• Title/Summary/Keyword: Hospital guide

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A Comparative Study of Prediction Models for College Student Dropout Risk Using Machine Learning: Focusing on the case of N university (머신러닝을 활용한 대학생 중도탈락 위험군의 예측모델 비교 연구 : N대학 사례를 중심으로)

  • So-Hyun Kim;Sung-Hyoun Cho
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.2
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    • pp.155-166
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    • 2024
  • Purpose : This study aims to identify key factors for predicting dropout risk at the university level and to provide a foundation for policy development aimed at dropout prevention. This study explores the optimal machine learning algorithm by comparing the performance of various algorithms using data on college students' dropout risks. Methods : We collected data on factors influencing dropout risk and propensity were collected from N University. The collected data were applied to several machine learning algorithms, including random forest, decision tree, artificial neural network, logistic regression, support vector machine (SVM), k-nearest neighbor (k-NN) classification, and Naive Bayes. The performance of these models was compared and evaluated, with a focus on predictive validity and the identification of significant dropout factors through the information gain index of machine learning. Results : The binary logistic regression analysis showed that the year of the program, department, grades, and year of entry had a statistically significant effect on the dropout risk. The performance of each machine learning algorithm showed that random forest performed the best. The results showed that the relative importance of the predictor variables was highest for department, age, grade, and residence, in the order of whether or not they matched the school location. Conclusion : Machine learning-based prediction of dropout risk focuses on the early identification of students at risk. The types and causes of dropout crises vary significantly among students. It is important to identify the types and causes of dropout crises so that appropriate actions and support can be taken to remove risk factors and increase protective factors. The relative importance of the factors affecting dropout risk found in this study will help guide educational prescriptions for preventing college student dropout.

Self-care Through Dynamic Appetite Alteration: A Grounded Theory Study of Patient Experience on Maintenance Hemodialysis

  • Wonsun Hwang;Ji-hyun Lee;Juha Nam;Jieun Oh;Inwhee Park;Mi Sook Cho
    • Clinical Nutrition Research
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    • v.11 no.4
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    • pp.264-276
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    • 2022
  • Hemodialysis (HD) patients can experience appetite alterations that affect meals and nutritional status. Few qualitative studies have assessed the chronic impact of HD on the everyday diet. This study aimed to characterise comprehensively the experiences of HD patients adapting to appetite alteration. Semi-structured, face-to-face interviews were conducted in a unit of a tertiary hospital to understand patient experiences with appetite alteration. An interview guide was used to consider adaptive processes developed after reviewing the literature and based on the researchers' clinical experiences. A single researcher conducted all interviews to maintain consistency in data collection. The interview content was analysed using Nvivo 11 based on grounded theory and constant comparison analysis. As a results, the mean age and HD vintage of 14 participants were 60 and 5.8 years, respectively. We developed a self-care model based on HD patient experiences with appetite alteration based on axial and selective coding. Differences in urea sensitivity, taste alteration, and social support could be explained by timing of transitions, life events, and responses to stress. Self-care processes are adapted through the processes of "self-registration" and "self-reconstruction," starting with "disruption." At the stage of adjustment, 4 self-management types were derived based on pattern of self-care: self-initiator, follower, realist, and pessimist. The results of this study provide unique qualitative insight into the lived experiences of HD patients experiencing appetite alteration and their self-care processes. By recognising dietary challenges, health teams can better support HD patients in the transition from dietary education to self-care.

