• 제목/요약/키워드: clinical effect

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Prediction of the human in vivo antiplatelet effect of S- and R-indobufen using population pharmacodynamic modeling and simulation based on in vitro platelet aggregation test

  • Noh, Yook-Hwan;Han, Sungpil;Choe, Sangmin;Jung, Jin-Ah;Jung, Jin-Ah;Hwang, Ae-Kyung;Lim, Hyeong-Seok
    • Translational and Clinical Pharmacology
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    • 제26권4호
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    • pp.160-165
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    • 2018
  • Indobufen ($Ibustrin^{(R)}$), a reversible inhibitor of platelet aggregation, exists in two enantiomeric forms in 1:1 ratio. Here, we characterized the anti-platelet effect of S- and R-indobufen using response surface modeling using $NONMEM^{(R)}$ and predicted the therapeutic doses exerting the maximal efficacy of each enantioselective S- and R-indobufen formulation. S- and R-indobufen were added individually or together to 24 plasma samples from drug-naïve healthy subjects, generating 892 samples containing randomly selected concentrations of the drugs of 0-128 mg/L. Collagen-induced platelet aggregation in platelet-rich plasma was determined using a Chrono-log Lumi-Aggregometer. Inhibitory sigmoid $I_{max}$ model adequately described the anti-platelet effect. The S-form was more potent, whereas the R-form showed less inter-individual variation. No significant interaction was observed between the two enantiomers. The anti-platelet effect of multiple treatments with 200 mg indobufen twice daily doses was predicted in the simulation study, and the effect of S- or R-indobufen alone at various doses was predicted to define optimal dosing regimen for each enantiomer. Simulation study predicted that 200 mg twice daily administration of S-indobufen alone will produce more treatment effect than S-and R-mixture formulation. S-indobufen produced treatment effect at lower concentration than R-indobufen. However, inter-individual variation of the pharmacodynamic response was smaller in R-indobufen. The present study suggests the optimal doses of R-and S-enantioselective indobufen formulations in terms of treatment efficacy for patients with thromboembolic problems. The proposed methodology in this study can be applied to the develop novel enantio-selective drugs more efficiently.

시뮬레이션 실습교육이 간호대학생의 임상판단력, 자신감, 임상수행능력에 미치는 효과 (The Effect of Simulation Practice Education on the Clinical Judgment, Self-confidence and Clinical Performance Ability in Nursing Student)

  • 이숙경
    • 한국콘텐츠학회논문지
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    • 제17권11호
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    • pp.577-587
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    • 2017
  • 본 연구의 목적은 시뮬레이션 실습교육이 간호대학생의 임상판단력, 자신감, 임상수행능력에 영향을 미치는 효과를 파악하고자 실시되었으며 단일군 사전-사후 실험연구이다. 연구 대상자는 S지역에 소재한 간호학과 2학년 시뮬레이션 실습교과목을 수강한 45명의 학생으로 자료는 설문지를 이용하여 시뮬레이션 실습교육 전 후에 수집되었다. 연구결과 임상판단력, 자신감, 임상수행능력 모두가 통계적으로 유의미하게 향상되었다. 그러므로 시뮬레이션 실습교육이 간호대학생의 임상판단력과 자신감, 임상수행능력에 미치는 긍정적인 효과를 확인하였다. 추후 임상판단력, 자신감, 임상수행능력을 향상시킬 수 있는 시뮬레이션 실습교육의 모듈 개발 및 효과를 검증할 수 있는 연구가 필요하다고 사료된다.

간호대학생의 전공만족도와 진로준비 행동과의 관계에서 임상실습만족도의 매개효과 (Mediating Effect of Satisfaction with Clinical Practice on the Relation between Satisfaction with Major and Career Preparation Behavior of Nursing Students)

  • 채민정;정효주
    • 보건의료산업학회지
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    • 제10권3호
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    • pp.213-222
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    • 2016
  • Objectives : This study identified the mediating effect of satisfaction with clinical practice on the relation between nursing students' satisfaction with major and career preparation behavior. Methods : Study participants were 454 nursing students with a clinical practice experiences who were enrolled as members of two university in Korea. Data were collected with self-report questionnaire and analyzed with SPSS 19.0 program. Results : Satisfaction with major was positively correlated with career preparation behavior, and satisfaction with clinical practice was also positively associated with career preparation. A mediating effect of satisfaction with clinical practice was found in the relation between satisfaction with major and career preparation behavior. Conclusions : Universities and departments should provide much effort and support for the development of clinical practice experience curriculum and hands-on training that are appropriate for the students' level and interests so that their outcomes can be connected to the career preparation behavior.

