• Title/Summary/Keyword: Tertiary Institution

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Nurses' Perception on Clinical Nutrition Services by Types of Medical Institution and Area (병원 유형 및 지역에 따른 임상영양서비스에 대한 간호사의 인식)

  • Lee, Han Na;Lee, Song Mi;Park, Yoo Kyung;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
    • Journal of the Korean Dietetic Association
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    • v.20 no.4
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    • pp.235-246
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    • 2014
  • The purpose of this study was to evaluate nurses' perception of clinical nutrition services. A cross-sectional survey design was performed. The research was accomplished by using questionnaires developed for this study and administered from September 12 to December 31, 2013 to 343 nurses at 43 tertiary hospitals and 20 general hospitals. The percentage of nurses who recognized clinical nutrition certificate as issued from nation was 27.8%. The mean scores of perceived usefulness on clinical nutrition services was 4.23/5.00, whereas that of perceived implementation was 3.76/5.00. The mean scores of necessity of disease-specialized clinical dietitian at capital hospitals were significantly higher for obesity (P<0.01), cancer (P<0.05), and infant & childhood disease (P<0.01) than at local hospitals. The rates of nurses' experience in group education on cancer at capital hospitals (21.7%) was significantly higher than that at local hospitals (10.3%) (P<0.05). The mean scores of perceived importance of clinical nutrition services were 4.46/5.00 for 'group nutrition education', 4.46/5.00 for 'individual consultation', and 4.40/5.00 for 'nutrition management for enteral nutrition (EN) patients'. The most common reason why clinical nutrition services are important was 'improving malnutritional status'. To activate clinical nutrition services especially at local hospitals, clinical dietitians should give systematic assistance to patients and also institutional supports are needed.

Current Status of Pediatric Surgical Practice in Korea -a Survey among the Members of Korean Association of Pediatric Surgeons- (대한소아외과학회 회원의 1995년도 진료현황 및 수련경력 설문조사)

  • Kim, W.K.;Kim, S.Y.;Kim, S.K.;Kim, I.K.;Kim, J.E.;Kim, C.S.;Kim, H.H.;Park, K.W.;Park, Y.S.;Park, W.H.;Park, J.S.;Song, Y.T.;Yang, J.W.;Oh, S.M.;Lee, D.S.;Lee, M.D.;Lee, S.K.;Lee, S.C.;Chang, S.I.;Jung, S.E.;Jung, P.M.;Choi, K.J.;Choi, S.O.;Huh, Y.S.;Hwang, E.H.
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.61-67
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    • 1997
  • To understand the current status of pediatric surgical practice of the members of the Korean Association of Pediatric Surgeons, a survey of the practice of the 31 members in both 1994 and 1995. Twenty five members(80%) representing 20 hospitals responded. An average of four hundred and seventy four cases pediatric surgical operations were performed at individual institution in 1995 with 40 newborn cases. Eighteen members(72%) are currently working at university hospital. Fourteen institutions(70%) are currently classified as tertiary by the health insurance agency. The majority(15 to 60%) of members are working in the metropolitan Seoul area, while five in Taegu area. Sixteen members reported having the title of department head/director. Four members reported occasional non-pediatric surgical practice. Nine members out of 20 reported having independent pediatric surgical out-patient clinic before the establishment of the association(1985). Eight out of 15 members reported being appointed chief of pediatric surgery before 1985. In 20 institutions, 34 full time physicians(27 members, reportedly) are working in pediatric surgery. In regarding to pediatric surgical training, 16 members(64%) received an average of 16 months of training abroad, 5 members trained at home and abroad, and 4 from only at home. There are no differences in length of training periods in these groups. Twenty one members received their basic pediatric surgical training before 1985, the year of inauguration of the association. Twelve members received post-pediatric surgery refresher courses averaging 11 months' duration, after 2-11 years. Thirteen participants of this study belongs to the founding members of the association.

