The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE Ⅲ and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE Ⅲ developed by Knaus and the Patient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, $x^2$, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing.
Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.
Purpose: A retrospective study was performed to assess the efficacy and tolerance of ${\beta}-blocker$ administration in patients with heart failure and diabetes. Method: Records of 164 patients who were treated for the heart failure condition more than a year were studied retrospectively. Patients were divided into 4 groups based on their diabetes(DM) status and the administration of ${\beta}-blockers$ ($DM+{\beta}-blocker$ group: 14, DM w/o ${\beta}-blocker$: 19, No DM + ${\beta}-blocker$: 62, No DM + no ${\beta}-blocker$: 69). All patients had been receiving conventional therapy such as digoxin, ACE-I, ARB, diuretics, nitrates, aspirin, anticoagulants or lipid-lowering agents. The primary endpoints (death and hospital admission) were recorded during 1 year period and hemodynamic factors (HR, LVEF, SBP, DBP) were obtained from all patient groups before and after 12 months of ${\beta}-blocker$ treatment. To evaluate toxicity of ${\beta}-blocker$, SCr, BUN, AST, ALT and Alkaline phosphatase were obtained. Result: There were less death and hospital admission in DM + ${\beta}-blocker$ group than in DM without ${\beta}-blocker$ group (p=0.014). Relative risk of hospital admission for $DM+{\beta}-blocker$ group over no DM group was 1.17. Long term ${\beta}-blocker$ administration was associated with an improvement of heart rate in patients with DM (P< 0.02) with no significant improvement of LVEF, SBP, DBP. in DM patient. In patient without DM, ${\beta}-blocker$ was associated with improvement in LVEF, HR and DBP (P<0.01, P<0.03), but not in SBP. The incidence of toxicity was similar between the four group with no significant difference. Conculsion: Treatment of heart failure patients with ${\beta}-blocker$ appears to be beneficial in terms of hospital admission event and several hemodynamic factors. The toxicities of ${\beta}-blocker$ treatment were not significant and the treatment is generally well-tolerated in most of the heart failure patients.
Rahman, Md. Asadur;Chowdhury, Mostafa Zaman;Jang, Yeong Min
Journal of Information Processing Systems
/
v.11
no.4
/
pp.583-600
/
2015
Generally, the wireless network provides priority to handover calls instead of new calls to maintain its quality of service (QoS). Because of this QoS provisioning, a call admission control (CAC) scheme is essential for the suitable management of limited radio resources of wireless networks to uphold different factors, such as new call blocking probability, handover call dropping probability, channel utilization, etc. Designing an optimal CAC scheme is still a challenging task due to having a number of considerable factors, such as new call blocking probability, handover call dropping probability, channel utilization, traffic rate, etc. Among existing CAC schemes such as, fixed guard band (FGB), fractional guard channel (FGC), limited fractional channel (LFC), and Uniform Fractional Channel (UFC), the LFC scheme is optimal considering the new call blocking and handover call dropping probability. However, this scheme does not consider channel utilization. In this paper, a CAC scheme, which is termed by a uniform fractional band (UFB) to overcome the limitations of existing schemes, is proposed. This scheme is oriented by priority and non-priority guard channels with a set of fractional channels instead of fractionizing the total channels like FGC and UFC schemes. These fractional channels in the UFB scheme accept new calls with a predefined uniform acceptance factor and assist the network in utilizing more channels. The mathematical models, operational benefits, and the limitations of existing CAC schemes are also discussed. Subsequently, we prepared a comparative study between the existing and proposed scheme in terms of the aforementioned QoS related factors. The numerical results we have obtained so far show that the proposed UFB scheme is an optimal CAC scheme in terms of QoS and resource utilization as compared to the existing schemes.
Many Koreans have been interested in health functional foods(HHFs). Use of health functional foods is growing rapidly. This study aims to identify the determinants of HFFs use focusing on health related factors. The subjects were 24,626 samples from Korea Health Panel in 2008. The subjects were divided into two group: under the 20 years old and 20 old and over. The logistic regression model was used to examine influence of health-related factors on use of HFFs for each group. About thirty percent of the subjects have used HFFs. The larger family size, higher education level of parents, more stable economic status and chronic diseases were positively related to use more HFFs in younger 20 years old. Higher education level, more stable economic status, chronic diseases were more likely to use HFFs in 20 years of age and over. Health related factors such as disability, chronic diseases, admission, and physician visit affect the use of HFFs in both groups. We confirmed that health related factors as well as socio-demographic and economic factors affect use of HFFs. In-depth knowledge about relationship between health related factors and HFFs is required.