Evidence-based Clinical Guidelines for Optimizing the Use of Standing Frame: A Systematic Review of Dosing Recommendations Among Cerebral Palsy

  • Changho Kim;Hyunsuk Park
    • Physical Therapy Korea
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    • v.31 no.2
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    • pp.131-141
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    • 2024
  • Background: Standing frames are a common intervention for children with cerebral palsy (CP), yet there is a lack of standardized dosing recommendations, impeding the enhancement of treatment outcomes in this population. Objects: This paper aims to optimize dosing strategies for standing frame programs in children with CP. It evaluates effective durations and frequencies for using standing frames to improve gait, hip joint integrity, functional activities, joint range of motion, and muscle tone. The goal is to provide evidence-based clinical recommendations to guide practitioners in treating pediatric CP patients. Methods: A comprehensive research was conducted across seven databases, yielding 23 studies meeting inclusion criteria. Strength of evidence was assessed using established tools. Clinical recommendations were formulated based on the amalgamation of existing evidence. Results: The paucity of evidence-based dosing recommendations for children with CP supported standing device is highlighted in this review. Key findings suggest that standing frames implemented 5 days per week demonstrate positive effects on gait (45 minutes/day, 3 times/week), hip joint integrity (60 minutes/day), functional activities (60 minutes/day in 30° to 60° of bilateral hip abduction), joint range of motion (60 minutes/day), and muscle tone (30 minutes/day). Conclusion: This systematic review of the treatment regimens for children with CP is providing useful insights to the dosing strategies of standing frames. The evidence supports a 30-60 minutes per day and 3-5 days a week intervention with specified durations for optimal outcomes. In enhancing the effectiveness of standing frames, as well as promoting evidence-based practices in the management of children with CP, these clinical recommendations offer guidance for practitioners.

The effectiveness of sealing technique on in-office bleaching (전문가 미백시 sealing technique의 효율성에 관한 연구)

  • Lee, Yoon;Kwon, So-Ran;Park, Jeong-Won
    • Restorative Dentistry and Endodontics
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    • v.33 no.5
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    • pp.463-471
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    • 2008
  • This study investigated the clinical effectiveness and safety of sealed bleaching compared to conventional in-office bleaching using a randomized clinical trial of split arch design. Ten participants received a chairside bleaching treatment on the upper anterior teeth, and each side was randomly designated as sealed or control side. A mixture of Brite powder (PacDent, Walnut, USA), 3% hydrogen peroxide and carbamide peroxide (KoolWhite, PacDent, Walnut, USA) were used as bleaching agent. The control side was unwrapped and the experimental side was covered with a linear low density polyethylene (LLDPE) wrap for sealed bleaching. The bleaching gel was light activated for 1 hour. The tooth shades were evaluated before treatment, after treatment, and at one week check up by means of a visual shade (VS) assessment using a value oriented shade guide and a computer assisted shade assessment using a spectrophotometer (SP). The data were analyzed by paired t-test. In the control and sealed groups, the visual shade scores after bleaching treatment and at check up showed statistically significant difference from the preoperative shade scores (p<.05). The shade scores of the sealed group were significantly lighter than the control immediately after bleaching and at the check-up appointment (p<0.05). Compared to prebleaching status, the ${\Delta}E$ values at post bleaching condition were $4.35{\pm}1.38\;and\;5.08{\pm}1.34$ for the control and sealed groups, respectively. The ${\Delta}E$ values at check up were $3.73{\pm}1.95\;and\;4.38{\pm}2.08$ for the control and sealed groups. ${\Delta}E$ values were greater for the sealed group both after bleaching (p<.05) and at check up (p<.05). In conclusion, both ${\Delta}E$ and shade score changes were greater for the sealed bleaching group than the conventional bleaching group, effectively demonstrating the improvement of effectiveness through sealing.

