• Title/Summary/Keyword: practice variation

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Development of Severity-Adjustment Model for Length of Stay in Hospital for Percutaneous Coronary Interventions (관상동맥중재술 환자의 재원일수 중증도 보정 모형 개발)

  • Nam, Mun-Hee;Kang, Sung-Hong;Lim, Ji-Hye
    • The Journal of the Korea Contents Association
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    • v.11 no.9
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    • pp.372-383
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    • 2011
  • Our study was carried out to develop the severity-adjustment model for length of stay in hospital for percutaneous coronary interventions so that we would analysis the factors on the variation in length of stay(LOS). The subjects were 1,011 percutaneous coronary interventions inpatients of the Korean National Hospital Discharge In-depth Injury Survey 2004-2006 data. The data were analyzed using t-test and ANOVA and the severity-adjustment model was developed using data mining technique. After yielding the standardized value of the difference between crude and expected length of stay, we analysed the variation of length of stay for percutaneous coronary interventions. There was variation of LOS in regional differences, size of sickbed and insurance type. The variation of length of stay controlling the case mix or severity of illness can be explained the factors of provider. This supply factors in LOS variations should be more studied for individual practice style or patient management practices and healthcare resources or environment. We expect that the severity-adjustment model using administrative databases should be more adapted in other diseases in practical.

Analysis of Performance and Emissions Characteristics on Gasoline Engine for Hybrid Vehicles with Optimum EGR Rate and the Cylinder Variation of EGR Rate (하이브리드용 가솔린 엔진에서 최적 EGR적용 및 실린더간 편차에 따른 성능 및 배출가스 특성 분석)

  • Park, Cheol-Woong;Choi, Young;Kim, Chang-Gi
    • Transactions of the Korean Society of Automotive Engineers
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    • v.17 no.1
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    • pp.87-95
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    • 2009
  • EGR(Exhaust gas recirculation) provides an important contribution in achieving the development targets of low fuel consumption and low exhaust emission levels on gasoline engine for hybrid vehicles while allowing stoichiometric fuelling to be retained for applications using the three-way catalysts. However, the occurrence of excessive cyclic variation with high EGR normally prevents substantial fuel economy improvements from being achieved in practice. Therefore, the optimum EGR rate in gasoline engine for hybrid vehicles should be carefully determined in order to achieve low fuel consumption and low exhaust emission. In this study, 2 liters gasoline engine with E-EGR system was used to investigate the effects of EGR with optimum EGR rate on fuel economy, combustion stability, engine performance and exhaust emissions. As the engine load becomes higher, the optimum EGR rate tends to increase. The increase in engine load and reduction in engine speed make the fuel consumption better. The fuel consumption was improved by maximum 5.5% at low speed, high load operating condition. As the simulated EGR variation on a cylinder is increased, due to the increase in cyclic variation, the fuel consumption and emissions characteristics were deteriorated simultaneously. To achieve combustion stability without a penalty in fuel consumption and emissions, the cylinder-to-cylinder variations must be maintained under 10%.

Variation in the Index of Dental Plaque Removal and Practice Assessment after Instruction on Toothbrushing (칫솔질 교육 후 치면세균막 지수와 수행도의 변화)

  • Kim, Ki-Eun;Ahn, Eunsuk;Han, Ji-Hyoung
    • Journal of dental hygiene science
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    • v.15 no.2
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    • pp.220-225
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    • 2015
  • This study was conducted to examine O'leary index, patient hygiene performance (PHP) index, and toothbrushing practice assessment in subjects of college students in 20s who had been randomly selected. The purpose of this study is to examine if it is easy for rolling method which is recommended by many dental professionals in Korea to implement and to effectively remove dental plaque. Also, the correlations between dental plaque index and toothbrushing practice assessment with the course of time was confirmed, after instruction session on toothbrushing was provided. STATA 11.0 (StataCorp) was used for analysis. There was no significant difference on the three ways of O'leary index, PHP index, and toothbrushing practice assessment in using rolling method, bass technique and toothpick method when comparing the average resulting from first to third instruction session on toothbrushing. O'leary index, PHP index, and toothbrushing practice assessment were inspected with Kruskal-Wallis test which is used for non-parametric statistics. They were checked three times: the first, before the toothbrushing instruction was given; the second, two weeks after the toothbrushing session was given; and the third, 4 weeks after the session. The results are as follows: O'leary index stood at the lowest in the first experiment but showed the highest in the second (p=0.0001). PHP index was the highest level in the first trial and decreased in the second time, but increased again in the last examination (p=0.0001). Toothbrushing practice assessment also showed a similar tendency with PHP index (p=0.0001). In conclusion, rolling method is not the best option for everyone, and it is thought that more various toothbrushing ways need to be reviewed and recommended to people. Also, institutional framework is required for the continuous education on toothbrushing to be in place as the effectiveness of the education is decreased with time.

