• Title/Summary/Keyword: Hospital performance

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Effects of an Intensive Management Program for Diabetic Patients on a Blood Biochemical Profile and Diabetes Knowledge (당뇨병 환자 대상 집중관리프로그램이 혈액성상 및 당뇨지식에 미치는 효과)

  • Yeo, Su-Jeong;Kim, Bok-Hee
    • Korean Journal of Community Nutrition
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    • v.23 no.2
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    • pp.148-161
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    • 2018
  • Objectives: This study examined the effects of nutrition education and exercise therapies on the hematological status and diabetes knowledge of diabetic patients. For this purpose, a 12-week intensive management program was provided to diabetic patients participating in an exercise program in S health subcenter in Kwangju city and the effects were analyzed. Methods: The subjects were 26 diabetic patients, who provided written informed consent. As a preliminary survey, this study examined the general characteristics, physical status, obesity, blood pressure, hematological status, daily activity level, diabetes knowledge, diet performance, and barriers to diet therapy. After the 12-week intensive management program was completed, a post-test was conducted in the same way as the preliminary test. The data were analyzed with using SPSS 18.0. The data from this study are presented as the mean${\pm}$standard deviation. A paired t-test was conducted to compare differences in the means before and after the program. Statistical significance was set to p<0.05. Results: The results of the program are presented as follows. The HDL-cholesterol levels changed from $39.8{\pm}10.5mg/dL$ to $48.3{\pm}13.1mg/dL$, showing a significant increase (p<0.001). The blood sugar 2 hours after a meal changed from $175.2{\pm}67.1mg/dL$ to $140.5{\pm}42.5mg/dL$, showing a significant decrease (p=0.014). The glycosylated hemoglobin levels decreased significantly from $6.7{\pm}1.1%$ to $6.3{\pm}1.0%$ (p=0.010). The total scores of the daily activity levels increased significantly from $3.8{\pm}2.4$ to $4.8{\pm}2.5$ (p=0.040). The scores of knowledge on diabetes increased from $11.5{\pm}3.6$ to $14.0{\pm}3.8$ (p=0.001). The scores of knowledge on diet therapy changed from $6.7{\pm}2.2$ to $7.9{\pm}1.7$, showing a significant increase (p=0.027). Conclusions: The 12-week intensive management program intervened by nutrition education and exercise therapies induced positive changes to the HDL-cholesterol, blood sugar 2 hours after a meal, glycosylated hemoglobin, daily activity levels, and knowledge on diabetes.

Three-Dimensional Approaches in Histopathological Tissue Clearing System (조직투명화 기술을 통한 3차원적 접근)

  • Lee, Tae Bok;Lee, Jaewang;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.1
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    • pp.1-17
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    • 2020
  • Three-dimensional microscopic approaches in histopathology display multiplex properties that present puzzling questions for specimens as related to their comprehensive volumetric information. This information includes spatial distribution of molecules, three-dimensional co-localization, structural formation and whole data set that cannot be determined by two-dimensional section slides due to the inevitable loss of spatial information. Advancement of optical instruments such as two-photon microscopy and high performance objectives with motorized correction collars have narrowed the gap between optical theories and the actual reality of deep tissue imaging. However, the benefits gained by a prolonged working distance, two-photon laser and optimized beam alignment are inevitably diminished because of the light scattering phenomenon that is deeply related to the refractive index mismatch between each cellular component and the surrounding medium. From the first approaches with simple crude refractive index matching techniques to the recent cutting-edge integrated tissue clearing methods, an achievement of transparency without morphological denaturation and eradication of natural and fixation-induced nonspecific autofluorescence out of real signal are key factors to determine the perfection of tissue clearing and the immunofluorescent staining for high contrast images. When performing integrated laboratory workflow of tissue for processing frozen and formalin-fixed tissues, clear lipid-exchanged acrylamide-hybridized rigid imaging/immunostaining/in situ hybridization-compatible tissue hydrogel (CLARITY), an equipment-based tissue clearing method, is compatible with routine procedures in a histopathology laboratory.

