• Title/Summary/Keyword: course outcomes

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Rationale, Design, and Interim Observations of the Steady Movement With Innovating Leadership for Heart Failure (SMILE HF) Registry: A Multicenter Prospective Cohort Registry for Patients With Acute Heart Failure

  • Jah Yeon Choi;Mi-Na Kim;Seongwoo Han;Sunki Lee;Myung Soo Park;Min Gyu Kong;Sung-Hea Kim;Yong-Hyun Kim;Sang-Ho Jo;Sungeun Kim;Seonghoon Choi;Jinsung Jeon;Jieun Lee;Byambakhand Battumur;Seong-Mi Park;Eung Ju Kim;SMILE HF Investigators
    • International Journal of Heart Failure
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    • v.6 no.3
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    • pp.129-136
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    • 2024
  • Background and Objectives: Heart failure (HF) is a leading cause of hospitalization and death worldwide. The Steady Movement with Innovating Leadership for Heart Failure (SMILE HF) aims to evaluate the clinical characteristics, management, hospital course, and long-term outcomes of patients hospitalized for acute HF in South Korea. Methods: This prospective, observational multicenter cohort study was conducted on consecutive patients hospitalized for acute HF in nine university hospitals since September 2019. Enrolment of 2000 patients should be completed in 2024, and follow-up is planned through 2025. Results: Interim analysis of 1,052 consecutive patients was performed to understand the baseline characteristics. The mean age was 69±15 years; 57.6% were male. The mean left ventricular ejection fraction was 39±15%. The prevalences of HF with reduced ejection fraction, HF with mildly reduced ejection fraction, and HF with preserved ejection fraction were 50.9%, 15.3%, and 29.2%. Ischemic cardiomyopathy (CMP) was the most common etiology (32%), followed by tachycardia-induced CMP (12.8%) and idiopathic dilated CMP (9.5%). The prescription rate of angiotensin-converting enzyme inhibitor/angiotensin receptor blockers/angiotensin receptor/neprilysin inhibitor, beta-blockers, spironolactone, and sodium-glucose cotransporter-2 inhibitors at discharge were 76.8%, 66.5%, 50.0%, and 17.5%, respectively. The post-discharge 90-day mortality and readmission rates due to HF aggravation were 2.0% and 6.4%, respectively. Our analysis reveals the current state of acute HF in South Korea. Conclusions: Our interim analysis provides valuable insights into the clinical characteristics, management, and early outcomes of acute HF patients in South Korea, highlighting the current state and treatment patterns in this population.

Clinicopathologic Changes of IgA Nephropathy in Children During Long-term (average 10.8 yrs) Follow-up (소아 IgA 신병증의 장기 추적(평균 10.8년)에 따른 임상 경과 및 병리학적 변화)

  • Moon, Chang-Min;Kim, Pyung-Kil;Lim, Beom-Jin;Song, Ji-Sun;Jeong, Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.154-165
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    • 2010
  • Purpose : We know little about the natural course of IgA nephropathy (IgAN) in association with histologic changes especially in children. We investigated clinicopathologic features with long-term follow-up biopsy to clarify the outcomes and prognostic indicators for childhood IgAN. Methods : From our patients' medical records, we retrieved 20 patients with IgAN, to whom renal biopsies had been performed for the initial diagnosis and follow-up to find out any histologic changes. Initial and follow-up biopsies were classified by Haas classification. The changes of these parameters were compared with the evolution of clinical features. Results : Patients were treated with angiotensin-converting enzyme inhibitors in combination with angiotensin receptor blockers (in subclass II or above) and short-term cyclosporine A(in patients showing nephrotic syndrome). Histologic improvement in 7 cases and deterioration in 3 cases were observed. At the time of last biopsy, 10 cases (50%) showed clinical remission and the others showed improved clinical features. These clinical outcomes did not correlate with initial Haas classifications. Hypertension at onset observed in 5 cases (25%) revealed significant correlation with clinical outcome (P =0.01) and last Haas classification (P =0.007). None of the cases showed progression to CRF or ESRD. Conclusion : During a mean follow-up of $10.8{\pm}3.4$ years, childhood IgAN showed good clinicopathologic outcome. Hypertension at onset was only a strong predictor of clinicopathologic outcomes, but initial Haas classification cannot predict outcomes in children. Histologic change of IgAN in long term follow-up period cannot be completely predicted by clinical data and vice versa. Therefore, a renal biopsy should be considered as a part of follow-up plan.

Intravitreal Anti-vascular Endothelial Growth Factor Injections to Treat Neovascular Age-related Macular Degeneration: Long-term Treatment Outcomes (삼출 나이관련황반변성에 대한 항혈관내피성장인자 유리체내주사 치료의 장기 임상 결과)

  • Park, Yu Jeong;Son, Gi Sung;Kim, Yoon Jeon;Kim, June-Gone;Yoon, Young Hee;Lee, Joo Yong
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1142-1151
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    • 2018
  • Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.

