• 제목/요약/키워드: the clinical document

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Keyform Analysis of Rasch Measurement Accessible to Clinicians in Rehabilitation Clinics

  • Choi, Bong-Sam
    • 한국전문물리치료학회지
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    • 제21권2호
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    • pp.74-81
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    • 2014
  • The versions of the Oswestry disability questionnaire (ODQ) is regarded as one of the most extensively used condition-specific instruments measuring disability resulting from low back pain. It has been shown to have adequate psychometrics, reliability, validity, and responsiveness as a whole, yet the summated total score of the instrument often provide little information to rehabilitation clinicians. A keyform analysis based on Rasch measurement model is an innovative way of illustrating the specific test items that an individual may or may not perform. By applying the keyform of the Rasch measurement model to the ODQ, rehabilitation clinicians may able to select more challenging ODQ items matching an individual's ability and document them as attainable treatment goals. The results demonstrated how a keyform analysis assist to setting possible goals for the treatment of individuals with low back pain. Forty-two individuals with low back pain were recruited from rehabilitation clinics in Gainesville, Florida. A series of Rasch analyses on the 10 items of the ODQ were performed using Winsteps software. The performance of two individuals on those 10 items was illustrated on the keyform. The keyform analysis of the Rasch measurement model may be translated into a useful tool for making clinical judgements.

조선 간행 『의학입문』 판본에 대한 서지학적 연구 (A Bibliographic Study on Introduction to Medicine (Euihak-ipmun) in Joseon Dynasty)

  • 박훈평
    • 한국의사학회지
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    • 제30권2호
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    • pp.33-44
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    • 2017
  • Introduction to Medicine (Euihak-Ipmun), written by Lee Chun of the Ming Dynasty, is a comprehensive medical book brought to Joseon in the 1600s. It directly influenced many medical books written in the Joseon Dynasty of the same period, and became a major citation document of Dongui-Bogam. Introduction to Medicine became a major text for medical education in 1834 and has since been used as a clinical primer of Korean medicine. This article first examines the Joseon's era published version of Introduction to Medicine using documentation of the Diary of the Royal Secretariat (Seungjeongwon Ilgi), and a woodblock list. Based on these investigations, the reviewer examined the existing versions of the book, and focused on various characteristics for comparison. This article reveals facts which include : 1) All editions of Introduction to Medicine published at the present office are published by Jeolla-do provincial office (Jeolla-Gamyeong). 2) The first edition was published before 1636. 3) A finely produced version (Jeongganbon) was published around 1760. 4) The Jeongrijache-iron type publication was published around 1801.

Persistent infection with Strongyloides venezuelensis in the Mongolian gerbil (Meriones unguiculatus)

  • Baek, Byeong-Kirl;Whang, In-Soo;Islam, M.-Khyrul;Kim, Byeong-Soo;Kakoma, Ibulaimu
    • Parasites, Hosts and Diseases
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    • 제40권4호
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    • pp.181-186
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    • 2002
  • To examine the fate of Strongyloides venezuelensis, Mongolian gerbils (Meriones unguicalatus) were orally infected with 1,000 $L_{3}$ larvae per animal. Altogether, 50 gerbils divided into 5 groups of 10 each were monitored for a period of 570 days to document the kinetics of faecal egg output, adults worm population, morphological development, fecundity, and hematological changes including peripheral blood eosinophilia. This study chronicled a life long parasitism of S. venezuelensis in the gerbil host, and showed that S. venezuelensis infection was quite stable throughout the course of infection and the worms maintained their normal development as evidenced by their body dimension. A progressive loss of body condition of the infected gerbils was observed as the level of infection advanced. However, no detectable pathological changes were observed in the gastrointestinal tract. The present findings indicate that an immunocompetent host, such as the Mongolian gerbil, can serve as a life long carrier model of S. venezuelensis if the worms are not expelled within 570 days after infection.

