• KSII Transactions on Internet and Information Systems (TIIS)
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• 제17권8호
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• pp.2016-2029
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• 2023

Accurate prediction of critical illness is significant for ensuring the lives and health of patients. The selection of indicators affects the real-time capability and accuracy of the prediction for critical illness. However, the diversity and complexity of these indicators make it difficult to find potential connections between them and critical illnesses. For the first time, this study proposes an indicator analysis model to extract key indicators from the preoperative and intraoperative clinical indicators and laboratory results of critical illnesses. In this study, preoperative and intraoperative data of heart failure and respiratory failure are used to verify the model. The proposed model processes the datum and extracts key indicators through four parts. To test the effectiveness of the proposed model, the key indicators are used to predict the two critical illnesses. The classifiers used in the prediction are light gradient boosting machine (LightGBM) and eXtreme Gradient Boosting (XGBoost). The predictive performance using key indicators is better than that using all indicators. In the prediction of heart failure, LightGBM and XGBoost have sensitivities of 0.889 and 0.892, and specificities of 0.939 and 0.937, respectively. For respiratory failure, LightGBM and XGBoost have sensitivities of 0.709 and 0.689, and specificity of 0.936 and 0.940, respectively. The proposed model can effectively analyze the correlation between indicators and postoperative critical illness. The analytical results make it possible to find the key indicators for postoperative critical illnesses. This model is meaningful to assist doctors in extracting key indicators in time and improving the reliability and efficiency of prediction.

• Journal of Yeungnam Medical Science
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• 제38권1호
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• pp.27-33
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• 2021

The gut is a complex organ that has played an important role in digestion, absorption, endocrine functions, and immunity. The gut mucosal barriers consist of the immunologic barrier and nonimmunologic barrier. During critical illnesses, the gut is susceptible to injury due to the induction of intestinal hyperpermeability. Gut hyperpermeability and barrier dysfunction may lead to systemic inflammatory response syndrome. Additionally, gut microbiota are altered during critical illnesses. The etiology of such microbiome alterations in critical illnesses is multifactorial. The interaction or systemic host defense modulation between distant organs and the gut microbiome is increasingly studied in disease research. No treatment modality exists to significantly enhance the gut epithelial integrity, permeability, or mucus layer in critically ill patients. However, multiple helpful approaches including clinical and preclinical strategies exist. Enteral nutrition is associated with an increased mucosal barrier in animal and human studies. The trophic effects of enteral nutrition might help to maintain the intestinal physiology, prevent atrophy of gut villi, reduce intestinal permeability, and protect against ischemia-reperfusion injury. The microbiome approach such as the use of probiotics, fecal microbial transplantation, and selective decontamination of the digestive tract has been suggested. However, its evidence does not have a high quality. To promote rapid hypertrophy of the small bowel, various factors have been reported, including the epidermal growth factor, membrane permeant inhibitor of myosin light chain kinase, mucus surrogate, pharmacologic vagus nerve agonist, immune-enhancing diet, and glucagon-like peptide-2 as preclinical strategies. However, the evidence remains unclear.

• 품질경영학회지
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• 제51권4호
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• pp.531-550
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• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• 한국학교ㆍ지역보건교육학회지
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• 제2권1호
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• pp.19-30
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• 2001

Korea has experiencing outbreaks of food borne illnesses since school feeding programs had been introduced to students. In order to prevent food borne diseases, preventive measures applicable to Korean school system were reviewed. The conclusions are summarized as follows; 1. Raw materials should be purchased through reliable sources in order to ensure the quality of food stuffs in the aspect of food safety and hygiene. 2. The potential causes of food borne illnesses should be carefully identified and control system should be established in order to monitor critical points. 3. Temperature of refrigeration should be monitored and controled continuously in order to safeguard the quality of foods. 4. National and local governments have to provide adequate equipment and utensils to the food establishments of school systems, and public health authorities have to make evaluation of the facilities periodically. The food handlers should be trained in safe food handling and the ways how to prevent food borne illnesses.