Objectives : The purpose of the study was to investigate the influencing factors of major and university choice in the changing environments that kick out the insincere universities keeping pace with the national policy. Methods : A self-reported questionnaire was completed by 177 subjects after receiving informed consents. The questionnaire consisted of general characteristics, influencing factors on university and department choice including multiple application. Chi-square test was used for analysis of the difference between early and regular admission. Results : Employment was the most important reason for choice of dental hygiene department that accounted for 96%. The access route for university information was college homepage for entrance information that accounted for 72.3% and 76.3% of applicants were advised by their parents for their choice for university. The information was mainly composed of school life(92.1%) and employment (81.9%). The applicants wanted to meet the students(58.8%) and to come in contact with the university homepage(57.1%). Early and regular applicants differed in reasons for college entrance(p=0.032), information delivery for major(p=0.013) and multiple application for entrance(p<0.01). Conclusions : University homepage and communication with the students will give much information to the applicants. So the university had better choose the homepage and communication for marketing strategy.
Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.
Kim, Jung-Hun Aj;Hwang, Na-Kyoung;Kim, Jong-Sung;Song, Young-Jin;Choi, Min-Kyung;Kim, Hyung-Sun;Han, Ga-Ram
Therapeutic Science for Rehabilitation
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v.9
no.3
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pp.103-120
/
2020
Objective : This study aims to understand the phenomenon of social admission in Korea's rehabilitation system by analyzing the perspectives of occupational therapists. Methods : We developed a written questionnaire based on RSAT and, in August 2019, distributed it to occupational therapists with more than three years of experience at the time. Data were analyzed using the van Kaam's method. Further, high frequency words were analyzed by word cloud in order to extract significant statements. Results : Forty-six written interviews were collected from various areas of Korea. We analyzed the data into 2 categories, 4 themes, 13 sub-themes. The two categories were 'hospital system' and 'external factors of occupational therapy practice'. The themes according to 'hospital system' were 'difficulties in implementing multidisciplinary approach' and 'inadequate discharge planning system'. The themes according to 'internal and external factors of occupational therapy' were analyzed as 'difficulties of occupational therapists' and 'difficulties in occupational therapy practice'. Conclusion : Occupational therapists in rehabilitation hospitals recognize that the reason for social admission is insufficient insurance systems related to occupational therapy services in rehab hospitals. This leads to difficulties in occupational therapy practice. We need to develop the insurance systems that can meet patient needs for social recovery.
The purposes of this research are: to observe the related variables; to compare the effect size; and make suggestions for leadership selection by admission officer system based on the results from the observation and comparison through meta analysis. The research questions crafted in order to achieve the purpose are as follows. First, what kind of variables were discussed in the previous studies? and can these variables be classified as the categories of the existing studies? Second, how are the effect sizes of the youth leadership related variable groups? Third, how are the effect sizes of sub factors of the related variable groups? The specific results of this research are as follows. First, youth leadership related variables can be classified as demographic, organization-activities, home environment and sociopsychological variables. Second, sociopshycological variable group shows the largest effect size. Third, among the sub factors, self esteems (ES=1.3231) and degree of satisfaction for life (ES=1.1737) show two largest effect sizes. In conclusion, based on the result of the research, this research suggests an alternative for a method to select students through admission counseling leadership selection system.
Park, Hyun Oh;Choi, Jun Young;Jang, In Seok;Kim, Jong Duk;Choi, Jae Won;Lee, Chung Eun
Journal of Chest Surgery
/
v.52
no.6
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pp.400-408
/
2019
Background: For decades, trauma has been recognized globally as a major cause of death. Reducing the mortality of patients with trauma is an extremely pressing issue, particularly for those with severe trauma. An early and accurate assessment of the risk of mortality among patients with severe trauma is important for improving patient outcomes. Methods: We performed a retrospective medical record review of 582 patients with severe trauma admitted to the emergency department between July 2011 and June 2016. We analyzed the associations of in-hospital mortality with the baseline characteristics and initial biochemical markers of patients with severe trauma on admission. Results: The overall in-hospital mortality rate was 14.9%. Multivariate logistic regression analysis showed that the patient's Rapid Emergency Medicine Score (REMS; odds ratio [OR], 1.186; 95% confidence interval [CI], 1.018-1.383; p=0.029), Emergency Trauma Score (EMTRAS; OR, 2.168; 95% CI, 1.570-2.994; p<0.001), serum lactate levels (SLL; OR, 1.298; 95% CI, 1.118-1.507; p<0.001), and Injury Severity Score (ISS; OR, 1.038; 95% CI, 1.010-1.130; p=0.021) were significantly associated with in-hospital mortality. Conclusion: The REMS, EMTRAS, and SLL can easily and rapidly be used as alternatives to the injury severity score to predict in-hospital mortality for patients who present to the emergency department with severe trauma.
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