• Quality Improvement in Health Care
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• v.21 no.2
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• pp.12-24
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• 2015

Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

• Asian-Australasian Journal of Animal Sciences
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• v.30 no.4
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• pp.538-545
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• 2017

Objective: The goal of this study was to investigate the effects of cupric citrate (CuCit) on growth performance, antioxidant indices, serum lipid metabolites, serum immune indices, and tissue residues of copper (Cu), zinc, and iron in weaned pigs. Methods: A total of 180 weaned pigs ($Duroc{\times}Landrace{\times}Large$ White) with an average body weight of $8.98{\pm}1.21kg$ were randomly assigned to a corn-soybean meal control ration, or 4 similar rations with 30, 60, 120, or 240 mg/kg Cu as CuCit. All diets contained 10 mg/kg Cu as cupric sulfate from the vitamin-mineral premix. The experiment was divided into two phases: 0 to 14 d (phase 1) and 15 to 28 d (phase 2). Results: Average daily gain (ADG; linearly, p<0.01) and average daily feed intake (ADFI; linearly and quadratically, p<0.05) were affected by an increase in CuCit during phase 2. Overall period, ADG (p<0.05) and ADFI (p<0.01) were linearly increased with increasing dietary levels of CuCit. Serum malondialdehyde concentrations (p<0.05) and glutathione peroxidase activity (p<0.01) linearly decreased and increased respectively with an increase in CuCit. Serum levels of Cu-Zn superoxide dismutase were linearly affected with an increase in CuCit (p<0.01). Hepatic malondialdehyde levels decreased with an increase in CuCit (linearly and quadratically, p<0.01). Serum total cholesterol concentrations were quadratically affected (p<0.05) and decreased in pigs fed Cu as CuCit at 60 and 120 mg/kg and increased in pigs fed 240 mg/kg Cu as CuCit. Serum high-density lipoprotein concentrations were linearly affected with an increase in CuCit (p<0.01). Serum $IL-1{\beta}$ levels were quadratically affected (p<0.05) by dietary treatment. Compared with other treatments, 240 mg/kg Cu from CuCit quadratically increased hepatic (p<0.01) and renal (p<0.05) Cu concentrations, and quadratically decreased hepatic and renal iron concentrations (p<0.05). Conclusion: Cu administered in the form of CuCit at a dosage range of 30 to 60 mg/kg, effectively enhanced the growth performance and antioxidant status of weaned pigs.

• Korean Journal of Psychosomatic Medicine
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• v.14 no.1
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• pp.47-52
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• 2006

Backgrounds : Depression has been prevalent in women and maintaining optimal glycemic control is an important goal of diabetes management. Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, espacilly in Korean women. The current study examined the relationship of depressive symptomatology with glycemic control in Korean women. Methods : Beck depression inventory (BDI), $HbA_{1c}$ as an index of long-term glycemic control, fasting glucose level and body mass index (BMI) were measured in sample of 4,567 women of whom 4.7%, 216 women had diabetes, and the relationship between depression and glycemic control was analyzed. BDI Scores of 16 and above is a cut off point to indicate possible clinical depression. Results The frequency of depressed women (p<0.001) and the mean score of BDI (p<0.001) were significantly higher in diabetic women. The mean level of $HbA_{1c}$ (p<0.01) and fasting glucose (p<0.05) were higher in depressed women. There was a graded relationship between the percentile of depressed women and a degree of glycemic control impairment (p=0.001). Conclusion : The current study found the relationship of depressive symptomatology with glycemic control in Korean women. This relationship may be mediated by decreased self-care behaviors or by neurobiological dysregulation. Improving identification and treatment of depression in women with diabetes might have favorable effects on diabetic outcomes.

• The Journal of the Korea Contents Association
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• v.9 no.11
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• pp.271-279
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• 2009

Frozen shoulder is clinically characterized by pain and reduced ROM. The therapeutic goal of frozen shoulder can be reducing pain and increasing ROM in shoulder joint, resulting in improvement of joint movement. Therefore, this study was conducted to know the effect of mobilization in parallel with conservative physical therapy(H/P, TENS, U/S) in patients with frozen shoulder on subjective pain scale and ROM. 26 patients diagnosed with frozen shoulder were included for study. Among them, 13 patients(experiment group) were managed by mobilization as well as conservative physical therapy, another 13 patients(control group) were only treated by conservative physical therapy alone. All the patients were treated three times a week for 4 weeks, and after each treatment subjective pain scale and ROM were measured. In experimental group, pain has decreased and ROM has increased in abduction, external rotation and internal rotation. In control group, pain has also decreased but ROM has not changed in abduction, external rotation and internal rotation. There were no significant difference in subjective pain scale between two groups but some difference in ROM (external rotation, internal rotation). According to the results, we concluded that both conservative physical therapy and joint mobilization technique are more effective for increasing ROM especially external rotation, internal rotation than conservative physical therapy alone.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.16-26
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• 2000

