• Title/Summary/Keyword: course outcomes

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The Extent of Late Gadolinium Enhancement Can Predict Adverse Cardiac Outcomes in Patients with Non-Ischemic Cardiomyopathy with Reduced Left Ventricular Ejection Fraction: A Prospective Observational Study

  • Eun Kyoung Kim;Ga Yeon Lee;Shin Yi Jang;Sung-A Chang;Sung Mok Kim;Sung-Ji Park;Jin-Oh Choi;Seung Woo Park;Yeon Hyeon Choe;Sang-Chol Lee;Jae K. Oh
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.324-333
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    • 2021
  • Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

The Third Nationwide Korean Heart Failure III Registry (KorHF III): The Study Design Paper

  • Minjae Yoon;Eung Ju Kim;Seong Woo Han;Seong-Mi Park;In-Cheol Kim;Myeong-Chan Cho;Hyo-Suk Ahn;Mi-Seung Shin;Seok Jae Hwang;Jin-Ok Jeong;Dong Heon Yang;Jae-Joong Kim;Jin Oh Choi;Hyun-Jai Cho;Byung-Su Yoo;Seok-Min Kang;Dong-Ju Choi
    • International Journal of Heart Failure
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    • v.6 no.2
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    • pp.70-75
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    • 2024
  • With advancements in both pharmacologic and non-pharmacologic treatments, significant changes have occurred in heart failure (HF) management. The previous Korean HF registries, namely the Korea Heart Failure Registry (KorHF-registry) and Korean Acute Heart Failure Registry (KorAHF-registry), no longer accurately reflect contemporary acute heart failure (AHF) patients. Our objective is to assess contemporary AHF patients through a nationwide registry encompassing various aspects, such as clinical characteristics, management approaches, hospital course, and long-term outcomes of individuals hospitalized for AHF in Korea. This prospective observational multicenter cohort study (KorHF III) is organized by the Korean Society of Heart Failure. We aim to prospectively enroll 7,000 or more patients hospitalized for AHF at 47 tertiary hospitals in Korea starting from March 2018. Eligible patients exhibit signs and symptoms of HF and demonstrate either lung congestion or objective evidence of structural or functional cardiac abnormalities in echocardiography, or isolated right-sided HF. Patients will be followed up for up to 5 years after enrollment in the registry to evaluate long-term clinical outcomes. KorHF III represents the nationwide AHF registry that will elucidate the clinical characteristics, management strategies, and outcomes of contemporary AHF patients in Korea.

A Phenomenological Study on Performance of Cultural Welfare Services (문화복지서비스 성과에 관한 현상학적 연구 - 서비스 이용자의 인식을 중심으로 -)

  • Yu, Young Ju
    • Korean Journal of Social Welfare Studies
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    • v.44 no.3
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    • pp.271-300
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    • 2013
  • The objective of this study is to discover how the performance of service is perceived by those who receive the services. For the purpose of this study, perception on service performance is defined as "the perception of the changes in daily life as a result or in the course of using Cultural Welfare Services, i.e., the users' own perception of the tangible changes made through the community experience, the perception of others arising from interaction within the community, and the perception of future social relations or vision of the future." The study was conducted by using the qualitative research method of phenomenological approach aimed at understanding the essential aspects of interpersonal phenomena as they occur in a sociocultural context. The outcomes of the study that users' perception on performance of Cultural Welfare Services is principally "a process of enabling users who have hitherto led a life devoid of meaning and values to explore the opportunities of changing the course of life by awakening their cultural sensitivity." With regard to the essence of performance, which is a higher category, the analyses have led to the following findings: "perception of 'me' within the community", "emotional stability acquired in the course of task performance", "perception of a new 'me' through community activities", "perception of 'others' face to face with me", and "exploration of opportunities for a new life".

Characteristics and Clinical Course of Fusiform Middle Cerebral Artery Aneurysms According to Location, Size, and Configuration

