Objective : The sub-axial injury classification (SLIC) and severity scale was developed to decide whether to operate the cervical injured patient or not, but the reliability of SLIC and severity scale among the different physicians was not well known. Therefore, we evaluated the reliability of SLIC among a spine surgeon, a resident of neurosurgery and a neuro-radiologist. Methods : In retrograde review in single hospital from 2002 to 2009 years, 75 cases of sub-axial spine injured patients underwent operation. Each case was blindly reviewed for the SLIC and severity scale by 3 different observers by two times with 4 weeks interval with randomly allocated. The compared axis was the injury morphology score, the disco-ligamentous complex score, the neurological status score and total SLIC score; the neurological status score was derived from the review of medical record. The kappa value was used for the statistical analysis. Results : Interobserver agreement of SLIC and severity scale was substantial agreement in the score of injury morphology [intraclass correlation (ICC)=0.603] and total SLIC and severity sacle (ICC value=0.775), but was fair agreement in the disco-ligamentous complex score (ICC value= 0.304). Intraobserver agreements were almost perfect agreement in whole scales with ICC of 0.974 in a spine surgeon, 0.948 in a resident of neurosurgery, and 0.963 in a neuro-radiologist. Conclusion : The SLIC and severity scale is comprehensive and easily applicable tool in spine injured patient. Moreover, it is very useful tool to communicate among spine surgeons, residents of neurosurgery and neuro-radiologists with sufficient reproducibility.
Obstructive sleep apnea syndrome(OSAS) is most frequently diagnosed in the sleep laboratories and its severity is objectively estimated. In terms of treatment, the most prevalent method is the continuous positive airway pressure(CPAP) application as of now. However, in Korea, CPAP is still not sufficiently known and it is attributable to the fact that sleep study facilities have not been popularized. In this article, the authors present their own experience with CPAP in nine subjects with OSAS. In this study, CPAP was found to decrease stage 1 sleep and to increase stage 2 sleep, with increasing mean oxygen saturation and decreasing lowest oxygen saturation during nocturnal sleep. Also, it tended to increase sleep continuity and generally to improve sleep architecture. Rebound slow wave and/or REM sleep stages during CPAP were also noted in 8 out of 9 cases. The authors suggest that CPAP should be considered as the primary mode of treatment for patients with obstructive sleep apnea syndrome and related educational programs for physicians should be developed and provided by sleep specialists.
Visceral leishmaniasis (VL) or kala-azar mainly affects children in endemic areas. This study was conducted to determine the seroprevalence of VL using direct agglutination test (DAT) in children living in rural districts of Alborz Province located 30 km from Tehran capital city of Iran. Multi-stage cluster random sampling was applied. Blood samples were randomly collected from 1,007 children under 10 years of age in the clusters. A total of 37 (3.7%) of the studied population showed anti-Leishmania infantum antibodies with titers of ${\geq}1:800$. There was a significant association between positive sera and various parts of the rural areas of Alborz Province (P<0.002). Two children with anti-Leishmania infantum antibodies titers of ${\geq}1:3,200$ indicated kala-azar clinical features and treated with anti-leishmaniasis drugs in pediatric hospital. The findings of this study indicated that Leishmania infection is prevalent in rural areas of Alborz Province. Therefore, it is necessary to increase the awareness and alertness among physicians and public health managers, particularly in high-risk rural areas of the province in Iran.
Ensuring the confidentiality of patient records is critical requirement for quality of care and in fulfilling legal obligation of healthcare organizations. This study analyzed the behavior of hospital employees who are dealing with confidential patient information in a hospital. Theory of Planned Behavior(TPB) model and TPB expanded models that add habit concept to TPB are tested for the validity in explaining the predisposing factors that affect the behavior of hospital employee in ensuring the confidentiality of patient records. Data were collected by administrating a survey to the 350 employee of a tertiary care hospital. Of the 350 questionaries distributed, 321 were responded resulting 92% of response rate. The mean differences among the groups classified by age, years of experience, gender, and occupation were analysis using ANOVA. The relationships among the concepts suggested in the models were analysed by applying the Structural Equations Modeling method. The results of ANOVA indicated significant mean differences in the frequency of confidentiality ensuing behavior. Administrative staff and medical technicians show higher frequency of ensuing behavior compared to the physicians and the nurses. And more experienced employee show more confidentiality ensuring behavior. The results of Structural Equations analysis showed that the strong effect of habit and attitude in predicting the behavior. However, the effect of perceived behavioral control was not significant. Based on the results the theoretical and practical implications are discussed.