이기종간 심전도 판독지 교환을 위한 CDA에 기반한 시스템 설계 및 구현 (The CDA-based System Design and Implementation for the Exchange of ECG Reports Between Heterogeneous Systems)

  • 전명주;이창건;최진욱;김인영;김선일
    • 대한의용생체공학회:의공학회지
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    • 제25권5호
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    • pp.415-419
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    • 2004
  • 의료산업 분야가 정보화되고 원격진료와 같은 네트웍에 기반한 차세대 의료서비스 시대가 가능하게 되면서 병원간의 진료 정보 공유 및 교환이 중요해졌다. 그럼에도 불구하고 대부분의 심전도 장비 업체들은 디지털 장비를 생산하고 자사 장비를 위한 관리 시스템을 제공하고 있지만, 소수의 자사 장비용으로 국한하며 범용적인 표준 ECC 데이터 표준의 부재로 데이터 및 임상 정보의 호환이 불가능한 상태에 놓여있다. 이에 본 연구에서는 심장병학 분야에서 널리 사용되고 있는 심전도 데이터 및 판독지를 전자적으로 교환하기 위해 의료정보 표준의 양대 산맥인 HL7의 CDA와 DICOM을 기반으로 한 심전도 데이터를 획득, 지장, 조회, 전승이 가능한 심전도관리시스템을 설계 및 구현하고자 한다.

정신요법(精神療法)에 대(對)한 동서의학적(東西醫學的) 고찰(考察) (The comparative study on the psychotherapy of oriental and occidental medicine)

  • 하수영;이상룡
    • 혜화의학회지
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    • 제8권2호
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    • pp.341-359
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    • 2000
  • The following result are obtained through that comparative study on the psychotherapy of oriental and occidental medicine. 1. The shamanism(祝由) and active emotion therapy(移精變氣療法) are a primitive form of psychotherapy. It is an opinion that between active emotion therapy(移精變氣療法) and psychoanalytic therapy or supportive psychotherapy are similar. Also, the basic cognition pattern of shamanism(祝由) is projection. 2. Taoism is inseparably related to the psychotherapy of korean oriental medicine, the major thought has become the ideal base of oriental psychotherapy. 3. According to study of clinical document in relation to oriental psychotherapy, psychotherapy had been widely used by medical cure. 4. The five emotion restraint therapy is a high level psychotherapy of oriental medicine. Oriental psychotherapy that disease caused by surprising must be cure by surprising is like to systematic desensitization in western, and that pseudopsychosis must be cure by patient rely on doctor is like to suggestive therapy in western. 5. There are psychotherapy in western that Supportive psychotherapy, Short-term dynamic psychotherapy, Psychoanalytic therapy, Group psychotherapy, Family therapy, Morita therapy, Hypnotherapy, Autogenic training, Behavioral therapy, Milieu therapy, Occupational therapy, Psychodrama, the others. I think that they have wide application to the psychotherapy of korean oriental medicine.

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Shift Work and Health: Current Problems and Preventive Actions

  • Costa, Giovanni
    • Safety and Health at Work
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    • 제1권2호
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    • pp.112-123
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    • 2010
  • The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers' health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

조산사의 기본업무를 위한 핵심능력 개발 (Core Competency of Basic Practice of Nurse-Midwifery)

  • 이경혜;김경원
    • 여성건강간호학회지
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    • 제9권4호
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    • pp.410-421
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    • 2003
  • Purpose : The purpose of this study was to develop core competency of midwife practices to improve midwifery education, national examination and clinical practices. Method: Literature and. document review and internet search and survey were used. 127 registered in the Korean Midwifery Association midwives by structured instrument were surveyed to analyze midwife's practices and work situation. Result : Midwifery education program has to be either a post graduate or a graduate program for people with nursing license. Midwifery practice has to be extended to a lifelong health care of all women including non-pregnant women, not just a health care of pregnant women and newborns. Thus, a primary health care of women, laws/ethics, and management skills were included in the core competencies of midwifery practice considering the international trend of future-oriented and extended role of a midwife. Also, newborn care and ability to cope with emergency situations were emphasized based on the midwife´s opinion. Conclusion: This study has to be developed midwifery practices and education and the standard of midwifery practice has to be stated based on that result.

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뇌혈관질환의 한양방적인 위험요인 규명 및 진단 표준화 연구를 위한 CRF 및 SOP 개발 (Development of CRF and SOPs for the Identification of Risk Factors of the Cerebrovascular Diseases in the East and West Medicine)

  • 고성규;전찬용;박종형;한창호;고호연;윤유식;최선미;김중길;정우상;문상관;김영석;배형섭;조기호
    • 대한한의학회지
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    • 제27권1호
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    • pp.204-219
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    • 2006
  • Objectives : This study is to report the proceeding of the project sponsored by the ministry of science and technology of Korea for the stroke study titled as 'fundamental study for standardization and objectification of differentiation and pattern identification of symptoms of Oriental Medicine in stroke'. Methods and Results : We works for clinical research and molecular epidemiology center and we are in charge of the development of case report form, education of the investigators, data entry, data validation, and analysis. In the process of this project, we need to development of standard operating procedures for development and education for the case report form. Conclusions : This study is to let researchers for Traditional Korean Medicine and clinical research know how to develop of case report form and standard operating procedures in clinical researches and maintain the resource document and data.