  • Seo, Dongwook;Lee, Si Un;Oh, Chang Wan;Kwon, O-Ki;Ban, Seung Pil;Kim, Tackeun;Byoun, Hyoung Soo;Kim, Young Deok;Lee, Yongjae;Won, Yu Deok;Bang, Jae Seung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.6
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    • pp.649-660
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    • 2019
  • Objective : To analyze the angiographic features and clinical course, including treatment outcomes and the natural course, of fusiform middle cerebral artery aneurysms (FMCAAs) according to their location, size, and configuration. Methods : We reviewed the literature on adult cases of FMCAAs published from 1980 to 2018; from 25 papers, 112 FMCAA cases, for which the location, size, and configuration could be identified, were included in this study. Additionally, 33 FMCAA cases in our hospital were included, from which 16 were assigned to the observation group. Thus, a total of 145 adult FMCAA cases were included. We classified the FMCAAs according to their location (l-type 1, beginning from prebifurcation; l-type 2, beginning from bifurcation; l-type 3, beginning from postbifurcation), size (small, <10 mm; large, ${\geq}10mm$; giant, ${\geq}25mm$), and configuration (c-type 1, classic dissecting aneurysm; c-type 2, segmental ectasia; c-type 3, dolichoectatic dissecting aneurysm). Results : The c-type 3 was more commonly diagnosed with ischemic symptoms (31.8%) than hemorrhage (13.6%), while 40.9% were found accidentally. In contrast, c-type 2 was more commonly diagnosed with hemorrhagic symptoms (14.9%) than ischemic symptoms (10.6%), and 72.3% were accidentally discovered. According to location, ischemic symptoms and hemorrhage were the most frequent symptoms in l-type 1 (28.6%) and l-type 3 (34.6%), respectively. Most of l-type 2 FMCAAs were found incidentally (68.4%). Based on the size of FMCAAs, only 11.1% of small aneurysms were found to be hemorrhagic, while 18.9% and 26.0% of large and giant aneurysms were hemorrhagic, respectively. Although four aneurysms of the 16 FMCAAs in the observation group increased in size and one aneurysm decreased in size during the observation period, no rupture was seen in any case and there were no significant predictors of aneurysm enlargement. Of 104 FMCAAs treated, 14 cases (13.5%) were aggravated than before surgery and all the aggravated cases were l-type 1. Conclusion : While ischemic symptoms occurred more frequently in l-type 1 and c-type 3, hemorrhagic rather than ischemic symptoms occurred more frequently in l-type 3 and c-type 2. In case of l-type 1 FMCAAs, more caution is required in determining the treatment due to the relatively high complication rate.

Developing and Pilot-Testing Blended Learning Program Prototypes for Health Coaching to Support Positive Growth of Cancer Patients (암환자의 긍정성 증진을 위한 블렌디드 건강코칭 교육프로그램 프로토타입 개발 및 적용)

  • Lim, Cheolil;Park, Taejung;Kim, Sungwook;Yun, Youngho
    • Journal of Information Technology Services
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    • v.18 no.5
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    • pp.71-83
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    • 2019
  • This study aimed to develop and pilot-test educational program prototypes of training health coaches to help cancer patients overcome crises and create positive growth. For this purpose, the educational contents and methods of the blended learning program prototypes were derived through learner needs and literature analysis. The prototypes, which consist of introducing of health management and health information and understanding and practice of basic coaching and health coaching, were developed to integrate with four sessions of face-to-face, off-line classes, training practices through 12 tele-classes, and use of online learning system. The prototypes were conducted and pilot-tested by a total of 35 students selected through the document screening and the interview. After participating in the blended learning program, learners expressed greater overall satisfaction with each session program (average score = 4.36, with 5 being most satisfied), satisfaction with learning contents (average score=4.42) satisfaction with course preparation (average score = 4.26) and satisfaction with lecture materials (average score = 4.19). The results of this study show that a systematic and integrative approach for designing a blended learning program can be useful for various educational needs in health and medical fields. In the future, empirical studies are expected to see how these curricula are actually implemented and assess whether the intended learning outcomes are achieved.

A study on Effects of the Concept Mapping for Concept Formation of Molecular Motion (개념도 작성 활동을 통한 수업이 분자운동 개념 형성에 미치는 효과)

  • 전근배;노석구
    • Journal of Korean Elementary Science Education
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    • v.20 no.1
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    • pp.31-43
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    • 2001
  • The purposes of this study were grasping the degree of students' understanding for course contents through the concept mapping strategy as meaningful learning in science and measuring the effect for change of conception and changing the misconception. The results of the study were as follows: 1. Before the lesson, only 10.7% of students had scientific conception of molecular motion. Other students had various kinds of misconceptions. 2. The extent of concept formation after lesson through the using concept mapping strategy was tested. As a result, compared with the controlled group, the experimental group showed higher extent of sound concept formation (statistical significance level 0.05). 3. The differences between the experimental group and the control group were analyzed into quantitative and qualitative points of view. The results of the comparison showed that the maps of the students were well configured in the categories of the relationship, the hierarchy and the examples; while students showed lower abilities in the category of the cross-links. 4. The student's attitudes to ward concept mapping was positive. Most of the students answered that teaching strategy of concept mapping benefits them in meaningful learning outcomes.

