Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.
Purpose: The objective of this study was to identify functional problems, including walking ability, of patients with strokes using the International Classification of Functioning, Disability, and Health (ICF) and to present a method that could solve functional problems, thereby determining the applicability of the ICF to increase the quality of evaluation and intervention in clinical fields in the future. Methods: Information on stroke patients who were admitted and treated in a hospital was collected. The authors conducted evaluations, interventions, and measurements of the results of the ICF tool in order to improve gait abilities of patients. The subjects were trained using proprioceptive neuromuscular facilitation (PNF) one hour a day and five times a week for four weeks. The result measurement variables were a six-minute gait test, 10 m velocity test, gait instability test, and measurements using the ICF sheet. Results: In the six-minute gait test, gait distance increased by 48 m, from 102 m to 150 m. The gait velocity test result showed an improvement from 0.36m/s to 0.44m/s. The subjects performed a gait instabilitytestwithacupfilledwith50mmwater. In the gait instability test, the amount of water was 38 mm before the intervention; however, it was 50 mm after the intervention. The gait velocity with a cup filled with water improved from 0.25m/s to 0.31m/s. Conclusion: An evaluation and intervention were designed with the ICF tool for stroke patients. Gait abilities improved when the PNF technique was used. The IFC method can be used for evaluation and intervention, and it could help improve gait abilities of stroke patients.
Background : Quality of professional nursing care is the most essential factor for survival and growth of nursing profession. Then, nursing professionals have responsibility for the evaluation of quality of professional nursing care. The purpose of this study was to develope an evaluation tool of nursing care for patients received gastrointestinal surgery with general anesthesia. This study was a primary work for the developement of a computer program for the evaluation of nursing care. Methods : This study was done through some consecutive steps. They were (1) Developement of items for the tool (2) Developement of an evaluation tool of nursing care quality for the G-I surgery patient (3) Test of reliability and validity of the tool. Two groups of experts and expert pannels who had much experience of the QA and the care of G-I surgery patients participated for developement of the items. 85 nursing records were used for the test of reliability and validity of the developed tool. The evaluation tools were developed with two types of scoring, norm-referenced tool and criterion-referenced tool. Results The system of items for tool was evaluation area evaluation item-indicator. There were 7evaluation areas which contained 32evaluation items which contained 7lindicators. Evaluation areas 1, 2, 3, 4 were for the evaluation of process and 5, 6, 7 were for the evaluation of outcome of nursing care for G-I surgery patient. For the test of interrator reliability, correlation coefficients of each scores of items and intragroup correlation coefficients were calculated. The average correlation coefficients between two rators were 0.65, 0.54 and the intragroup correlation coefficient were 0.99 and 1.00 by the types of scoring. The Cronbach alpha coefficients of the tools were 0.54 and 0.46 by the types of scoring. The average content validity index of the items was 0.95 from 4 pairs of experts. Because there were significant differences between some scores of quality of nursing care of 3 general hospitals regardless of the types of scoring, the tools could be thought to have some construct validity. And also, there were significant correlations between some scores of quality of nursing care and admission days and admission days after surgery regardless of the types of scoring, the tools could be thought to have predictive validity. Conclusion In this study, the evaluation tool of nursing care was developed for the very specified group of patient, G-I surgery patient. And the items were developed and tested by the experts of nursing practice. Because of these reasons, it was supposed that the tool could be used effectively in nursing pratice. And the procedures for the development and the test of the evaluation tool of nursing care in this study were supposed to be used for the developement of other tools.
In this article, we introduce a practical case study of the structural design improvement for a vertical machining center. During test operations, it have experienced excessive deflections and vibrations due to the fluctuating forces generated by the ball-screw thrust motor. At first we did investigate where and how much deflections and vibrations had been brought about on it. Next we made some possible structural design alternatives. It is a matter of course to compare finite element static and dynamic analysis results of both the original design and alternatives. Fortunately we have been able to find out a good one among those alternatives.