Stakeholders' Opinion on the Desired Characteristics of Nursing School Graduates and Factors Concerning Nursing Curriculum Development in Thailand

  • Kittiboonthawal, Prapai;Siriwanij, Wareewan;Ubolwan, Kanyarat;Maneechot, Munthana
    • Asian Journal for Public Opinion Research
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    • v.5 no.4
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    • pp.319-345
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    • 2018
  • Effective higher educational management in undergraduate nursing programs is an important issue from the viewpoint of stakeholders. This qualitative research aimed to examine the characteristics of nursing students and curriculum development of undergraduate nursing education from the opinions of Boromarajonani College of Nursing Saraburi, Thailand stakeholders. The population included 4 groups: 1) the alumni who have graduated within the past 5 years and currently work in primary, secondary, and tertiary care units, 2) the supervisors and colleagues of the alumni, 3) nursing lecturers, and 4) the current nursing students. The respondents who are the alumni, nursing lecturers, and current nursing student were selected using a purposive sampling, for the supervisors and colleagues were selected using snowball techniques. Semi-structured interview questions were used for data collection. Group discussions were conducted until saturation on 55 key informants. The qualitative data was analyzed using content analysis. Results showed the viewpoints of stakeholders on the characteristics of future nurse graduates were comprised of four elements: knowledge that meets standards; essential skills for self-development and lifelong learning process; good morals and professional ethics in providing nursing care; and nurse competencies in teamwork, communication, language, research, management, IT, life skills, and global literacy. The viewpoints on the development of the nursing curriculum focus on four elements: the learner, teaching and learning, course content, and instructor tasks. For learners, the admission criteria should include a minimum not only of knowledge, but also positive attitude, science, and art skills, since the nursing profession is both a science and the art of caring. Teaching and learning elements should be authentic, including exposure to real situations, an integrated network, and activities that improve nursing care. Course content was comprised of an updated curriculum, humanized nursing care, student center, theory and practice with moral integration, case-based study, critical thinking, multidisciplinary work, and love for the nursing profession. Instructor tasks are to elicit student ideas, provide opportunities to learn, support infrastructure, support technology use, and extra-curricular activities to develop the competencies of nursing students. Recommendations were that the curriculum administration should review the selection process of student candidates and instructional management to achieve expected outcomes of nursing characteristics in the future. The nurse lecturer should provide authentic and integrated instruction, decrease lecturing, cultivate a lifelong learning process, and sustain the nursing characteristics.

A Study On The Current State And Argument Over the Accreditation of Engineering Education In Japan (일본의 기술자교육인정평가의 실제와 문제점에 관한 연구)

  • Shin, Dong-Eun;Choi, Keum-Jin;Im, Seung-Soon
    • Journal of Engineering Education Research
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    • v.14 no.1
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    • pp.20-31
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    • 2011
  • This study was conducted to get the significant implications for the accreditation of engineering education in Korea from the case of Japan. We researched the terminology of 'accreditation', the outline, the current progress, and argument over the accreditation of engineering education in Japan. We suggested the seven implications for ABEEK. First, ABEEK has to use the engineering societies more in assessing the programs. Second, ABEEK should be flexible to meet the original goals. Third, ABEEK can use the observer system to train the examiners. Fourth, ABEEK needs to provide the real benefits to the students and accredited programs to encourage them to finish the accredited course. Fifth, the programs need to organize the committes in the direction that every faculty member can share the assessment results and execute the real course improvement. Sixth, ABEEK should permit the programs to use the curricular courses to check the achievement of program outcomes. And seventh, ABEEK needs to have meta-evaluation to exercise the reasonable authority.

The raise the efficiency of game graphics design education using game engine : In focus of Unity3D and Torque (게임엔진 활용으로 게임 그래픽 교육 효율성 제고: 유니티3D(Unity3D)와 토크(Torque) 엔진을 중심으로)

  • Kim, Chee-Hoon;Park, Sung-Il
    • Cartoon and Animation Studies
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    • s.29
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    • pp.151-172
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    • 2012
  • Game production education in a university is very important because it is the stage for completing a game education course as well as for determining a future of game industry. In order to perform various experience and creative learning, it should be able to effectively use a computer infrastructure representing the knowledge and information society for the purpose of obtaining and re-processing information necessary for game production through prediction of directions of game industry as well information technology. This research is focused on an effective game engine education for students whom want to become game graphics designers. The purpose of this study is to draw a lesson of game production utilizing game engines and it enables practice-focused class for game production. It also allows the class participant to manufacture prototypes without support from game programmers for their outcomes of works planned during the game production class. The theoretical background of game production compared and analyzed exemplary game engines. Based on the result, the study selected Unity 3D engine and conducted the research on the background where the Unity engine has been selected and its characteristics. In addition, this study provided an example of game production utilizing a game engine, and also described the details of actual realization. This study selected Torque3D with the Unity in order to identify the purpose of this study and efficiency of learning. Thus, the previous situation is that the class remained in making a game plan during the course of game production project and, students whose major is not game programming. Now, it is necessary for students to make many efforts to make a game in an active and positive attitude by utilizing a game engine beyond the previous method of class.