Susceptibility tests of oral antibiotics including cefixime against Escherichia coli, isolated from pediatric patients with community acquired urinary tract infections (소아 원외 요로감염 환아에서 분리된 E. coli에 대한 cefixime을 포함한 경구 항생제의 감수성 연구)

  • Lee, Soo Young;Lee, Jung Hyun;Kim, Jong Hyun;Hur, Jae Kyun;Kim, Sun Mi;Ma, Sang Hyuk;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.777-783
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    • 2006
  • Purpose : Urinary tract infection(UTI) is one of the most frequent infections in children. E. coli is the most frequent etiological micropathogen in pediatric community UTI, and E. coli has developed resistance to many antibiotics, highlighting the need for regular surveys of this organism resistant patterns in the community. The aim of this study was to determine the oral antibiotic susceptibility patterns of E. coli, isolated from pediatric patients with uncomplicated community acquired UTI. Methods : E. coli isolates, obtained from pediatric patients with uncomplicated community acquired UTI between October in 2004 to September in 2005. And minimal inhibitory concentrations(MICs) of oral aminopenicillins and beta-lactamase inhibnitors(ampicillin, amoxacillin, ampicillin-sulbactam), oral cephalosporins(cefaclor, cefixime) and sulfa drug(trimethoprime-sulfamethoxazole) were performed according to the National Committee for Clinical Laboratory Standards(NCCLS) guide line. Results : Total 211 organisms were isolated from pediatric out-patients with community UTI. E. coli was the most common organism(89 percent), followed by E. fecalis, Proteus species, S. aureus, M. morganii, and P. aeruginosa. The resistant rates of aminopenicillins and beta-lactamase inhibitors, cefaclor and sulfa drug to E. coli were very high. But, the resistant rate of cefixime was markedly low, and ESBL strains were isolated with small rates. Conclusion : Our study results suggest that aminopenicillins, cefaclor and sulfa drug may not be useful as first line empirical antibiotics to treat pediatric patients with community UTI in Korea. But, 3rd generation cephalosporin such as cefixime can be used as effective second line antibiotics after primary treatment failure, also may be useful as an empirical first line antibiotic. Finally, we conclude that a continuous surveillance study to monitor susceptibility patterns of E. coli in community UTI will be needed for the standard guide lines of empirical oral antibiotic treatment.

Clinical Results of Arthroscopic Anterior Cruciate Ligament Reconstruction using Hamstring Tendon (슬괵건을 이용한 관절경적 전방십자인대 재건술)

  • Song, Eun-Kyoo;Seo, Hyoung-Yeon;Lee, Geun-Bae;Yoon, Taek-Rim;Shim, Sang-Don
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.17-23
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    • 1999
  • Purpose : We intend to review clinical results after Anterior cruciate ligament(ACL) reconstruction using hamstring tendon arthroscopically. Materials & Methods : Sixty two patients who had underwent arthroscopic ACL reconstruction using hamstring tendon from Mar. 1996 to Mar. 1997 were reviewed. The average follow-up was 16 months and average age at operation was 27 years old. Clinical results were evaluated with physical examination, Lysholm Knee score and instrumented anterior laxity test with Telos Results : The average preoperative Lysholm knee score was 57.0 and postoperative average of that was 91.8. All cases of 62 patients had normal range of motion of knee and were able to walk with no problems at follow-up. On the Lachmann test, there were mild(+) instability in 24 cases, moderate(++) in 24 cases, severe(+++) in 14 cases preoperatively and 48 cases were converted to negative, 14 cases mild postoperatively. On instrumented anterior laxity test with Telos, difference between normal and affected knee on 20 lb which was 13.4mm preoperatively was decreased to 4.7mm at follow-up and anterior stability was regained(P<0.05). Parapatellar complications such as crepitus in 18 cases(29.5%), atrophy of quadriceps in 23 cases(36.5%) were observed. There were 2 cases of inaccuracy of guide pin of semifix screw intraoperatively and 3 cases of malposition of semifix screw postoperatively. Conclusion : ACL reconstruction using hamstring tendon seems to be a effective procedure to establish the stability of knee joint but is technically demanding procedure and leaves some parapatellar complications.