Knowledge and Management of Tracheal Tube Cuffs Among ICU Nurses in Korea (중환자실 간호사의 기관 내관 기낭관리의 지식과 수행정도)

  • Chang, Sun-Ju;Song, Mi-Soon
    • Korean Journal of Adult Nursing
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    • v.21 no.6
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    • pp.570-579
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    • 2009
  • Purpose: The aim of this research was to determine knowledge and management of tracheal tube cuffs among nurses of ICU. Methods: This descriptive survey recruited 150 nurses working at 8 different adult ICUs within 2 tertiary hospitals in Seoul. A survey questionnaire was developed to measure cuff management. The internal reliability of the tool was examined by Cronbach's ${\alpha}$. Descriptive statistics and multiple regressions were used to analyze data. Results: Among the 150 nurses, 94.0% replied that they would measure the pressure themselves. With regard to nurses' knowledge about tracheal tube cuffs, only 6% answered that they knew 'the appropriate cuff pressure'. The existence of a measuring device (p < .001), a guideline (p < .001), the level of knowledge on its related complications(p = .003), and clinical experience (p < .001) together accounted for 35.0% of the total variation in cuff management. They pointed out that the lack of time and the lack of education were major barriers to appropriate management; whereas education update was the most imperative factor for good management. Conclusion: ICU nurses have inappropriate knowledge and practice in cuff management. Therefore continuing education is necessary for better practice of tracheal tube cuff management.

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Factors Influencing Empathy in Nursing Students in Korea (한국 간호대학생의 공감 능력에 영향을 미치는 요인)

  • Kim, Haejin;Yi, Myungsun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.21 no.2
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    • pp.237-245
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    • 2015
  • Purpose: The purpose of the study was to explore the levels of self-awareness, assertiveness, life stress, and empathy in nursing students and identify influential factors on empathy. Methods: A predictive correlational design was used. The data was collected by questionnaires from a convenience sample of 319 nursing students in 2014 in Korea. The data was analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. Results: The mean items scores of self-awareness, assertiveness, life stress, and empathy were 3.49, 3.02, 2.20 and 3.58, respectively, of a possible score ranging from 1 to 5. Empathy significantly differed by gender, grade, satisfaction with nursing as a major, and clinical practice experience. Empathy was correlated with self-awareness and interpersonal relationship stress. As a result of multiple regression analysis, empathy accounted for 20.1% of the variance by self-awareness, gender, clinical practice experience and interpersonal relationship stress. The most important factor was self-awareness, which explained 11.6% of the variation. Conclusion: The results of the study reveal that strengthening self-awareness and relieving interpersonal relationship stress ought to be integrated in developing effective educational intervention for enhancing empathy in nursing students.

A Practice of Developing New Environment-friendly System by Composites

  • Kim, Yun-Hae;Yang, Dong-Hun;Jo, Young-Dae;An, Seung-Jun;Park, Se-Ho;Yoon, Sung-Won
    • Journal of Engineering Education Research
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    • v.13 no.5
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    • pp.8-14
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    • 2010
  • This study intends to study about the blade performance loss occurred due to the variation in the shape of an airfoil from attachment/non-attachment of an erosion shield for the hovercraft. The model in this study has used NACA44XXseries, has designed NACA44XX-series by using the Auto CAD, and it designed the shape that has attached an erosion shield to this model according to the thickness and length. By using these models, a grid was generated by GAMBIT and the lift coefficient ($C_l$) and the drag coefficient ($C_d$) were calculated FLUENT code for flow analysis. Through this, the $C_l$ and $C_d$ have calculated and compared the lift-to-drag ratio that an indicator of airfoil performance according to the shape and attachment/non-attachment of erosion shield.

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Optimal design of stone columns reinforced soft clay foundation considering design robustness

  • Yu, Yang;Wang, Zhu;Sun, HongYue
    • Geomechanics and Engineering
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    • v.22 no.4
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    • pp.305-318
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    • 2020
  • Stone columns are widely used to treat soft clay ground. Optimizing the design of stone columns based on cost-effectiveness is always an attractive subject in the practice of ground treatment. In this paper, the design of stone columns is optimized using the concept of robust geotechnical design. Standard deviation of failure probability, which is a system response of concern of the stone column-reinforced foundation, is used as a measure of the design robustness due to the uncertainty in the coefficient of variation (COV) of the noise factors in practice. The failure probability of a stone column-reinforced foundation can be readily determined using Monte Carlo simulation (MCS) based on the settlements of the stone column-reinforced foundation, which are evaluated by a deterministic method. A framework based on the concept of robust geotechnical design is proposed for determining the most preferred design of stone columns considering multiple objectives including safety, cost and design robustness. This framework is illustrated with an example, a stone column-reinforced foundation under embankment loading. Based on the outcome of this study, the most preferred design of stone columns is obtained.