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Predictors of Outcome in Management of Paediatric Head Trauma in a Tertiary Healthcare Institution in North-Central Nigeria

  • Gyang Markus Bot; Danaan J. Shilong; Jerry A. Philip; Ezekiel Dido Dung; Andrew H. Shitta; Nanpan Isa Kyesmen;Jeneral D. Alfin; Lena Mary Houlihan; Mark C. Preul; Kenneth N. Ozoilo; Peter O. Binitie
    • Journal of Korean Neurosurgical Society
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    • v.66 no.5
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    • pp.582-590
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    • 2023
  • Objective : Trauma is a leading causes of death and disability in all ages. The aim of this study was to describe the demography and characteristics of paediatric head trauma in our institution and examine the predictors of outcome and incidence of injury related mortality. Methods : We examined our institutional Trauma Registry over a 2 year period. Results : A total of 1100 trauma patients were seen over the study period. Of the 579 patients who had head injury 99 were in the paediatric age group. Of the paediatric head trauma patients 79 had documented Glasgow coma score (GCS), 38 (48.1%), 17 (21.5%) and 24 (30.4%) had mild, moderate and severe head injury respectively. The percentage mortality of head injury in the paediatric age group was 6.06% (6/99). There is an association between mortality and GCS (p=0.008), necessity for intensive care unit (ICU) admission (p=0.0001), associated burns (p=0.0001) and complications such as aspiration pneumonia (p=0.0001). The significant predictors of outcome are aspiration (p=0.004), the need for ICU admission (p=0.0001) and associated burns (p=0.005) using logistic binary regression. During the study period 46 children underwent surgical intervention with extradural haematoma 16 (34.8%), depressed skull fracture 14 (30.4%) and chronic subdural haematoma five (10.9%) being the commonest indication for surgeries. Conclusion : Paediatric head injury accounted for 9.0% (99/1100) of all trauma admissions. Majority of patients had mild or moderate injuries. Burns, aspiration pneumonitis and the need for ICU admission were important predictors of outcome in children with traumatic brain injury.

Factors Influencing Suicidal Ideation of College Students (대학생의 자살사고 영향 요인)

  • Lee, Sung-Hee;Jung, Hyun-Ok;Park, Kyung-Ran;You, Jun-Ok;Ha, Tae-Hi;Kim, Hee-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.21 no.2
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    • pp.190-201
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    • 2015
  • Purpose: This study was conducted to explore the influence of academic institutional interest, open parent-adolescent communication, social (friend) support, and existential spiritual well-being on suicidal ideation of college students. Methods: The research design was descriptive survey research involving 285 college students in city G. Data was collected from May 18, 2011 to November 2, 2011 and analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical regression analysis. Results: The findings reveal that suicidal ideation of college students was low, i.e., average score was $9.2{\pm}3.65$ (possible range 5~25). This study determined that suicidal ideation is negatively correlated with interest on the part of the academic institution, open parent-adolescent communication, social support from friends, and existential spiritual well-being. The extent of existential spiritual well-being was a significant predictor of suicidal ideation, controlling for general characteristics variables (gender, number of close friends, first supporter) and institutional interest, open parent-adolescent communication, and social support. Existential spiritual well-being accounted for 50% of the explanation of suicidal ideation of college students. Conclusion: Based on the outcomes of this study, designing an intervention program that emphasizes existential spiritual well-being in order to decrease suicidal ideation of tertiary education students is strongly recommended.