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Risk of Breast Cancer and Total Malignancies in Rheumatoid Arthritis Patients Undergoing TNF-α Antagonist Therapy: a Meta-analysis of Randomized Control Trials

  • Liu, Yang;Fan, Wei;Chen, Hao;Yu, Ming-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3403-3410
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    • 2014
  • Context: Interest exits in whether TNF-alpha antagonists increase the risk of breast cancer and total malignancies in patients with rheumatoid arthritis (RA). Objectives: To analyze the risk of malignancies, especially breast cancer, in patients with RA enrolled in randomized control trials (RCTs). Methods: A systematic literature search for RCTs from 1 January 1998 to 1 July 2013 from online databases, such as PubMed, WILEY, EMBASE, ISI web of knowledge and Cochrane Library was conducted. Studies included RCTs that compared the safety of at least one dose of the five TNF-${\alpha}$ antagonists with placebo or methotrexate (MTX) (or TNF-${\alpha}$ antagonists plus MTX vs placebo plus MTX) in RA patients for more than 24 weeks and imported all the references into document management software EndNote${\times}6$. Two independent reviewers selected studies and extracted the data about study design, patients' characteristics and the type, number of all malignancies. Results: 28 RCTs from 34 records with 11,741 patients were analyzed. Of the total, 97 developed at least one malignancy during the double-blind trials, and breast cancer was observed in 17 patients (17.5% of total malignancies). However, there was no statistically significant increased risk observed in either the per protocol (PP) model (OR 0.65, 95%CI [0.22, 1.93]) or the modified intention to treat (mITT) model (OR 0.75, 95%CI [0.25, 2.21]). There were also no significant trend for increased risk of total malignancies on anti-TNF-${\alpha}$ therapy administered at approved doses in either model (OR, 1.06, 95%CI [0.64, 1.75], and OR, 1.30, 95%CI [0.80, 2.14], respectively). As to the two models, modified intention to treat model analysis led to higher estimation than per protocol model analysis. Conclusions: This study did not find a significantly increased risk of breast cancer and total malignancies in adults RA patients treated with TNF-${\alpha}$ antagonists at approved doses. However, it cannot be ignored that more patients developed malignancies with TNF-${\alpha}$ antagonists therapy compared with patients with placebo or MTX, in spite of the lack of statistical significance, so that more strict clinical trials and long-term follow-up are needed, and both mITT and PP analyses should be used in such safety analyses.

검사실 정보 교류를 위한 임상문서표준규격의 적용 (Adoption of CDA(Clinical Document Architecture) for reporting laboratory results)

  • 송준현;김일곤;이성현;도형호;예정훈
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2007년도 한국컴퓨터종합학술대회논문집 Vol.34 No.1 (B)
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    • pp.21-26
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    • 2007
  • HITSP(Healthcare Information Technology Standards Panel)은 헬스 케어 관련 산업의 상호 운용성을 위해 일반적으로 수용되고 유용한 표준들을 선별하여 표준 세트를 제공하는 것을 목적으로 한다. HITSP에서는 평생전자건강진료정보(EHR, Electronic Health Record)의 활성화를 위해 첫 번째 해결해야 할 영역으로 검사실 결과 정보 교류를 정하였다. 이에 본 논문에서는 검사실 결과 정보 교류를 위한 방법으로 HITSP에서 제시하는 HL7 버전 2.x 메시지와 CDA 방법 중 인증(authentication) 처리가 가능하고 영속성(persistence)이 있는 CDA 방법을 선택하였다. 또한 CDA를 작성하고 처리하는 방법을 제시하고, 더 나아가 평생전자건강진료정보(EHR)를 위해 CDA를 적용하여 검사실 결과 정보를 교류하여 보았다. 이에 병원과 EHR 시스템의 상호 운용성이 높아져 진료 과정의 효율성을 높일 수 있었고 환자와 의료진에게 양질의 검사 결과 정보를 제공할 수 있었다.

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