Management and Curricular Components of Pharmacy Residency Programs in Korean Hospitals (우리나라 종합병원에서 실시되고 있는 전문약사과정의 운영 및 교육과정 현황)

  • Park, Sun-Young;Choi, Hye-Yoon;Nagaya-Sriraman, Santoshkumar;Yong, Chul-Soon;Yoo, Bong-Kyu
    • YAKHAK HOEJI
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    • v.53 no.4
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    • pp.165-172
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    • 2009
  • Pharmacy residency program in Korea was first implemented in Seoul National University Hospital in 1983 to train hospital pharmacists regarding theories and practice which were not appropriately educated in the colleges of pharmacy. There are currently seven hospitals operating the program in Korea, and all of those are located in Metropolitan Seoul area. Most hospitals administer examination and interview to select competent pharmacists while some other hospitals select those based on paperwork and interview tests. Although the program contents are mostly similar, some variation were identified between the programs. Title conferred after accomplishment of the program has not been officially accredited by educational authority. In June of 2008, Korean Society of Health-System Pharmacists promulgated an internal regulation as an attempt to standardize the program contents and to encourage efficient management of the program. Since the regulation has now been effective, it is expected that the regulation may help clinical pharmacy education in Korea move toward advanced level.

Effects of SULT1A1 Copy Number Variation on Estrogen Concentration and Tamoxifen-Associated Adverse Drug Reactions in Premenopausal Thai Breast Cancer Patients: A Preliminary Study

  • Charoenchokthavee, Wanaporn;Ayudhya, Duangchit Panomvana Na;Sriuranpong, Virote;Areepium, Nutthada
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1851-1855
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    • 2016
  • Tamoxifen is a pharmacological estrogen inhibitor that binds to the estrogen receptor (ER) in breast cells. However, it shows an estrogenic effect in other organs, which causes adverse drug reactions (ADRs). The sulfotransferase 1A1 (SULT1A1) enzyme encoded by the SULT1A1 gene is involved in estrogen metabolism. Previous research has suggested that the SULT1A1 copy number is linked with the plasma estradiol (E2) concentration. Here, a total of 34 premenopausal breast cancer patients, selected from the Thai Tamoxifen (TTAM) Project, were screened for their SULT1A1 copy number, plasma E2 concentration and ADRs. The mean age was $44.3{\pm}11.1years$, and they were subtyped as ER+/progesterone receptor (PR)+ (28 patients), ER+/PR- (5 patients) and ER-/PR- (1 patient). Three patients reported ADRs, which were irregular menstruation (2 patients) and vaginal discharge (1 patient). Most (33) patients had two SULT1A1 copies, with one patient having three copies. The median plasma E2 concentration was 1,575.6 (IQR 865.4) pg/ml. Patients with ADRs had significantly higher plasma E2 concentrations than those patients without ADRs (p = 0.014). The plasma E2 concentration was numerically higher in the patient with three SULT1A1 copies, but this lacked statistical significance.

Evaluation of Usefulness and Fabrication of Femur Phantom on Quality Control of Bone Mineral Density Using 3D Printing Technology (3D 프린팅기술을 이용한 골밀도 정도관리 대퇴골 팬텀 제작 및 유용성 평가)

  • Da-Yeong, Hong;Jeong, Lee;Jun-Ho, Lee;Jae-Won, Mun;Han-Saem, Oh;Yu-Won, Jeong;Seong-Hyun, Jin;Jong-Min, Hong;In-Ja, Lee
    • Journal of radiological science and technology
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    • v.46 no.1
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    • pp.1-8
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    • 2023
  • As the demand for bone mineral density testing increases in Korea, which is close to an aging society, it is necessary to evaluate the repeatability of equipment such as femur phantom other than l-spine for more accurate diagnosis. However, in clinical practice, it is often not possible to proceed such evaluation due to insufficient quality control conditions. Therefore, this study is to evaluate the usefulness of the femur phantom after fabricating the same using 3D printing technology. The femur phantom was output using GlowFill filament and FDM 3D printing type. Each phantom was repeatedly scaned 20 times to compare whether the existing l-spine phantom and the fabricated femur phantom were suitable as a phantom for quality control. Each time the seven researchers took three times, the location of the femur phantom was readjusted, and then scanned to confirm the error between the researchers. As a result of conducting repeatability evaluation using femur phantom, the coefficient of variation rate was 2%, which was within the minimum precision tolerance of 2.5%. The reproducibility between the researcher was also found to be suitable as the average coefficient of variation was 0.031 and the coefficient of variation rate was 3.1%, which was within the minimum precision error range of 5%. In conclusion, it is considered that the prospective attitude and usefulness of the femur phantom fabricated by 3D printing in clinical practice will be sufficient.