Background: The aim of this study is to illustrate the historical role of the International Commission on Occupational Health (ICOH) congresses as an arena where national and international occupational medicine can dialogue and as the first example of scientific transferability of the research and prevention results that have had such an impact on global public health. Methods: We used the ICOH Heritage Repository, in which ICOH congress proceedings (from the first congress in Milan in 1906 to the last congress, held in Dublin in 2018), are organised in an orderly way, updated and easily accessible according to open access logic. Results: We describe studies by three physicians who submitted significant scientific work to ICOH congresses, one on the battle against ancylostomiasis (Volante, 1906), the second (Quarelli, 1928) on carbon disulphide poisoning, and the third (Viola, 1969) on the carcinogenicity of vinyl chloride monomer. Priority is given to Italian cases, on account of the authors' obvious familiarity with the issues. Conclusion: The visibility offered in ICOH conferences and their published proceedings has boosted the international spread of their findings, contributing to the scientific transferability of the research results and influencing the development of policies and prevention interventions that have had a great impact on global public health.
This literature review explores artificial intelligence (AI) technology trends and IBM Watson health and medical references. This study explains how healthcare will be changed by the evolution of AI technology, and also summarizes key technologies in AI, specifically the technology of IBM Watson. We look at this issue from the perspective of 'information overload,' in that medical literature doubles every three years, with approximately 700,000 new scientific articles being published every year, in addition to the explosion of patient data. Estimates are also forecasting a shortage of oncologists, with the demand expected to grow by 42%. Due to this projected shortage, physicians won't likely be able to explore the best treatment options for patients in clinical trials. This issue can be addressed by the AI Watson motivation to solve healthcare industry issues. In addition, the Watson Oncology solution is reviewed from the end user interface point of view. This study also investigates global company platform business to explain how AI and machine learning technology are expanding in the market with use cases. It emphasizes ecosystem partner business models that can support startup and venture businesses including healthcare models. Finally, we identify a need for healthcare company partnerships to be reviewed from the aspect of solution transformation. AI and Watson will change a lot in the healthcare business. This study addresses what we need to prepare for AI, Cognitive Era those are understanding of AI innovation, Cloud Platform business, the importance of data sets, and needs for further enhancement in our knowledge base.
Purposes: Patient experience is a tool to evaluate the process and results of medical services provided by medical institutions from the patient's point of view. Patient satisfaction surveys are a meaningful and essential source of information for improving quality in healthcare organizations. This study aims to provide basic data for improving the quality of medical service that patients can feel by analyzing the recommendation intention and satisfaction of inpatients in specialty hospitals. Methodology: The subjects of this study were 879 inpatients in 28 specialty hospitals in 14 designated fields. We conducted a telephone survey with a structured questionnaire on the satisfaction and recommendation intention for specialty hospitals. Findings: In inpatients, hospital satisfaction was higher in nursing care services and hospital satisfaction was low in physicians care services. The overall patient satisfaction score was 91.4(SD=11.9) out of 100, and the intention of recommendation was 92.0(SD=14.1) out of 100. The factors affecting patient experience were designated fields, sex, age, residential area, monthly household income, and perceived health status. Practical Implications: This study confirmed the high level of patient satisfaction and recommendation intention among inpatients of specialty hospitals. Patient satisfaction can be of great value to healthcare providers in recognizing and improving the quality of care, as well as predicting patients' willingness to revisit medical institutions. This study can be used to improve the quality of hospital care services in specialty hospitals rather than general and tertiary general hospitals.