Prescribing Patterns of Antivirals for Chronic Hepatitis B (만성 B형간염 진단 환자의 항바이러스제 처방양상)

  • Kong, Hye-Kyung;Sohn, Hyun-Soon;Choi, Kyung-Eob;Kwon, Jin-Won;Shin, Hyun-Taek
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.1
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    • pp.81-86
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    • 2012
  • This study was aimed to examine the prescribing patterns of antivirals in outpatients with chronic hepatitis B (CHB), using National Health Insurance adjudicated claims data (total 1,426,065 claims) dated March 19, 2008 submitted from nationwide healthcare providers to Health Insurance Review and Assessment Service. From the data, there were 2,965 claims with CHB diagnosis (ICD-10 code B18.0 and B18.1), and 44.2% (1,311 claims) of the CHB related claims included antivirals such as lamivudine, clevudine, adefovir and entecavir. Lamivudine, adefovir, clevudine and entecavir shared 54.9%, 19.9%, 13.2% and 11.9%, respectively, among antiviral prescriptions. Adefovir and entecavir 1mg presumed as the 2nd line therapy for HBV resistant cases were shared 23.3% of overall antiviral prescriptions. There were statistically significant difference in prescription patterns according to age and institution type: Lamivudine usage was higher in younger (< 20 years old) and older age group (> 70 years old) than the others (p = 0.016), and adefovir and entecavir, which were relatively newer antivirals, had higher prescription rates in higher level of institutions such as tertiary hospitals than the others (p < 0.001). This study would be of help to make an appropriate drug therapy plan for patients with CHB.

The Status for Radiation Treatment of Cancer Patients focused on Busan Area (부산지역을 중심으로 조사된 암환자의 방사선 치료 현황)

  • Park, Euntae;Park, Sungkwang
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.151-156
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    • 2013
  • As the number of cancer patients and its death rate increases, this study is to understand the occurrences in cancer patients in Busan area and to provide active help for treatment, prevention and management of cancer patients. It was investigated and analyzed based on 4462 patients who were diagnosed with cancer and received radiation therapy from Jan. 2011 to Dec. 2012 at tertiary medical institution in Busan area. The seven main cancer types were breast cancer, cervical cancer, lung cancer, colon rectal cancer, brain tumor, laryngopharyngeal cancer and liver cancer. The most common type of cancer was breast cancer which takes up 38.1% of cancer patients stood out from other cancer types. Breast cancer is that shows increasing trend and in need of appropriate countermeasures and managements for decreasing cancer risk. Therefore the causes and prevention of breast cancer analysis, an appropriate management program is required.

Role of the Neutrophil-to-Lymphocyte Ratio at the Time of Arrival at the Emergency Room as a Predictor of Rhabdomyolysis in Severe Trauma Patients

  • Bae, Jin Chul;Sun, Kyung Hoon;Park, Yong Jin
    • Journal of Trauma and Injury
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    • v.33 no.2
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    • pp.96-103
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    • 2020
  • Purpose: In patients with trauma, rhabdomyolysis (RM) can lead to fatal complications resulting from muscle damage. Thus, RM must be immediately diagnosed and treated to prevent complications. Creatine kinase (CK) is the most sensitive marker for diagnosing RM. However, relying on CK tests may result in delayed treatment, as it takes approximately 1 hour to obtain CK blood test results. Hence, this study investigated whether the neutrophil-to-lymphocyte ratio (NLR) could predict RM at an earlier time point in patients with trauma, since NLR results can be obtained within 10 minutes. Methods: This retrospective study included 130 patients with severe trauma who were admitted to the emergency room of a tertiary institution between January 2017 and April 2020. RM was defined as a CK level ≥1,000 U/L at the time of arrival. Patients with severe trauma were categorized into non-RM and RM groups, and their characteristics and blood test results were analyzed. Statistical analysis was performed using SPSS version 26.0 for Windows. Results: Of the 130 patients with severe trauma, 50 presented with RM. In the multivariate analysis, the NLR (odds ratio [OR], 1.252; 95% confidence interval [CI], 1.130-1.386), pH level (OR, 0.006; 95% CI, 0.000-0.198), presence of acute kidney injury (OR, 3.009; 95% CI, 1.140-7.941), and extremity Abbreviated Injury Scale score (OR, 1.819; 95% CI, 1.111-2.980) significantly differed between the non-RM and RM groups. A receiver operating characteristic analysis revealed that a cut-off NLR value of 3.64 was the best for predicting RM. Conclusions: In patients with trauma, the NLR at the time of arrival at the hospital is a useful biochemical marker for predicting RM.