• 중환자간호학회지
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• 제12권2호
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• pp.1-12
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• 2019

Purpose : The purpose of this study was to validate the Korean version of Partners In Health scale (PIH-K) which is used to measure the self-management of patients with chronic illnesses in Korea. Methods : Translation of the 12-item PIH-K was conducted according to the World Health Organization guidelines. Data from 306 participants who took medicines over 3 months by doctor's prescription were collected from October to November 2017. Validity such as content validity, construct validity, and concurrent validity were conducted using content validity index (CVI), exploratory and confirmatory factor analyses (CFA). To evaluate concurrent validity, the correlation coefficients between the PIH-K and concurrent scales (Self-As-Carer Inventory) were calculated. The reliability of the PIH-K was examined using the internal consistency and test-retest reliability tests. Results : The CVI of the PIH-K was 0.91. According to the CFA, factor loadings for four factors ranged from .64 to .97, which explained 67.5% of the total variance. The PIH-K was significantly correlated with concurrent variables such as those on the Self-As-Carer Inventory. The Cronbach's ${\alpha}$ was .86 and the intraclass correlation coefficient for the two-week test-retest reliability was .88. Conclusion : Findings show that the PIH-K is reliable and valid in measuring self-management of patients with chronic illnesses.

• 대한신경집중치료학회지
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• 제11권2호
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• pp.63-70
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• 2018

Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

• 식품보건융합연구
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• 제5권1호
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• pp.1-11
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• 2019

Smoking has become one of the public health harzard affecting the world. In the UK, smoking is responsible for around one in five deaths. The illnesses caused by smoking extend beyond the well-reported links with cancer, heart disease and respiratory illnesses. Hence the research to determine the awareness of the predisposing factor to smoking among adults in sokoto metropolis. A cross-sectional form of descriptive survey research design was used for this study. This is because descriptive studies are used when the characteristics of a population are either unknown or partially known (Hennekens & Buring, 2007), and it was used by Ganley and Rosario (2013) in a related research this justified the use of similar design in a study of similar nature.Two hundred and seventy returned questionnaire was collected, analyzed using descriptive statistic of frequency count, normative percentage and grand mean; as well as inferential statistics of chi-square (${\chi}^2$). The level of significant was fixed at 0.05. Appropriate degrees of freedom were worked out. There was statistical significant influence or relationship with marital status on the predisposing factors of smoking chi-square of 19716.516 greater than the critical value 43.77297at df 30 p<0.05. There were statistical significance chi-square =27468.348 which is greater than the critical value 43.77297 at df= 30. These show that there is a relationship on gender awareness of predisposing factors to smoking rejecting the null hypotheses. The respondents across different lever/year higher institution shows that the awareness of predisposing factors of smoking there were a statistical significance difference chi-square =7168.429 (df=88) greater than critical value 102.342 rejecting the null hypotheses. There is consistent evidence that links exposure to depictions of smoking in movies and initiation of smoking in young people. Over the years television shows and films have effectively built up associations between smoking and glamour, sex and risk-taking. Social learning theory describes how we learn by example from others. We are strongly influenced by our parents, and other people we look up to, such as peers, actors and pop stars. This can lead us to emulate their behaviour and try smoking.

• 중환자간호학회지
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• 제15권1호
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• pp.13-23
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• 2022

Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• 한국산업보건학회지
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• 제4권1호
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• pp.117-126
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• 1994

Some of the important and vital roles performed by the Health Care Center of Pohang Iron & Steel Co., Ltd.(POSCO) are the periodic monitoring of the work sites as well as regular medical check-ups for each workers to ensure both pleasant and safe working conditions and to protect employees' health. Pohang Steel Works, which has 42 plants, 26 facilities and 12,000 employees, has an annual crude steel production capacity of 9,670,000 using 24,500,000 ton of raw materials. We have measured lots of areal and personal working environment according to Occupational Safety and Health Law semiannually. All data collected on industrial hygiene is stored and managed by personal computer. The developed of a computerized industrial hygiene control system linked to the company's main computer system will provide efficient evaluation of the working environment as well as critical informations on employees' health. Development of this system had begun in May, 1992 and was completed in March, 1994. The computerized industrial hygiene control system can; 1. store industrial hygiene data, providing key pertinent to the diagnosis of occupational related illnesses, and if necessary, the basis for improving the working environment, 2. decide type and time of medical examination of each work for exposure to specific agents, and supply proper protection periodically, 3. prevent occupational related illnesses through evaluation of environmental and biological monitoring, and performance of epidemiological surveillance, 4. facilitate proper job placement through linking of industrial hygiene control and personnel information systems, 5. monitor job processes. levels of chemical agents used, and new agents introduced, 6. and increase productivity by saving time resulting from the implementation of the computerized sysyte,