Evaluation of the clinical efficacy of a TW3-based fully automated bone age assessment system using deep neural networks

  • Shin, Nan-Young;Lee, Byoung-Dai;Kang, Ju-Hee;Kim, Hye-Rin;Oh, Dong Hyo;Lee, Byung Il;Kim, Sung Hyun;Lee, Mu Sook;Heo, Min-Suk
    • Imaging Science in Dentistry
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    • v.50 no.3
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    • pp.237-243
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    • 2020
  • Purpose: The aim of this study was to evaluate the clinical efficacy of a Tanner-Whitehouse 3 (TW3)-based fully automated bone age assessment system on hand-wrist radiographs of Korean children and adolescents. Materials and Methods: Hand-wrist radiographs of 80 subjects (40 boys and 40 girls, 7-15 years of age) were collected. The clinical efficacy was evaluated by comparing the bone ages that were determined using the system with those from the reference standard produced by 2 oral and maxillofacial radiologists. Comparisons were conducted using the paired t-test and simple regression analysis. Results: The bone ages estimated with this bone age assessment system were not significantly different from those obtained with the reference standard (P>0.05) and satisfied the equivalence criterion of 0.6 years within the 95% confidence interval (-0.07 to 0.22), demonstrating excellent performance of the system. Similarly, in the comparisons of gender subgroups, no significant difference in bone age between the values produced by the system and the reference standard was observed (P>0.05 for both boys and girls). The determination coefficients obtained via regression analysis were 0.962, 0.945, and 0.952 for boys, girls, and overall, respectively (P=0.000); hence, the radiologist-determined bone ages and the system-determined bone ages were strongly correlated. Conclusion: This TW3-based system can be effectively used for bone age assessment based on hand-wrist radiographs of Korean children and adolescents.

Comparison Between Stroke Patients and Normal Persons for Trunk Position Sense and It's Relation to Balance and Gait (정상인과 뇌졸중 환자의 체간 위치감각 비교 및 보행과 균형에 미치는 영향)

  • Yang, Hea-Duck;Kim, Chang-beom;Choi, Jong-Duk;Moon, Young
    • Physical Therapy Korea
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    • v.27 no.3
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    • pp.178-184
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    • 2020
  • Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

Clinical Usefulness on K-MBI for Decision of Driving Rehabilitation Period in Patients with Stroke: A pilot study (뇌졸중 환자의 운전재활 시기 결정을 위한 K-MBI의 임상적 유용성: 예비 연구)

  • Park, Myoung-Ok
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.11 no.2
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    • pp.91-98
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    • 2017
  • Background & Object: Basic daily activity screening tool such as the Modified Barthel Index (MBI) has been used commonly in rehabilitation clinic and community based rehabilitation setting. Previous studies have shown the significant relations between the level of daily activities and driving ability on stroke or elderly people. However, there is a lack of studies to investigate the usefulness of MBI on prediction of driving ability for stroke patient. This study was to predict driving abilities of stroke survivor using Korean version Modified Barthel Index (K-MBI). Methods: A sample of 48 patients with stroke in rehabilitation hospital was recruited. All participants were tested level of basic daily activities using K-MBI. The driving ability of participants was tested using virtual reality driving simulator. The predictive validity was calculated of the K-MBI among pass or fail group of driving simulator test using receiver operating characteristics curves. Results: The cut-off score of >86.5 on the K-MBI is proper sensitivity to predict on driving performance ability. Conclusion: This pilot result offers clinical reference to therapists and caregivers for reasoning on driving recommendation period during rehabilitation stage of stroke survivors. Further studies need to identify prediction using real on-road test in a large population group.

The Effect of Action Observation Training on Dexterity of Affected Upper Extremity Motor Function and ADL in Stroke Patients (과제지향적 동작관찰훈련이 뇌졸중 환자의 환측 상지기민성과 일상생활활동에 미치는 영향)

  • Eom, Sook;Kim, Su-Kyoung
    • The Journal of Korean society of community based occupational therapy
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    • v.3 no.1
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    • pp.55-66
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    • 2013
  • Objective : The purpose of present study was to determine effects of task oriented action observation training on dexterity of upper limb function after stroke. Training was progressed to imitation and intensive training after observation to required action in ADL. Method : 15 stroke patients were selected and one group pretest-posttest design was applied. Targets observed performance actions of task orientated task through a video and limitated action repeatedly, Training was performed 3 times a week and 20~30 minutes for each round for 3 weeks. Manual function test and 10-second test and Box and block test were performed for a dexterity of upper extremity motor function, Modified Barthel index and Motor activity log were performed for ADL. Result : After the training, a dexterity of affected upper extremity motor function of the target showed significant difference between before and after intervention, ADL showed significant improvement between before and after intervention. Conclusion : Task orientated Action observation lead a positive effect of recovering a dexterity of upper extremity motor function and ADL. Therefore, this study suggest a action observation training as one strategy of an intervention type of th e occupational therapy.