The Use of the Movie 'The Island' for Nursing Informatics in Nursing Students (간호정보학 이해를 위한 영화 'The Island' 활용)

  • Oh, Jina;Shin, Hyewon;De Gagne, Jennie C.
    • The Journal of the Korea Contents Association
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    • v.15 no.4
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    • pp.330-341
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    • 2015
  • The purpose of this study was to examine the effect of the film 'The Island' on 2nd year nursing students' nursing informatics (NI) competency. The participants were sixty-eight students in a baccalaureate nursing program of a private university, taking the course, 'Nursing & Informatics' in the 2012 fall semester. Over the 15 weeks, the film was used for five weeks as introduction to NI, peer-to-group discussions, and self-reflection on lessons learned regarding NI. A qualitative content analysis was used to explore the students' experiences and perceptions on their NI competency. As a result, students signified the NI concept as the assessment of biometrics data, promotion of optimal health with the support of various technologies, and integration of patient-centered care into routine practice. They also highlighted the importance of security and safety measures as well as high quality health technology including the ubiquitous health monitoring system. Overall, the lesson outcomes of the course were met. As a supportive, instructional strategy, the use of the movie, 'The Island', was effective for nursing students in achieving NI competencies. Further study is warranted to determine if movies can be used as a means of continuing education to improve informatics competences in healthcare professionals.

Clinical Features and Outcomes of Pelvic Insufficiency Fractures (골반 부전 골절의 임상 양상과 치료 결과)

  • Seo, Yong Min;Kim, Young Chang;Kim, Ji Wan
    • Journal of the Korean Fracture Society
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    • v.30 no.4
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    • pp.186-191
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    • 2017
  • Purpose: The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population. Materials and Methods: At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture. Results: A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability. Conclusion: We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

Evaluation of Project-Based Learning on Community Dental Hygiene Practice Education (지역사회치위생학 실습 교육에서의 프로젝트 기반 학습 효과 평가)

  • Yoo, Sang-Hee;Bae, Soo-Myoung;Shin, Bo-Mi;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.368-374
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    • 2017
  • The purpose of this study was to evaluate community dental hygiene practice education, by verifying its effect after applying project-based learning in improving the practical and social skills of learners. A 15-week project-based community dental hygiene practice course was held for 27 senior students, who took community dental hygiene practice course in the Department of Dental Hygiene, Gangneung-Wonju National University. Twenty-seven students were composed of 4 teams. Each team selected a target group for four workplaces for adult workers to apply the oral health promotion project. The project was then planned and conducted based on a survey on the health problems confronting each group, and an evaluation was carried out after 4 weeks. From the results obtained in comparing confidence in problem solving ability, project value, teamwork competency, and community dental hygienist competence before and after course, the improvement in project value and teamwork competence scores was not statistically significant, but all four areas showed positive results. After analyzing the project actuality, learning outcomes, and project satisfaction after course results, the actuality of the project was 19.30 points, the learning achievement was 45.19 points, and the satisfaction was 19.19 points, demonstrating that the aim of achieving actual performance competence and a learning performance exceeding expectations was accomplished. After conducting an interview survey with 8 students, it was found that they had learned social skills involving problem-solving abilities and confidence, and teamwork competence such as cooperation, role responsibility, creative thinking ability, and communication skills. Community dental hygienists should be able to acquire learner-level practical skills and social skills in the community dental hygiene and practical courses, according to their competencies and job needs. It is necessary to develop a project?based systematic learning module to enable the community dental hygiene practice to operate as a subject closely related to fields in other dental hygiene departments.

Forehead Osteoma Excision by Anterior Hairline Incision with Subcutaneous Dissection

  • Kim, Jun Sik;Lee, Jeong Hwan;Kim, Nam Gyun;Lee, Kyung Suk
    • Archives of Craniofacial Surgery
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    • v.17 no.1
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    • pp.39-42
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    • 2016
  • Forehead osteomas are benign but can pose aesthetic and functional problems. These osteomas are resected via bicoronal or endoscopic approach. However, large osteomas cannot be removed via endoscopic approach, and bicoronal approach can result in damage to the supraorbital nerve with resultant numbness in the forehead. We present a new approach to resection of forehead osteomas, with access provided by an anterior hairline incision and subcutaneous dissection. Three patients underwent resection of the forehead osteoma through an anterior hairline incision. The dissection was carried in the subcutaneous plane, and the frontalis muscle and periosteum were divided parallel to the course of supraorbital nerve. The resulting bony defect was re-contoured using $Medpor^{(R)}$. All three patients recovered without any postoperative infection or complication and symptoms. Scalp sensory was preserved. Aesthetic outcomes were satisfactory. Patients remain free of recurrence for 12 months of follow up. The anterior hair line approach with subcutaneous dissection is an effective method for removal of forehead osteoma, since it offers broad visualization and hides the scar in the hairline. In addition, the dissection in the subcutaneous plane avoids inadvertent injury to the deep nerve branches and helps to maintains scalp sensation.