Objectives：This study was done as a part of investigating individual and socioenvironmental factors affecting test anxiety in adolescent. The focusing of this study was detecting specific family enviromental factors affecting worry and emotionality of test anxiety. Methods：The subjects of this study were 880 middle and high school students in Seoul, Korea. To evaluate test anxiety level, Spielberger's Test Anxiety Inventory was applied and to evaluate familial factor, Moos and Moos' Family Environmental Scale was done. Results：The results were as follows. 1) Total and worry part of test anxiety scores were negatively correlated with cohesion and independence scores. Total, worry, and emotional part of test anxiety scores were positively correlated with achievement orientation and control scores. 2) High test anxiety group showed higher achievement orientation and control scores, and lower cohesion scores than low test anxiety group. 3) The higher socioeducational level of parents were, the higher three subscale (cohesion, independence, and achievement orientation) scores were, except control score. Conclusion：In therapeutic approach of adolescent's test anxiety, the importance of education and treatment of their parents should be emphasized. Parents should set their children's appropriate achievement goal, encourage their children's independency instead of control. Cohesion of familial members are also needed.

• The Korean Journal of Elementary Counseling
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• v.5 no.1
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• pp.43-63
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• 2006

This study aims at examining effects of study skills training on elementary school children's self-directed learning ability. To achieve this goal, the following hypotheses were built. Hypothesis 1. There are significant differences in self-directed learning ability between experimental and control groups. Hypothesis 2. There are significant differences in study skills by self-directed learning ability in the experimental group. To test these hypotheses, two classes in the fourth grade were selected from S Elementary School in the city of Busan for experimental and control groups, each of which consisted of 23 children: seven for the advanced group, eight for the intermediate group, and eight for the lower group according to self-directed learning ability. The experimental group participated in twenty sessions of study skills training while the control group went through no treatment. The study skills training program was the reconstruction to meet the requirements of this study in reference to domestic study skills training programs on the basis of the Study Skills Training Program for Elementary School Children in the Higher Grades developed by Byeon and others (2001), The effects of the program was tested by using the Study Skills Test for Elementary School Children in the Higher Grades developed by the educational institute of Busan National University (Bye on et al., 1999) and Lee's (1998) translation of the Self-Directed Learning Preparation Test by Guglielmino (1977) for elementary school children. To analyze the effects of the program, the SPSSWIN (10.0) program was used to carry out ANCOVA on results of pretest and post-test for experimental and control groups, along with repetitive one-way ANOVA to examine differences in results of pretest, post-test, and further test and an individual comparative test (Scheffe) to see differences in means of the three tests. This study obtained the following results. First, there were significant differences in marks for self-directed learning ability between the experimental group participating in study skills training and the control group and the effect was shown to last. Second, in terms of three levels of self-directed learning ability, there was no significant difference between advanced and intermediate groups in the effects on study skills but there were significant differences in the lower group. The results demonstrated that study skills training had a significant effect on their self-directed learning ability. and the study skills training program had a meaningful effect on the lower group.

• Journal of agricultural medicine and community health
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• v.43 no.2
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• pp.97-107
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• 2018

Objectives: The purpose of this study was to examine the success and barrier factors of hypertension registration program in Goseong community health center proven improving hypertension treatment rate by community health survey. Methods: We conducted a qualitative research using both a performance review of the program and in-depth interviews with the 8 operators who had worked for this program in April 2018. Results: In this study, the success factors were analysed as follows: First, the willingness to improve health indicators, second, the implementation of large-scale projects, third, improving program processes, fourth, continuous efforts for achievement of goal, not output or reward, and the barrier factors are as follows. First, uniform output monitering, second, evaluation after the fashion of contest, third, the confusing concept of an integrated health promotion program, fourth, the attitude of the person worried with task change. Conclusions: This study suggested that the health community health center should follow the basic principles of public health, and the central government should introduce a health policy of decentralization.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.9 no.1
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• pp.41-49
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• 2011

This study purposes to conduct visual feedback and body posture control training on stroke patients with pusher syndrome in order to reduce their pusher syndrome. This study also examines changes resulting from the training and applies the guidelines necessary for documentation of patient/customer management. The participant for this study was one patient with pusher syndrome. The study progressed from a medical examination of the subject followed by evaluation, diagnosis, prognosis, intervention and treatment plan, and finally re-examination in order of precedence. Problems in the participant's functional activities, difficulties in changes from sitting postures into standing postures, and maintaining standing postures were determined as primary restrictions on activities and the improvement of these activities was set up as a goal through discussions with the patient. Interventions were mainly implemented to reduce the pusher syndrome with visual feedback provided using mirrors and exercises focusing on leaning in order to maintain posture while sitting. Changes from supine postures to sitting postures and the degree of changes in maintaining standing postures were compared between before and after the intervention by measuring times in the same environment and the degree of pusher syndrome was measured using the SCP tool. The process of this clinical practice was documented. The SCP score that indicates the degree of changes in the participant's pusher syndrome changed from 3.75 points to 0.8 point indicating a decrease in pushing. Among functional activities, posture changes from sitting postures to standing postures and maintaining standing postures were improved. In addition, since the patient could maintain standing postures, the patient could walk indoors. In this case study, mirrors and body posture control training used as interventions to relieve pusher syndromes can be easily applied in clinics to examine the form of functional recovery. The results indicated that these intervention methods were effective and thus it is thought that the results can be used as basic data to utilize these intervention methods diversely. In addition, the documentation of patient/client management was applied as actual documentation in Korean and based on the results, we could show decision making processes for patients' functional goals and objectively explain problems, prognoses and changes made through the interventions.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.239-250
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• 2012