간호대학생의 피로와 임상실습 스트레스의 관계에서 의사소통 능력의 매개효과 (Mediating Effect of Communication Skill in the Relationship between Fatigue and Clinical Practice Stress in Nursing Students)

  • 양야기
    • 기본간호학회지
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    • 제25권1호
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    • pp.58-67
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    • 2018
  • Purpose: Fatigue and clinical practice stress can negatively influence nursing students. This study was done to examine of communication skill as mediating effect variable in the relationship between fatigue and stress during clinical practice. Methods: A cross-sectional study design was employed. Research participants were 124 nursing students from G city and J province. Data were collected from December 1, 2016 to January 30, 2017 using self-report questionnaires. Data were analyzed using Baron and Kenny method. Results: Fatigue had a significant negative correlation with communication skill (r=-.28, p=.001). Fatigue had a significant positive correlation with clinical practice stress (r=.39, p<.001). In addition, communication skill had a mediating effect in the relationship between fatigue and clinical practice stress. Conclusion: The findings of this study indicate that communication skill plays an important role in reducing clinical practice stress in nursing students. Therefore, in the field of nursing education, a program to improve the communication ability of nursing students should be developed and applied.

치주치료 후 유지치주치료의 효과에 관한 평가 : 1년 관찰 (The effect of supportive periodontal therapy after periodontal treatment : A 1-year follow up.)

  • 김신영;김용건
    • 대한치과의사협회지
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    • 제55권1호
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    • pp.22-29
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    • 2017
  • Purpose : Preservation of the periodontal health of the treated patient requires supportive periodontal therapy for the elimination of periodontal disease. After Phase I therapy is completed, patients are placed on a schedule of periodic recall visits for maintenance care to prevent recurrence of the disease. The amount of tooth loss would be the most relevant criterion in an evaluation of the effect of periodontal treatment, but this would require studies with extremely long follow-up periods. Thus the most commonly used outcome criteria in clinical research have been clinical attachment level change, reduction of pocket depth and bleeding frequency. The purpose of this case study is to identify the effect of supportive periodontal therapy after periodontal flap surgery. Materials & Methods : Following routine hygienic phase of treatment, patients with chronic periodontitis received surgical periodontal treatment. Bleeding on probing, pocket depth and clinical attachment level were measured at baseline, pre-operation and 1 year follow up. All procedures were performed by one operator. Results : One year a total of 28 patients (58sites) to recheck remained, when conducted maintenance program after periodontal flap surgery was observed reduction of bleeding frequency, pocket depth and improvement of clinical attachment level. Conclusion : The results from this study indicate that supportive periodontal therapy after periodontal flap surgery is effective for reduction of bleeding frequency, pocket depth and gain of clinical attachment level.

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간호시뮬레이션 학습자의 간호역량에 관한 구조모형 (A Structural Model on the Nursing Competencies of Nursing Simulation Learners)

  • 박수진;지은선
    • 대한간호학회지
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    • 제48권5호
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    • pp.588-600
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    • 2018
  • Purpose: The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory. Methods: Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs. Results: The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability. Conclusion: In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.

항생제 처방 지원 프로그램이 항생제 처방과 사용량에 미치는 효과 (Effects on the Antimicrobial Use of Clinical Decision Support System for Prescribing Antibiotics in a Hospital)

  • 김현영;조재현;고영택
    • 한국임상약학회지
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    • 제23권1호
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    • pp.26-32
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    • 2013
  • Objective: This study was to define the clinical effect on the clinical decision support system (CDSS) for prescribing antibiotics integrated with the order communication system in a National Hospital. Method: We extracted data collected before integrating the CDSS of 4,406 adult patients in 2007 and data collected after integrating the CDSS of 4,278 adult patients in 2009. These patients were 50.4% and 45.2% of all patients admitted in 2007 and 2009, respectively. The clinical effect was defined as the proportion of prescribed antibiotics, the length of antibiotics use, and the DDDs (defined daily doses) of antibiotics per 1,000 patient-days using these retrospective data. Results: There were a significant change in the proportion of patient prescribed penicillins with extended spectrum (OR=0.55, p=001), penicillins included beta-lactamase inhibitors (OR=0.75, p<.001), 3rd cephalosporin (OR=1.47, p<.001). The mean of the length of antibiotics use was decreased statistically from $6.09{\pm}5.48$ to $5.85{\pm}5.51$ days (p=.003). The DDD of glycopeptides was decreased from 24.43 DDD to 19.55 DDD per 1000 patient-days. The DDD of 3rd cephalosporins was also decreased from 15.88 to 11.65. Conclusion: Therefore, the clinical decision support system for prescribing antibiotics was effective for the clinical outcomes.