An Analysis on Factors Relating to Fiscal Deficit for Regional Health Insurance Program in Korea (지역의료보험의 재정 적자요인 분석)

  • Kim, Han-Joong;Cho, Woo-Hyun;Lee, Sun-Hee;Kang, Hyung-Kon;Kim, Yang-Kyun
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.4 s.40
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    • pp.399-412
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    • 1992
  • This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason fur the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium rate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.

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Demographic and Clinical Characteristics of Adult Acute Myeloid Leukemia - Tertiary Care Experience

  • Sultan, Sadia;Zaheer, Hasan Abbas;Irfan, Syed Mohammed;Ashar, Sana
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.1
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    • pp.357-360
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    • 2016
  • Background: Acute myeloid leukemia (AML) is an acquired clonal frequent malignant disorder of myeloid progenitor cells. Our aim was to study demographical and clinicopathological features of adult Pakistani AML patients at presentation. Materials and Methods: In this single centre study extending from January 2010 to December 2014, data were retrieved from the patient records with a predetermined performa and analyzed with SPSS version 22. Results: Overall 125 patients were diagnosed at our institution with de novo AML during the study period. There were 76 males and 49 females (ratio 1.5:1), with an age range between 15 and 85 years and a mean age of $38.8{\pm}20.1years$. The major complaints were fever (72.8%), generalized weakness (60%), bleeding (37.6%) and dyspnea (12%). Physical examination revealed pallor in 56.8%, splenomegaly and hepatomegaly in 16% and 12.8%, respectively, and lymphodenopathy in 10.4%. The mean hemoglobin was $8.19{\pm}2.12g/dl$ with a mean MCV of $86.0{\pm}9.83fl$, a mean total leukocyte count of $43.1{\pm}68.5{\times}10^9/l$, an ANC of $3.09{\pm}6.66{\times}10^9/l$ and a mean platelet count of $62.3{\pm}78.6{\times}10^9/l$. Conclusions: AML in Pakistani patients is seen in a relatively very young population with male preponderance, compared with the west. However, clinico-pathological features appear comparable to published data.

Multiple Myeloma: a Retrospective Analysis of 61 Patients from a Tertiary Care Center

  • Sultan, Sadia;Irfan, Syed Mohammed;Parveen, Saira;Ali, Hamza;Basharat, Maria
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1833-1835
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    • 2016
  • Background: Multiple myeloma (MM) is an acquired clonal B-cell malignancy which primarily affects elderly individuals with an annual incidence of approximately 1% of all malignancies. Our aim is to study demographic and clinicopathological features of adult Pakistani MM patients at presentation. Materials and Methods: This single centre retrospective study extended from January 2010 to December 2014. Data were retrieved from the patients' maintained records on predetermined performa. Results: Overall, 61 patients were diagnosed at our institution with MM during the study period. There were 43 males and 18 females. Age ranged between 34 and 81 years with a mean of $56.1{\pm}12.8$ and a median of 57 years. The male to female ratio was ~2:1. Common presenting complaints included fatigue (81.9%), backache (80.3%) and bone pain (67.2%). Physical findings revealed pallor (44.2%) as a presenting clinical feature. The mean hemoglobin value was $8.9{\pm}1.7g/dl$ with a mean MCV of $85.3{\pm}11.0fl$. Severe anemia with hemoglobin <8.5 gm/dl was seen in 40.9%. The mean total leukocyte count was $8.9{\pm}8.2{\times}10^9/l$, the ANC was $5.0{\pm}3.1{\times}10^9/l$ and the mean platelet count was $188.4{\pm}150.6{\times}10^9/l$. Conclusions: MM in Pakistani patients is seen in a relatively young population with male preponderance. The majority of patients present with symptomatic anemia and backache to seek medical attention. However, clinico-pathological features appear comparable to the published literature.