• Journal of Korean Critical Care Nursing
• /
• v.14 no.2
• /
• pp.42-56
• /
• 2021

Purpose : The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master's course professors at a graduate school. Methods : Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis. Results : Based on the data, we extracted four themes and 14 categories. The themes were "Role and system of APNs started according to healthcare environment changes", "Optimal healthcare provider to ensure quality of care", "Confused role and system of APNs due to incomplete medical law", and "Tasks for the stable operation of the APN system." Conclusion : For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs' scope of practice is required. Finally, a discussion is necessary about the integration of APNs' 13 fields.

• Communications for Statistical Applications and Methods
• /
• v.29 no.4
• /
• pp.421-439
• /
• 2022

Phase I dose-finding trials are essential in drug development. By finding the maximum tolerated dose (MTD) of a new drug or treatment, a Phase I trial establishes the recommended doses for later-phase testing. The primary toxicity endpoint of interest is often a binary variable, which describes an event of a patient who experiences dose-limiting toxicity. However, there is a growing interest in dose-finding studies regarding non-binary outcomes, defined by either the weighted sum of rates of various toxicity grades or a continuous outcome. Although several novel methods have been proposed in the literature, accessible software is still lacking to implement these methods. This study introduces a newly developed R package, UnifiedDoseFinding, which implements three phase I dose-finding methods with non-binary outcomes (Quasi- and Robust Quasi-CRM designs by Yuan et al. (2007) and Pan et al. (2014), gBOIN design by Mu et al. (2019), and by a method by Ivanova and Kim (2009)). For each of the methods, UnifiedDoseFinding provides corresponding functions that begin with next that determines the dose for the next cohort of patients, select, which selects the MTD defined by the non-binary toxicity endpoint when the trial is completed, and get oc, which obtains the operating characteristics. Three real examples are provided to help practitioners use these methods. The R package UnifiedDoseFinding, which is accessible in R CRAN, provides a user-friendly tool to facilitate the implementation of innovative dose-finding studies with nonbinary outcomes.

• Journal of Korean Academy of Nursing
• /
• v.53 no.1
• /
• pp.39-54
• /
• 2023

Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

• Korean Journal of Exercise Nutrition
• /
• v.23 no.3
• /
• pp.29-38
• /
• 2019

[Purpose] Effective nutritional intervention can help reduce the risk of nutritional problems and improve athletic performance in adolescents. The five A's (assess, advise, agree, assist, and arrange) model is widely used as the theoretical framework for advice on nutrition, smoking, drinking, and physical activity and it recommends that practitioners in primary health care promote behavior change to facilitate positive outcomes. This model has also been useful in understanding the underlying processes of behavior change. This study aimed to develop both a novel evidence-based nutritional intervention protocol, rooted in sound nutritional theory, and a customizable nutritional intervention program to support sustainable healthy eating, enhance nutrient intake, and improve athletic performance in adolescent athletes. [Methods] In this study, we adapted the 5 A's behavioral change model and motivational interview to develop a theoretical framework to help adolescent athletes change their behavior and achieve their goals. [Results] During each step of the 5 A's protocol, a customized nutritional intervention protocol was developed by nutrition experts for each of adolescent athletes. Each plan was developed to improve the eating habits of adolescent athletes through group education and counseling. All nutritional counseling sessions were designed to enable participants to apply nutritional knowledge and practical action plans to their training and competition conditions to enable each of them to achieve individual athletic goals and facilitate self-management. [Conclusion] A theoretical and evidence-based nutritional intervention protocol was developed to identify and address obstacles to healthy dietary habits in adolescent athletes. This could be used as the basis for further studies aimed at improving nutrient intake and athletic performance in adolescent athletes.

• Journal of Distribution Science
• /
• v.22 no.2
• /
• pp.41-50
• /
• 2024

Purpose: This study aims to identify the distribution of skill evolution for accounting personnel during the health crisis and investigate the impact of accounting skills in developing resilience among accounting personnel. Research design, data, and methodology: A total of 131 respondents of accounting personnel participated in a self-administered survey questionnaire. This data is analysed using the partial least square structural equation modeling. Results: The results show that accounting skills, digital skills, and writing skills have a significant impact on developing accounting personnel's motivation, subsequently leading to resilience. Conclusions: This study adds to the literature on the new requirements and future profiles of Malaysian organisation and the accounting profession. This will be a good reference for the practitioners to identify the relevant skills required for accountants after the pandemic. Furthermore, this study includes encouraging motivation and skills to improve resilience in the Malaysian context further to understand the push factors on skills evolution among the accountants. Higher education institutions with accounting courses would consider the potential future skills of accountants to meet market demands on time when updating the institutions' curricula program. Hence, the relevant skills required can be developed and practiced at the education level, especially secondary and tertiary levels.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.4
• /
• pp.261-269
• /
• 2023

Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

• Journal of Veterinary Clinics
• /
• v.40 no.6
• /
• pp.393-398
• /
• 2023

We identified mastitis-causing pathogens using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) in an organic dairy farm and evaluated the effects of antimicrobial restriction on antimicrobial susceptibility. A total of 43 Holstein cows without any clinical sign of mastitis were used in this study, and 172 quarter milk samples were cultured on blood agar plates for 24 hours at 37℃. Subsequently, bacterial species were identified and antimicrobial susceptibility tests were performed. The subclinical mastitis infection rates in the cows and quarters were 58.1% (25/43) and 25.6% (44/172), respectively. In the species identification, Staphylococcus aureus (40.9%) was the most prominent isolate, followed by S. chromogenes (22.7%), S. epidermis (18.2%), S. simulans (11.4%), S. haemolyticus (2.3%), S. muscae (2.3%), and S. xylosus (2.3%). In the antimicrobial susceptibility test, all isolates were 100% susceptible to 24 of 28 antibiotics, except for benzylpenicillin, cefalotin, cefpodoxime, and trimethoprim/sulfamethoxazole. The resistance rates of S. aureus, S. chromogenes, and S. muscae isolates to trimethoprim/sulfamethoxazole were 27.8%, 10%, and 100%, respectively, and the resistance rates of S. epidermis and S. xylosus to benzylpenicillin were 50% and 100%, respectively. S. chromogenes, S. epidermis, S. simulans, S. haemolyticus, and S. xylosus were resistant to cefalotin and cefpodoxime. In conclusion, restrictions on antimicrobial use for organic dairy farm certification have resulted in a high Staphylococcus spp. infection rate. Therefore, our study indicates the importance of mastitis management strategies implemented by farmers together with veterinary practitioners, even if mastitis does not appear clinically in organic dairy farms.

• Child Health Nursing Research
• /
• v.6 no.2
• /
• pp.224-239
• /
• 2000

This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's α coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

• Journal of Preventive Medicine and Public Health
• /
• v.1 no.1
• /
• pp.9-23
• /
• 1968

A survey was conducted by the staff of the College of Medicine and School of Public Health, Seoul National University in cooperation with Seoul Special City from 1 December 1967 through 28 February 1968, on such events as delivery, death, abortion and pregnancy. The survey directed to a total population of 47,811 residing in 9,157 households led us to the following findings: 1. Two year averages of crude birth rate, crude death rate and natural increase rate were 30.1, 5.6 and 24.5, respectively. 2. Of all deliveries, home and hospital deliveries constituted 61.1 per cent and 35.5 per cent, respectively. 3. Deliveries other than hospital deliveries were found to be attended more often by mother-in-laws (26.5 per cent) than by doctors or midwives(23.4 per cent). 4. About 51 per cent of all women having experiences in pregnancy during the last two years had an experience of consulting a doctor at least one time throughout whole period of pregnancy. 5. In most cases scissors were used to cut umbilical cords, of which 71.0 per cent were not sterilized and only 20.3 per cent sterilized. 6. In many cases placenta was incinerated(48.2 per cent) and on many other occasions it was thrown away into water(28.3 per cent). 7. Cement bags(37.4 per cent), gauze and absorbent cotton(29.8 per cent) were found to be most frequently used to receive new-born babies. 8. In 1966 8. 8 per cent of the women had at least one abortion induced and in 1967 the percentage was 9.2 per cent. 9. Nearly all(95.8 per cent) of the induced abortions reportedly were done at doctor's clinics. 10. Of all the abortions induced 65.3 per cent were done by specialists in obstetrics, 30.3 per cent by general practitioners and 2.7 per cent by midwives. 11. Those who experienced spontaneous abortions were 1.9 per cent of all women both in 1966 and 1967. 12. About 9.2 per cent of women investigated were found to be currently pregnant. 13. Age specific death rate turned out to be highest among those under 1 year of age. 14. Ten major causes of death in their order of frequency were: 15. Places of death can be classified into homes(75.3 per cent) and hospitals(13.2 per cent). 16. Method of disposing of corpses comprised burials(54.2 per cent) and cremations(44.6 per cent). 17. Infant, neonatal and hebdomadal mortality rates have been computed at 32.2, 18.9 and 13.7, respectively. 18. Infants were found to have died either at homes(81.5 per cent) or at hospitals(18.5 per cent). 19. Birth registrations had been done for about 18.5 per cent of the dead infants.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.27 no.3
• /
• pp.164-172
• /
• 2016

Objectives: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. Methods: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. Results: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. Conclusion: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.