eun-Bi San pharmacopuncture was made in a clean room at the Korean Pharmacopuncture Institute (KPI, K-GMP). The constituents of the Eun-Bi San pharmacopuncture are Angelicae gigantis radix, Strychni semen and Glycyrrhizae radix. These were extracted at low temperature and low pressure in an aseptic room at the KPI. Doses of Eun-Bi San pharmacopuncture, 0.25, 0.5 and 1.0 mL, were administered to the experimental groups, and a dose of normal saline solution, 1.0 mL, was administered to the control group. This study was performed under the approval of the Institutional Animal Ethics Committee of Biotoxtech Co., Ltd. Results: No deaths or abnormalities occurred in any of the four groups. No significant changes in weight, hematological parameters or clinical chemistry between the control group and the experimental groups were observed. To determine if abnormalities existed in any organs and tissues, we used microscopy to examine representative histological sections of each specified organ; the results showed no significant differences in any of the organs or tissues. Conclusion: The results of this study suggest that treatment with Eun-Bi San pharmacopuncture is relatively safe and that its clinical use may be beneficial. Further evaluations and studies on this subject will be needed to provide more concrete evidence in support of these conclusions.

Current Status and Development Direction Through a Review of Yoga Therapy Literature (요가치료 문헌 고찰을 통해 본 현황과 발전 방향)

  • Jung, Youn-Heui;Lee, Geo-Lyong
    • Journal of Naturopathy
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    • v.11 no.1
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    • pp.68-78
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    • 2022
  • Background: Integrative medical research is needed to explore the development direction of new yoga therapy. Purposes: A systematic literature review is conducted to analyze the current status of clinical research on yoga therapy into scientific categories, and to explore the content and development direction of yoga therapy. Methods: Through electronic databases such as RISS, NDSL, DBpia, e-article, and KISS, 530 domestic academic papers were selected from 2010 to 2018 and the final 28 were extracted based on PRISMA guidelines. Results: As a result of the study, in terms of quality, it remained at 3b of the CEBM level of evidence, and in terms of quantity, the number of experimental groups in the entire clinical study was 288, so domestic clinical studies of yoga therapy are insufficient. It was found that 80% of yoga therapy was exercise therapy focusing on asana movements. This seems to be due to a lot of researchers in the field of physical education. Conclusions: These results indicate that understanding and practice of the Ashtanga-yoga's training system and Pancha-kosha theory from the perspective of integrative medicine are necessary. In other words, yoga therapy is required to develop into an integrated mind-body therapy program that integrates holistic healing yoga based on individual mental and physical constitution, meditation therapy based on Ayurveda, and exercise therapy.

A Study on the Effective Independent Study of Nursing Student (간호학생의 효과적인 자율학습을 위한 조사연구)