The ion implantation technology is generally used in order to improve surface mechanical properties, especially tribological properties, of engineering metals. In this study, experimental works were carried out to investigate the surface properties, such as hardness, wear quantity, wear rate and friction force, of a nitrogen ion implanted tool steel STD11 under dry condition. Specimens for the wear test were made to investigate the influences of the initial ion implantation temperature and the total ion radiation. Wear properties, such as the wear quantity and the wear rate, of the nitrogen ion implanted tool steel were considerably improved, especially under the low sliding speed and the low applied load.
Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.
Purpose: The purpose of this study was to identify effects of self-evaluation using smartphone recording on competency in nursing skills, satisfaction and learning motivations in nursing students'. The setting was the open laboratory hours. Methods: A quasi-experimental pre/post-test design was conducted in September 2015. The participants were 82 sophomore nursing students from one University. The experimental group did self-evaluation by watching recorded video clips of their performance. The control group did not have any self-evaluation. The primary outcomes were scores from the foley catheterization checklist, scores from a student satisfaction tool, and scores from a learning motivation tool. Data were analyzed using ${\chi}^2$ test, Fisher's exact test, independent t-test, and paired t-test. Results: There was a significant higher mean score in levels of satisfaction by students in the experimental group compared to the control group (t=2.26, p=.027). In addition, improvement in communication skills by the experimental group was significantly higher than improvement in the control group (t=3.96, p<.001). Conclusion: Findings show that self-evaluation using smartphone recordings has positive effects on increasing both communication skills and satisfaction with practice during open laboratory hours. These results indicate that, self-evaluation using smartphone recording is useful as a supplement to traditional open laboratory education.
According to the development of tool material and the improvement of machinability of cutting material like aluminium alloy, the higher spindle speed is needed. However, the higher speed causes the heat generation of bearings, the deformation of spindle unit parts, and the rotational accuracy of spindle to be worse. Therefore, it is essential to analyze and control the heat generation and the thermal behavior of spindle unit in order to have higher speed and better rotational accuracy. This paper shows the analogy between the analyzation of heat generation and thermal behavior of high speed spindle system by finite element method and the test results of actual temperature rise through running test, and shows the necessity of cooling the spindle and inner ring side of bearings for the thermal balance of high speed spindle system.
A study for the roundness of machining center is classified into two ways. one is the way that progresses the roundness amending the parameter of machining center based on the measured value after the measurement of the roundness of machining center by means of a existing measuring device, another is the way that measures the roundness by remodeling the existing measuring device. The former is studied by pack hei jae team in Seoul university, the latter is studied by TSUTSUMI. Especially TSUTSUMI measures the roundness according to circular compensation after the insertion of developed measuring desire using a rotary encoder to the spindle of machining tool. We study how regulation velocity occuring with circular motion of machining center table influences the roundness after measuring the roundness using Circular Test method by a 2 dimention probe and a standard discus in this experiment.
Objective: The aim of this study was to perform a usability test for CPAD (Cognitive Perceptual Assessment for Driving) and improve it based on the test results. Background: The cognitive perceptual assessment for driving is a computer-based assessment tool to assess the driving capacity of people with brain-damages. It may be a good tool for evaluating the brain-damaged drivers' safe driving capabilities and screening cognitive and perceptual deficits related to driving. We performed a usability test to improve the CPAD based on the result. Method: Both the software consisting of 8 sub-tests (depth perception, sustained attention, divided attention, stroop test, field dependency, digit span, trail making A, trail making B) and the hardware including the input and output devices ( joystick, mouse, keyboard, touch screen) were evaluated through user interviews. Also we identified the problems and issues in using them by observing the participants performing the CPAD tasks. Results: Based on the results, the task instructions were visually and auditorily improved and more practice examples were added to help the users understand the instructions better and increase the input accuracy, a response time window was added and the joystick and touch screen were simplified, which made it easier for the user to perform the CAPD tasks. Conclusion: User discomforts were minimized by improving the task environment, unless it had affected the evaluation criteria. Application: We plan to distribute the improved version of the CPAD to the regional rehabilitation hospitals, and the driving support centers for people with disabilities throughout the country, so it could be used as an evaluation tool for disabled drivers' cognitive and perceptual functions.
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