Background: Organizational changes that involve healthcare hospital departments and care services of health districts, and ongoing technological innovations and developments in society increasingly expose healthcare workers (HCWs) to work-related stress (WRS). Minimizing occupational exposure to stress requires effective risk stress assessment and management programs. Methods: The authors conducted an integrated analysis of stress sentinel indicators, an integrated analysis of objective stress factors of occupational context and content areas, and an integrated analysis between nurses and physicians of hospital departments and care services of health districts in accordance with a multidimensional validated tool developed in Italy by the National Network for the Prevention of Work-Related Psychosocial Disorders. The purpose of this retrospective observational study was to detect and analyze in different work settings the level of WRS resulting from organizational changes implemented by hospital healthcare departments and care services of health districts in a sample of their employees. Results: The findings of the study showed that hospital HCWs seemed to incur a medium level risk of WRS that was principally the result of work context factors. The implementation of improvement interventions focused on team development, safety training programs, and adopting an ethics code for HCWs, and it effectively and significantly reduced the level of WRS risk in the workplace. Conclusion: In this study HCW resulted to be exposed to occupational stress factors susceptible to reduction. Stress management programs aimed to improve work context factors associated with occupational stress are required to minimize the impact of WRS on workers.
Objective: The purpose of this study was to investigate the musculoskeletal diseases (MSDs) that occur in heavy industrial workers according to the occupational category, prevalence, environment, and number of physical therapy visits. Design: Retrospective cohort study. Methods: For this study, data was collected of workers who were engaged in heavy industry in Korea and who visited the company physicians and received physical therapy in 2016. Data was collected from 855 subjects and was analyzed. With the data collected, analysis of the type and prevalence of MSDs and the number of physical therapy visits that have occurred according to the occupational category and environment was performed. Results: The most common MSDs were lumbar sprains and spasms (31.1%), and shoulder sprain and spasm (19.4%). In addition, the most common type of MSDs according to the occupational category and environment (occupational type) were lumbar sprain and spasms in 11 occupations, including white collar workers, and in milling, inspection, crane operation, and finishing jobs, shoulder muscle sprain and strain were the most common disorders. Also, the prevalence of MSDs according to occupational category and environment (occupational type) was the highest in workers involved with welding, which was 29.7%. Conclusions: Through this study, the type and prevalence of MSDs according to the occupational category and environment of heavy industrial workers have been confirmed. Further studies are necessary to study the future types of the work patterns of industrial workers and to develop a system for preventing and managing MSDs that may occur.
This study purports to investigate the readiness of the university hospital employees in the knowledge-based management. Data were collected from 550 employees including administrative, nursing, and technical staff of 9 university hospitals located in Seoul and Kyunggi Province through the self-administered questionnaires. The response rate was 79% and 425 questionnaires were used as final data and analyzed using 2 test, t-test, and ANOVA. The main findings of the study are as follows. 1) It seems that most employees of the study hospitals have basic knowledge on the concept of knowledge-based management. This finding implies that the implementation of the knowledge-based management in Korean university hospitals will not likely to face strong resistance from their employees. 2) The results show that Korean hospital employees are still not so accustomed to using e-mail as the main communication tool. This finding suggests that it is necessary to use various communication tools which include electronic data interchange, teleconference, and cyber chatting for facilitating the knowledge-based management in Korean university hospitals. 3) It is desirable to appoint a chief knowledge officer(CKO) for operating knowledge-based management system effectively. 4) A reward system for employees who show a distinguished performance in the creation and sharing of new knowledge should be established. Knowledge mileage system, selection of the best knowledge employee and team will be a good example of the effective reward system. 5) The participation and support from the chief executive officers (CEO) of the hospitals is an important factor for successful knowledge-based management. Furthermore, to make physicians actively participate in the knowledge-based management is another important factor for obtaining valuable outputs from the system. 6) It is found that the knowledge and skills of the hospitals employees on the information technology (IT) are not sufficient for making knowledge-based management more popular. This implies that it is very important to select IT-oriented employees and educate them continuously on the knowledge-based management.
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