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Traumatic Intracerebellar Hematomas (외상성 소뇌내 혈종들)

  • Kim, Young-Dae;Park, Hyung-Ki;Chang, Jae-Chil;Cho, Sung-Jin;Choi, Soon-Kwan;Byun, Park-Jang
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.213-216
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    • 2005
  • Objective: We report six patients with traumatic intracerebellar hematomas between 1997 and 2003 at our hospitals. Methods: Each data about patients' clinicoradiologic findings, management, and outcomes, which were retrospectively reviewed. Results: All patients had skull fracture on occiput and five patients with large hematomas(three cm or greater) were operated on. In the results of surgery, three patients were good outcome but two patients were fatal due to compression of brain stem. One patient with small hematoma (1.5cm) was treated conservatively and recovered. Conclusion: In our cases, the clinical course and prognosis of traumatic intracerebellar hematoma were grave. The results of this study support that early diagnosis based on strict observation in patients with occipital fracture will lead to best results.

The Effectiveness of a Cultural Competence Training Program for Public Health Nurses using Intervention Mapping

  • Kim, Yune Kyong;Lee, Hyeonkyeong
    • Research in Community and Public Health Nursing
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    • v.27 no.4
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    • pp.410-422
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    • 2016
  • Purpose: This study evaluated the effects of a cultural competence training program for public health nurses (PHNs) using intervention mapping. Methods: An embedded mixed method design was used. Forty-one PHNs (experimental: 21, control: 20) and forty marriage migrant women (MMW) (20, in each group) who were provided nursing care by PHN participated in the study. The experimental group was provided with a four-week cultural competence program consisting of an eight hour offline and online course, e-mail newsletters and social networking services (BAND). Transcultural Self-efficacy (TSE) of the PHNs, client-nurse trust, and satisfaction with nursing care of MMW were measured. Ten PHNs in the experimental group were interviewed after the experimental study. Results: The experimental group showed a significantly greater improvement in TSE, client-nurse trust, and satisfaction with nursing care than did the control group. Six themes emerged from qualitative data: (a) Recognizing cultural differences, (b) Being interested in the multicultural policy, (c) Trying to communicate in MMW's own language, (d) Providing medical information using internet and smart phone, (e) Embracing culturally diverse people into society, and (f) Requiring ongoing cultural competence training. Conclusion: Cultural competence training enabled PHNs to provide culturally competent care and contribute to MMW's health outcomes.

The Development of a Communication Model for Teaching-Learning in Culinary Practical Education - A Constructivism Point of View - (조리 실기 교육을 위한 교수-학습 의사 소통 모형 개발 - 구성주의 관점에서 -)

  • Kim, Tae-Hyeong;Na, Jeng-Ki
    • Culinary science and hospitality research
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    • v.14 no.4
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    • pp.14-26
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    • 2008
  • The purpose of this study is to develop a communication model of teaching-learning at culinary practical learning class in school. Statistically, the organizational culture of culinary schools was influenced by the nature of hierarchical culture, task outcomes, and the conservative culture of organizations in companies. First, in basic skill class, teaching and learning methods are based on a teacher who leads students according to his plans and decisions. Second, in a higher skill course, teaching and learning methods are based on students who take an active part by injecting some fresh ideas into their class. Third, the model of three courses for culinary skill development has an effect on processing into a modeling-scaffolding-fading method by teaching and learning in school. It was ascertained that organizational culture directly or indirectly influenced organizational effectiveness and organizational culture in culinary schools. Moreover, it was found that organizational culture was the biggest influencing concept for communication effectiveness between teachers and students.

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Experiences among Undergraduate Nursing Students on High-fidelity Simulation Education: A Focus Group Study (일 대학 간호대학생의 시뮬레이션 교육 경험 분석)

  • Lee, Ju-Hee;Kim, So-Sun;Yeo, Ki-Sun;Cho, Su-Jin;Kim, Hyun-Lye
    • The Journal of Korean Academic Society of Nursing Education
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    • v.15 no.2
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    • pp.183-193
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    • 2009
  • Purpose: The purpose of this study was to explore experiences among undergraduate nursing students in a high-fidelity simulation education course for a semester. Method: The participants in this study were 10 nursing students in the senior classes and volunteers. Data collection was conducted using a focus group interview for 100 minutes, which was recorded on video tape. Transcribed data was analyzed through qualitative content analysis. Result: The results of this study were deduced as 4 codes and 22 themes. Study participants reported experiences due to the simulation method itself, interaction among peer group and personal experiences during high-fidelity simulation education. Additionally, experiences related to clinical application were examined. The participants indicated positive outcomes such as developing clinical judgment skills and confidence. Conclusion: Overall, the results of this study supported the usability and effectiveness of a high-fidelity simulation education method in undergraduate nursing curriculum. Further studies are needed to provide more reliable and valid educational information.