• Title/Summary/Keyword: Outcome Indicators

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A Quantitative Study of the Quality of Deconvolved Wide-field Microscopy Images as Function of Empirical Three-dimensional Point Spread Functions

  • Adur, Javier;Vicente, Nathalie;Diaz-Zamboni, Javier;Izaguirre, Maria Fernanda;Casco, Victor Hugo
    • Journal of the Optical Society of Korea
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    • v.15 no.3
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    • pp.252-263
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    • 2011
  • In this work, for the first time, the quality of restoration in wide-field microscopy images after deconvolution was analyzed as a function of different Point Spread Functions using one deconvolution method, on a specimen of known size and on a biological specimen. The empirical Point Spread Function determination can significantly depend on the numerical aperture, refractive index of the embedding medium, refractive index of the immersion oil and cover slip thickness. The influence of all of these factors is shown in the same article and using the same microscope. We have found that the best deconvolution results are obtained when the empirical PSF utilized is obtained under the same conditions as the specimen. We also demonstrated that it is very important to quantitatively check the process' outcome using several quality indicators: Full-Width at Half-Maximum, Contrast-to-Noise Ratio, Signal-to-Noise Ratio and a Tenengrad-based function. We detected a significant improvement when using an indicator to measure the focus of the whole stack. Therefore, to qualitatively determinate the best deconvolved image between different conditions, one approach that we are pursuing is to use Tenengrad-based function indicators in images obtained using a wide-field microscope.

Differential Effects of Family Income on Self-rated Health by Age: Analysis of Seoul Citizens Health Indicators Survey 2001, 2005 (소득수준이 주관적 건강상태에 미치는 영향의 연령대별 차이: 2001, 2005년 서울시민보건지표조사 자료의 분석 결과)

  • Jung, Youn;Oh, Ju-Hwan;Cho, Young-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.5
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    • pp.381-387
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    • 2007
  • Objectives: This study was conducted in order to determine how the association between socioeconomic position(SEP) and health status changes with age among Seoul residents aged 25 and over. Methods: We utilized the 2001 and 2005 Seoul Citizens Health Indicators Surveys. We used self-rated 'poor' health status as an outcome variable, and family income as an indicator of SEP. In order to characterize the differential effects of socioeconomic position on health by age, we conducted separate multivariate analyses by 10-year age groups, controlling for sociodemographic covariates. In order to assess the relative health inequality across socioeconomic groups, we estimated the Relative Index of Inequality (RII). Results: The risk of 'poor health' is significantly high in low family income groups, and this increased risk is seen at all ages. However, the magnitude of relative socioeconomic inequality in health, as measured by the odds ratio and RII, is not identical across age groups. The difference in health across income groups is small in early adulthood (ages 25-34), but increases with age until relatively late in life (ages 35-64). It then decreases among the elderly population (ages more than 65). When the RII reported in 2005 is compared to that reported in 2001, RII can be seen to have increased across all ages, with the exception of individuals aged 25-34. Conclusions: The magnitude of health inequality is the greatest during mid- to late adulthood (ages 45-64). In addition, health inequalities have worsened between 2001 and 2005 across all age groups after economic crisis.

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients (체외막산소화장치 적용 중환자를 위한 근거기반 간호 프로토콜 개발 및 효과 평가)

  • Kim, Soomi;Kim, Chul-Gyu
    • Journal of Korean Academy of Nursing
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    • v.53 no.3
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    • pp.275-294
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    • 2023
  • Purpose: This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol. Methods: The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol's effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses' outcome variables were evaluated using a questionnaire. Results: First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001). Conclusion: This protocol may help prevent infections and pressure injuries in patients, and improve nurses' satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

A Taxonomy of Geriatric Hospitals Using National Health Insurance Claim Data (건강보험청구자료로 본 요양병원의 기능 유형)

  • Min Kyoung Lim;Sun-Jea Kim;Jeong-Yeon Seon
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.9-20
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    • 2023
  • Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

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Evaluation of Oral Health Promotion Program Connected with Hypertension and Diabetes Management Programs: Use of a Logical Model (일부 보건소 고혈압·당뇨관리교실 연계 구강건강증진 프로그램 운영 및 평가: 논리적 모형을 이용하여)

  • Yoo, Sang-Hee;Shin, Bo-Mi;Bae, Soo-Myoung;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.16 no.4
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    • pp.293-301
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    • 2016
  • This study aimed to design and operate a complementary integrated health management program based on the connection between the hypertension and diabetes management programs and the oral health programs at a public health center. It also proposed to suggest the phased evaluation indicators. In this study, 48 adults registered in the hypertension and diabetes management program were selected from the Gangneung public health center. The clinic-specific programs were led by dental hygienists and operated for visitors twice every two weeks. The programs were designed based on the logical model, and indicators for evaluating the structure, process, and outcome were presented and applied to the input, process, output, and outcome. The evaluation indices consisted of quantitative and qualitative indicators, and the planning and operation, goal achievement, and effect of each program were assessed. The process evaluations were assessed by the appropriateness of the managers and the operating fidelity of the programs. Indicators for evaluating the outcomes were gingival bleeding, oral health knowledge, oral health awareness, and the satisfaction of the participant and the manager. The clinic-specific programs resulted in positive changes in the evaluated outcomes. The integrated health management of visitors to the hypertension and diabetes management program is important as the general and oral health has common risk factors. Furthermore, long-term operation and continuous monitoring of oral health programs are necessary to evaluate the common factors in chronic disease management.