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Development and Evaluation of a Scenario for Simulation Learning of Care for Children with Respiratory Distress Syndrome in Neonatal Intensive Care Units (시뮬레이션 학습을 위한 호흡곤란증후군 환아 시나리오 개발 및 학습 수행 평가)

  • Lee, Myung-Nam;Kim, Hee-Soon;Jung, Hyun-Chul;Kim, Young-Hee;Kang, Kyung-Ah
    • Child Health Nursing Research
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    • v.19 no.1
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    • pp.1-11
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    • 2013
  • Purpose: This study was done to develop a scenario and evaluate student performance in simulation learning of care for children with respiratory distress syndrome in neonatal intensive care units. Methods: To test the application effect, a one group pre-test design was applied. The scenario based on actual patients and textbook material was developed through several meetings of experts. The scenario was used with 17 groups of 55 senior nursing students who participated voluntarily. Results: Contents were organized focusing on the nursing process for simulation learning. In the application of knowledge and skills, nursing students had high scores in the contents of observation of oxygen saturation, and care to relieve dyspnea. Participants' ability, especially in suction and oxygen supply in the evaluation of objective structured clinical examination was not adequate. There was a significant positive correlation between problem-solving ability and satisfaction in learning. Conclusion: The respiratory distress syndrome simulation scenario developed in this study was an effective tool to give students experience in problem solving and critical thinking ability under conditions similar to reality. The development of various scenarios for child nursing care is needed.

Symptoms and Cognitive Function in Chronic Schizophrenia: 6 Months Follow-up Study (만성 정신분열병 환자에서 증상과 인지기능:6개월 개월 추적연구)

  • Kim, Chul-Kwon;Kim, Seong-Hwan;Choe, Byeong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.44-49
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    • 2004
  • Objectives: The purpose of this study was to investigate whether longitudinal changes in positive and negative symptoms affect cognitive functioning in chronic schizophrenia. Methods: Sixty-eight patients diagnosed with DSM-IV schizophrenia were examined on two occasions over 6 months for symptoms and cognitive changes. Symptoms were measured by PANSS. Cognitive functions were examined for sustained attention, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test, respectively. Twenty control subjects were assessed to compare the cognitive scores of remitted schizophrenic patients. Results: Patients showed significant improvement in symptoms and all cognitive tests after 6 months treatments. Significant improvements in positive and negative symptoms did not predict improvements in any aspect of cognitive functioning measured. Normal controls performed significantly better than remitted schizophrenic patients on all cognitive tests. The results show no relationship between change in symptoms and change in cognition in chronic schizophrenia. Conclusion: We suggest that symptomatic and cognitive impairment may be a distinct construct. These findings highlight the importance of treating cognitive impairment in addition to the clinical symptoms of schizophrenia.

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Neuropsychiatric Evaluation of Head-Injured Patients(I) : Comparison of Structural and Functional Brain Studies in Post-Traumatic Organic Mental Disorder (두부외상 환자의 신경정신의학적 평가(I) : 외상후 기질성정신장애 환자에서 뇌의 구조적 및 기능적 검사소견의 비교)