간호대학생의 임상실습 중 경험한 언어폭력, 임상실습 스트레스 및 스트레스 대처가 전공 만족도에 미치는 영향 (The effect of verbal violence, clinical practice stress, and coping with stress on nursing students' major satisfaction during clinical practice)

  • 허희정;송영숙
    • 한국간호교육학회지
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    • 제29권2호
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    • pp.190-198
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    • 2023
  • Purpose: This study was conducted to identify the effect of verbal violence, clinical practice stress, and coping with stress on the major satisfaction in nursing students during clinical practice. Methods: A cross-sectional study was used. A survey was conducted from May 3 to May 10, 2022, on 200 nursing students who were in their junior and seneior years at two universities in Gyeongsangbuk-do. Descriptive statistics, frequency analysis, independent t-test, one-way ANOVA, Scheffé's test, Pearson correlation coefficient, and hierarchical regression analysis were employed to analyze the data. Results: Major satisfaction was found to be significantly negatively correlated with verbal violence (r=-.30, p<.001) and clinical practice stress (r=-.15, p=.032) and to be positively correlated with coping with stress (r=.24, p<.001). Their satisfaction with clinical practice (β=.29, p=.037), verbal violence (β=-.23, p<.001), coping with stress (β=.16, p=.015), religion (β=.14, p=.041), and clinical practice stress (β =-.13, p=.048) explained 19.3% of the variance in nursing students' major satisfaction during clinical practice. Conclusion: A verbal violence and coping with stress program for nursing students should be developed to increase nursing students' major satisfaction during clinical practice.

도시 저소득층 노인들의 영양 및 건강상태 조사와 급식이 노인들의 영양 및 건강 상태의 개선에 미치는 영향 -IV. 급식이 도시 저소득층 노인들의 무기질 영양 상태 및 임상 증상에 미치는 영향- (Nutritional and Health status of Korean Elderly form Low-Income, Urban Area and Improving Effect of meal Service on Nutritional and Health Status -IV. The Effect of Meal Serivice on Mineral Status and Clinical symptoms-)

  • 손숙미;박양자;구재옥;김숙배;이경신;윤혜영
    • 대한지역사회영양학회지
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    • 제1권3호
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    • pp.395-404
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    • 1996
  • The effect of meal service for home-staying, urban elderly with low income on their mineral status and prevalence of clinical symptoms was evaluated. One hundred. One hundred and eighty three subjects were assigned to meal-served(served) and non-served(non-served)groups. A meal containing approximately one half of the RDA for energy, protein, calcium and iron was served as lunch every day to served group at a welfare center. Dietary, biochemical and clinical data were collected before and after 6 months of meal service and the changes of parameters were analyzed with paired t-test. served female showed significantly increased intake of calcium. The mean hemoglobin, serum iron, TIBC and serum copper of female were significantly increase with meal service. The proportion of anemic female compared to reference data on hemoglobin, hematocrit and serum iron were 45.5$\%$, 29.1$\%$ and 16.4$\%$ respectively, but were lowered to 18.2$\%$, 7.3$\%$, and 5.5$\%$ after 6 months of meal service. served male showed significant increase in MCHC, serum copper, and urinary Na. The urinary Ca/Creatinine, which is often used as an index of bone resorption, was decreased significantly in served group. The decrease in the proportion of served women suffering from edema of ankle and diarrhea was most apparent and less women reported feeling clinical symptoms of dizziness, constipation, difficulty in hearing, and coughing after meal service. The symptoms of benumbness of hands and feet and coughing was lowered most among men after meal service. Clinical symptoms of non-served elderly did not show improvement in feeling clinical symptoms except slightly decreased frequency in coughing of female and buzzing sound in the ears and diarrhea of male.

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간호학생의 임상수행능력 경로모형 분석 (Validation of a Path Model on Clinical Practice Competency of the Nursing Students)

  • 권윤희;곽오계
    • 한국산학기술학회논문지
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    • 제13권10호
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    • pp.4572-4581
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    • 2012
  • 본 연구는 간호학생의 비판적사고성향, 진로정체감, 간호전문직 자아개념, 임상실습만족 및 임상수행능력의 관계에 대한 경로모형을 검증하고자 시도되었다. 간호학생 581명을 대상으로 자가보고형 설문지를 이용하여 자료수집 하였다. 자료는 SPSS 및 AMOS 프로그램을 이용하여 분석하였다. 연구결과, 간호학생의 임상수행능력에 대해 비판적사고성향, 진로정체감, 간호전문직 자아개념 및 임상실습만족이 직접효과가 있었다. 그리고 비판적사고성향과 진로정체감이 간접효과가 있었다. 간호학생의 간호전문직 자아개념과 임상실습만족에 대해 비판적사고성향과 진로정체감이 직접효과가 있었다. 이러한 결과에서 간호학생의 임상수행능력에 영향을 미치는 요인을 고려하고, 적절하고 효율적인 교육과정 및 교수학습 프로그램을 개발해야 한다.