Prostate Cancer: A Hospital-Based Survival Study from Mumbai, India

  • Balasubramaniam, Ganesh;Talole, Sanjay;Mahantshetty, Umesh;Saoba, Sushama;Shrivastava, Shyam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2595-2598
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    • 2013
  • Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.

Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.21-30
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    • 2014
  • Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Development and Application of a Computerized Nursing Process Program for Orthopedic Surgery Inpatients - NANDA, NOC, and NIC Linkages - (정형외과 입원환자를 위한 간호과정 전산프로그램 개발 및 적용 - 간호진단, 간호결과, 간호중재 연계 -)

  • Kim, Hye-Suk
    • Journal of Korean Academy of Nursing
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    • v.35 no.6
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    • pp.979-990
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    • 2005
  • Purpose: The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. Method: The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. Results: Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain $(28.4\%)$, Impaired physical mobility $(15.6\%)$, Impaired walking $(8.7\%)$, Chronic pain $(5.5\%)$ and Risk for disuse syndrome $(5.0\%)$. The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(95.2\%)$, Comfort level $(35.5\%)$ and Pain level $(17.7\%)$. The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(71.0\%)$, Splinting $(24.2\%)$ and Analgesic administration $(17.7\%)$. In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. Conclusion: It is expected that this program will help nurses perform their nursing processes more efficiently.

Analysis of Intervention Studies for Married Immigrant Women (결혼 이주여성 대상 중재연구 분석)

  • Kim, Tae Im;Kim, Ji Young;Choi, Sun Mi;Jung, Gye Hyun
    • Research in Community and Public Health Nursing
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    • v.24 no.2
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    • pp.172-184
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    • 2013
  • Purpose: The purpose of this study is to analyze the intervention studies for married immigrant women. Methods: Based on inclusion criteria, 45 articles published from 2006 to 2011 were reviewed and analyzed. Results: Among the total amount of studies, 77.8% have been conducted since 2009; and 46.7% of them were for a master's thesis, 11.1% were for a doctoral thesis, and 42.2% were journal articles. Most of them were quantitative research (77.8%) and 71.1% were conducted in urban areas. The most frequently conducted intervention was art therapy (35.6%), whereas 6.7% was health education. In total, 104 outcome indicators were used with 57 (54.8%) in the mental health domain, 29 (27.9%) in the social health domain, and 18 (17.3%) in the physical health domain. The most commonly used outcome indicator was self-esteem (23.2%), and the next, in the order of frequency, included self-efficacy (23.2%), acculturative stress (21.4%), and depression (10.7%). Conclusion: Most intervention studies were conducted to support the sociocultural adaptation of married immigrant women, while few intervention studies were conducted to support the health of married immigrant women. To promote the health and quality of life of married immigrant women, many health related intervention programs should be undertaken.

Analysis of Researches on the Warming Therapy for Surgical Patients (수술 환자에게 적용한 가온요법 연구논문 분석)

  • Jun, Jum-Yi
    • Korean Journal of Adult Nursing
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    • v.22 no.3
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    • pp.260-270
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    • 2010
  • Purpose: The main question is systematic review of the published in Korea and foreign countries on warming therapy for surgical patients. Methods: The researchers searched at Medline, CINAHL, KERIS, Adult Nursing Association, Korean Society of Nursing Science, Korean Academy of fundamentals of Nursing, and National Assembly Library web site for the published on warming therapy for surgical patients from 1980 to 2008. Words for search were operation/surgery, warming, operation/surgery and warming. Studies were included randomized controlled trial, and there were no restrictions regarding operative phase and outcome measures. Results: 36 published researches that met the criteria were mostly published in foreign countries between 2000 and 2008 and focused on surgery with general anesthesia. Sample size ranged from 21 to 60 subjects, age range between 21 and 60 years of age. Thirty different warming therapies were reported, fifty-two different dependent variables. Outcome indicators included active external warming, intra-operative, and body temperature. 'Positive effects' and 'no effects' equaled. The most frequently reported 'positive effects' were body temperature, shivering, and acid-base balance. No effects were more likely to be heart rate, blood pressure, and hemodynamics. Conclusion: Many types of warming therapy, are reported in the literature with little information about the efficacy of each, many different dependant variables were studied. There were no consistent reports as to length of time used for warming procedures. Overall, the effects of warming therapy are inconsistent. And additional research must be down before any particular method of warming can be used with confidence as to its effectiveness. Attention must be made as to the research design, better measurement of the dependent variables. This review may serve as a base.