  • Yi, Jang Ho;Chang, Hwan-Il
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.57-65
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    • 1996
  • The Evaluation of patients complaining of psychiatric symptoms following head injury is much affected by the results of various tests. The objecive of this paper is to investigate the effectiveness of each lest by comparing the structual and fuctional brain studies. The subjects were 93 organic menial disorder in and out patients at the Dept. of Neuropsychiatry of the Kyung Hee University Hospital. After carrying out MRI, CT, SPECT, EEG, the results of each were analysed for the sesitivity and ability to detect focal lesion. The degree of inter-test correlations of lest results were also investigated. Furthermore, the characteristic features of psychological tests were studied and the relationship between each of above mentioned tests and psychological test was examined. As for the test sensitivity to diagnosis, the SPECT was the most superior followed by MRI, CT, EEG in thai order. In the case of abnormality, SPECT ranked 1st in detection of focal lesion, followed by MRI, CT in that order. In the inter-test result correlation, the correlation of SPECT-MRI was statistically significant. When mare than moderate abnormality EEG finding was reported, it correlated significantly with that of MRI findings. In the MMPI, the average scores on F, Hs, D, Hy, Pa, Pt, Sc subscales were above 60. Abnormal SPECT group scored significantly high on the F, Pd, Pa, Sc, Ma scales and therefore in comparison ot the SPECT normal group, displayed more psychotic features. In K-WAIS, the mean full scale IQ was down to 77. 23(Verbal IQ : 78.76, Performance IQ : 77.44) but there was no characterogic significant relationship between the lowered to and abnormal SPECT, MRI, CT and EEG results. In conclusion, 1) The SPECT was mast superior in sensitivity and detection of focal lesions. In comparision with other tests, the results of SPECT correlated well with MRI had thus is thought to be very usefull testing method in the evaluation of organic mental disorder patients. 2) The MRI had relatively high sensitivity, ability to detect focal lesion and superior correlation with other test. 3) Although EEG fared less an sensitivity in comparison to other tests, the results of above moderate abnormal grade group and that of MRI correlated significantly. 4) In the MMPI highly scored in F, Hs, D, Hy, Pa, Pt, Sc subscales and abnormal SPECT patients were shown to display more sever psychotic features. There was no significant character relationship between the lowered IQ(in K-WAIS) and abnormal findings on MRI, CT, SPECT, EEG.

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The Effects of Exercise Therapy Applied in an Efficacy Expectation Promoting Program on Self-Efficacy and Metabolism.- in NIDDM(Non-Insulin Dependent Diabetes Mellitus) Patients - (효능기대증진프로그램을 적용한 운동요법이 자기효능과 대사에 미치는 영향-인슐린 비의존성 당뇨병 환자를 중심으로-)

  • 김춘자
    • Journal of Korean Academy of Nursing
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    • v.28 no.1
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    • pp.132-142
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    • 1998
  • This study was conducted to investigate whether exercise therapy applied in an efficacy expectation promoting program based on the self-efficacy theory of Bandura(1977) would increase self-efficacy and metabolism in NIDDM patients. The study design was a nonequivalent control group pre-test post-test quasi-experimental desist The exercise therapy applied in the efficacy expectation promoting program was composed of a staged exercise program, a small booklet relating personal experience with diabetes mellitus and a telephone coaching program on performance accomplishment. vicarious experience and verbal persuasion, which are all induction modes of efficacy expectation. The subjects of the study were twenty eight NIDDM patients who received follow-up care regularly through the out-patient department of endocrine medicine in one general hospital which had a diabetic clinic. Fourteen were assigned to the experimental group and fourteen to the control group. The experimental group participated in the exercise therapy applied in the efficacy expectation promoting program from three to five times per week for four weeks and the control group did not have the program. The collected data were analyzed using the X²-test, t-test, paired t-test, and Cronbach's Alpha using SPSS /PC/sup +/. The results are summarized as follows 1. Experimental group had higher efficacy score than control group(t=5.98, p=.00). And. There was a significant different in the efficacy score before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(t=-6.42, p=.00). 2. Experimental group did not have lower level of glucose metabolism than control group(FBS : t=.32, p=.75, HbAlC : t=.60, p=.55, pc 2hrs. glucose : t=-.29, p=.78). But, There was a significant different in the aunt of glucose metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(FBS : t=3.63, p=.003, HbAlC t=4.20, p=.00, pc 2hrs. glucose : t=1.93, p=.001). 3. Levels of lipid metabolism were partly a significant different between Experimental group and control group(triglyceride t=-1.87, p=.07, HDL cholesterol : t=-.29, p=.77. body weight : t=1.78, p=.09, Total cholesterol : t=-2.17, p=.04). And, There was partly a significant different in the amount of lipid metabolism before exercise therapy applied in the efficacy expectation promoting program and after in experimental group(triglyceride : t=2.50, p=.03, HDL cholesterol : t=-.43, p=.67, body weight : t=5.34. p=.00, Total cholesterol : t=2.26, p=.04). In conclusion, it was found that exercise therapy applied in an efficacy expectation promoting program was an effective nursing intervention for increasing self-efficacy and metabolism.

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