  • 김광주;이향련
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.16-42
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    • 1978
  • This survey was made for a month starting from November 15 to December 15, 1977 covering 711 students taking the junior. (3rd-yea.) and the senior. (4th-year) at nine college of nursing in Seoul concerning their perception and Attitude toward the profession of nursing, motive for the necessity of learning, environment of study, attitude of study and particulars relevant with study performance, particulars of library, references and reading, assignments and particulars of the degree of confidence for the learning achievement. Through the survey of the above Particulars, the following results were obtained by classifying all subject matters and by analysing motive of the selection of their course, awarding or not awarding of scholarships. 1. General characteristics: it was revealed that 406 students (57.1%) were attending at the junior. while 305 students (42.9%) were taking the senior. Thus, the total number was 711 and their average age was 21.4 years. Their dwelling category was; 73.9 percent of them resided at their parent's home, 214 students (30.1%) were awarded with scholarships. The reason to be attracted by nursing science was the possibility of continuing social life after graduation (43.5%). 2. Their perception and attitude toward the profession of nursing: According to the perception of profession by the students of each grade, students of the 4th grade showed comparatively strong conception. Also, students of the 4th grade showed more positive attitude in the purchase and reading of magazines relative with the science of nursing, in the reading of Code for Nurses and in their interest in the activity of nursing field. For the necessity of mission of nurse, 97.7 percent of the entire number of students covered responded to necessity. For the necessity of the particular humanity and particularity in the character of nurses, 95.8 percent of those students responded to necessity. By the each grade, students of the 4th grade showed more response. 3. As to professional field desired after completing the professional course: 57 percent of those students desired for clinician nurse while 55 percents desired for community health-nurse. 4. As to the environment of study: they were mostly satisfied with their present residential environment. However, they complained of inconvenience at their lecture-halls. Students of the 3rd grade showed more complain. As to their attitude toward the adjustment of environment of study, they showed a affirmative response. As to the opinion of factors which interfere with their study, comparatively strong response was showed in their scepticism in the science of nursing, insufficient comprehension in general learning, relation with professors n4 discrepancy in the method of study. According to opinions of students at each grade, students of the 4th grade showed more scepticism. 5. Particulars relative with their attitude and performance of study : As to their knowledge of the objectives of their study of subject, the majority was to study with a partial knowledge of the objectives of their study. As to the plan of study, a low percentage indicated management of routine life under regular scheduling. Students of the 4th grade responded to rather planned life. As to time spent in independent study, response to concentrated study when necessary was stronger than that to regular daily study. Students of the 4th grade showed stronger response to regular study than that of the 3rd grade. As to the contents of their note-taking, 67.4 percents of those students responded to such regulatory procedure performing in the lecture-hall as they listen to lectures. 17.3 percents of those students showed response to adding supplementary informations from references to what was entered in choir note-taking at their lecture-halls. 6. Particulars of library, references and reading books: As to receiving of instruction for the utilization of library and time of receiving such instruction 64.7 percents of those students had received such instruction. 66.7 percents of the those responded received such instruction at orientation conducted for freshmen. As to the convenience of the utilization of library, 49.9 percents of those students responded to convenience. However, students of the 3rd grade showed a much stronger response to inconvenience. As to the time of the utilization of library,92.5 percents of those students showed a response to occasional utilization for particular purpose than regular utilization. 53.2 percents of those students responded to ordinary in quantity that library have references. 34.2 percents of those students responded to insufficient. As to the particular relative with the method and field of reading: 53.5 percents of those students responded to intensive reading and was the majority. As to the reading field, fiction u as the majority. When read any books for their major, they usually rend Korean text-b, oks. 7. Particular relative with giving assignment: All respondents were well aware of the objectives of giving home tasks. As to the attitude toward assignments and performing home tasks, 54.8 percents of those students to making ostentatious study because of an excessive quantity of assignments imposed. For performing assignment, they showed comparatively positive response. Also, 52.2 percents of those students responded that they usually submitted complected assignment with references. 8. As to motive to realize the necessity of study : 55.6 percents of those students responded that they realized such necessity in communication with patients when they were engaged in clinical practice. Also, 8.6, the lowest percents of those students responded that they realized such necessity in the course of conversation with nurses when they were engaged in clinical practice. 9. As to the determination of their confidence in the performance of study relative with clinical experience: They showed a general inclination of having in nursing. The major response was that they came to well comprehend the patients families. the lowest response was that they could apply what was learned at lecture-hall to practice. This response incidentally showed the distance the lecture-hall and practical study. In general items, students of the 4th grade showed more favorable response than students of the 3rd grade and there was a significant difference. 10. As to the perception and attitude toward profession according to the motive of selecting the nursing science : Those who selected the nursing voluntarily showed stronger conception than those who selected the nursing through indirect influence. However, there was no significant difference on this point. Only there was a remarkable difference in the reading of Code for Nurses. 11. Those who showed a stronger conception in the profession of nursing according to the motives of attractive nursing science indicated a strong will and ability to manage stable life and comparatively strong response was shown in the management of good home life because of the good adaptability of the science to their character. This group showed a strong conception of the profession than those who responded that they prefer this profession out of a longing for the work of a hospital and for the easy obtaining of opportunity to immigrate to over seas and for economic cause and for high school grade. There was significant difference between these two groups, 12. As to the conception and attitude toward the profession of nursing according to benefits by scholarships, those who were benefitted by scholarship showed stronger conception of profession than those who did not receive scholarship and there was a remarkable difference between these two categories. However, there was no remarkable difference between these two categories in the extent of interest of the activities of nursing fields and in the reading of Code for Nurses. 13. As activation for study according to the benefits of scholarships, those who were benefitted by scholarships showed stronger response to the motive for study comparing with those who receive. 14. As to tile field of reading according to the benefits by scholarships, those who received scholarships tended to read autobiographies and essayers to a considerable extent. Those who did not receive scholarships tended to read novels. Those who received scholarships more read nursing boots than those who did not receive scholarships. 15. As to the attitude of study and doing of assignment according to benefits of scholarships, those who received scholarships managed a favorable life with schedules for study, More students of receiving scholarship showed a regular study for more than one hour per day. Also, in the method of doing home tasks, more students of receiving scholarship showed reference to relative books frequently for the submission of completed assignments.

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