In recent years, national health insurance(NHI) coverage had been expanded gradually for cancer as a severe disease requiring high level of medical expenditure, to reduce patient's financial burden. But, subjective burdens level for out-of-pocket(OOP) money expense are still considerable owing to high medical cost and decent numbers of services not covered by benefit plan. This study aimed to investigate OOP medical expenditures and identify factors influencing subjective financial burden in cancer patients. A 28-items questionnaire for self-reporting by responders was designed to satisfy study goal and finalized following by one pilot study and experts' verification process. Subjects were enrolled during July to October 2010 through regular meetings organized by five patient or patient-advocacy groups had acknowledged the study purpose. Subjects who aged 20 or more, have histories of cancer diagnosis and anticancer drug use, and voluntarily agreed to participate in this study were recruited. Total 107 subjects included in the analysis have cancer lesions in breast, colon, kidney, liver or stomach at the stages from I to IV. Approximately 73% of them has passed less than 5 years since cancer diagnosis. For the OOP medical expenditure regarding cancer, less 6 million won was in 31%, 6-15 million won in 35% and more than 15 million won in 28% of responders, and more than half responders(58%) felt financial burden subjectively. 63% of responders had subscribed commercial insurances, resulting in money receipts of more than 10 million won since cancer diagnoses in 76% of responders. Logistic regression results showed significant differences in subjective OOP financial burden level depending on gender, household income level, benefit type, commercial insurance money receipt degree, year cancer diagnosed, cancer lesion, therapy type, duration of anticancer drug use, drug listing in national formulary, total OOP medical expenditure and total OOP anticancer drug expense. They had mixed feelings both wishes to expand NHI coverage to reduce financial burden(70%) and no willingness to increase premium(59%). This result suggested that NHI might direct future strategies to reduce absolute total OOP medical cost and expand benefit plan coverage in higher burden groups in particular.

• Journal of Periodontal and Implant Science
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• v.26 no.4
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• pp.799-821
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• 1996

The ultimate goal of periodontal treatment has been to facilitate regeneration of diseased periodontal tissues, destroyed by inflammatory periodontal disease. For regeneration of the periodontium to occur, all of component tissues must be restored to their original position and architecture. Growth factors which were known to promote the cellular processes, ie, proliferation, migration and matrix synthesis, have been in the spotlight of current periodontics. Platelet-derived growth factor(PDGF) stimulates collagen and non collagen protein synthesis, migration and proliferation of periodontal ligament cells. Insulin-like growth factor(IGF) has potentials to induce collagen and bone matrix synthesis so that it regulates normal bone remodeling. Application of the combination have been known to facilitate formation of bone and cementum, and to synergistically interact to promote coronal migration and proliferation of periodontal ligament cells. These two growth factors have been reported to exhibit positive effect in the periodontally diseased teeth or class m furcation defects. The aim of the present study was to test the hypothesis that PDGF-BB alone or the combination of PDGF-BB and IGF-I can predictably enhance regeneration of the periodontium in the dehiscence defect. Following the resection of premolars, roots were embedded. After 12 weeks of healing period, standardized experimental $4{\times}4mm$ dehiscence defects were created on the mid-facial of the premolar roots in each of 4 young adult dogs. In control group, only methylcellulose gel was inserted in the defects. In experimental group I and II, gel with $2{\mu}g$ of PDGF-BB or $2{\mu}g$ of PDGF-BB and $1{\mu}g$ of IGF-I was inserted in the defects, respectively. At 8 weeks postsurgery, the dogs were sacrificed. The results were observed histologically and analyzed histomorphometrically.The results of this study were as follws. 1. The new cementum formation was $1.26{\pm}0.69mm$ in the control group, $1.80{\pm}0.84mm$ in the experimental group I, $1.93{\pm}0.51mm$ in the experimental group II. The experimental group III, the experimental group I, the control group were in the order of cementum formation without statistically significant differences between control and all experimental groups. 2. The new bone formation was $1.00{\pm}0.53mm$ in the control group, $1.53{\pm}0.63mm$ in the experimental group I, $l.33{\pm}0.45mm$ in the experimental group II. The experimental group I, the experimental group II, the control group were in the order of bone formation without statistically significant differences between control and all experimental groups. 3. The root resorption was $1.12{\pm}0.64mm$ in the control group, $1.34{\pm}0.73mm$ in the experimental group I, $0.79{\pm}0.59mm$ in the experimental group II without statistically significant differences between control and all experimental groups. These results suggested that the use of PDGF-BB alone or PDGF-BB and IGF-I in the dehiscence defects might facilitate periodontal regeneration in some degree, but has not shown statistically significant results.