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Survival Analysis of Patients with Brain Metastsis by Weighting According to the Primary Tumor Oncotype (전이성 뇌종양 환자에서 원발 종양 가중치에 따른 생존율 분석)

  • Gwak, Hee-Keun;Kim, Woo-Chul;Kim, Hun-Jung;Park, Jung-Hoon;Song, Chang-Hoon
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.140-144
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    • 2009
  • Purpose: This study was performed to retrospectively analyze patient survival by weighting according to the primary tumor oncotype in 160 patients with brain metastasis and who underwent whole brain radiotherapy. Materials and Methods: A total of 160 metastatic brain cancer patients who were treated with whole brain radiotherapy of 30 Gy between 2002 and 2008 were retrospectively analyzed. The primary tumor oncotype of 20 patients was breast cancer, and that of 103 patients was lung cancer. Except for 18 patients with leptomeningeal seeding, a total of 142 patients were analyzed according to the prognostic factors and the Recursive Partitioning Analysis (RPA) class. Weighted Partitioning Analysis (WPA), with the weighting being done according to the primary tumor oncotype, was performed and the results were correlated with survival and then compared with the RPA Class. Results: The median survival of the patients in RPA Class I (8 patients) was 20.0 months, that for Class II (76 patients) was 10.0 months and that for Class III (58 patients) was 3.0 months (p<0.003). The median survival of patients in WPA Class I (3 patients) was 36 months, that for the patients in Class II (9 patients) was 23.7 months, that for the patients in Class III (70 patients) was 10.9 months and that for the patients in Class IV (60 patients) was 8.6 months (p<0.001). The WPA Class might have more accuracy in assessing survival, and it may be superior to the RPA Class for assessing survival. Conclusion: A new prognostic index, the WPA Class, has more prognostic value than the RPA Class for the treatment of patients with metastatic brain cancer. This WPA Class may be useful to guide the appropriate treatment of metastatic brain lesions.

Evaluation of Real-time Measurement Liver Tumor's Movement and $Synchrony^{TM}$ System's Accuracy of Radiosurgery using a Robot CyberKnife (로봇사이버나이프를 이용한 간 종양의 실시간 움직임 측정과 방사선수술 시 호흡추적장치의 정확성 평가)

  • Kim, Gha-Jung;Shim, Su-Jung;Kim, Jeong-Ho;Min, Chul-Kee;Chung, Weon-Kuu
    • Radiation Oncology Journal
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    • v.26 no.4
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    • pp.263-270
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    • 2008
  • Purpose: This study aimed to quantitatively measure the movement of tumors in real-time and evaluate the treatment accuracy, during the treatment of a liver tumor patient, who underwent radiosurgery with a Synchrony Respiratory motion tracking system of a robot CyberKnife. Materials and Methods: The study subjects included 24 liver tumor patients who underwent CyberKnife treatment, which included 64 times of treatment with the Synchrony Respiratory motion tracking system ($Synchrony^{TM}$). The treatment involved inserting 4 to 6 acupuncture needles into the vicinity of the liver tumor in all the patients using ultrasonography as a guide. A treatment plan was set up using the CT images for treatment planning uses. The position of the acupuncture needle was identified for every treatment time by Digitally Reconstructed Radiography (DRR) prepared at the time of treatment planning and X-ray images photographed in real-time. Subsequent results were stored through a Motion Tracking System (MTS) using the Mtsmain.log treatment file. In this way, movement of the tumor was measured. Besides, the accuracy of radiosurgery using CyberKnife was evaluated by the correlation errors between the real-time positions of the acupuncture needles and the predicted coordinates. Results: The maximum and the average translational movement of the liver tumor were measured 23.5 mm and $13.9{\pm}5.5\;mm$, respectively from the superior to the inferior direction, 3.9 mm and $1.9{\pm}0.9mm$, respectively from left to right, and 8.3 mm and $4.9{\pm}1.9\;mm$, respectively from the anterior to the posterior direction. The maximum and the average rotational movement of the liver tumor were measured to be $3.3^{\circ}$ and $2.6{\pm}1.3^{\circ}$, respectively for X (Left-Right) axis rotation, $4.8^{\circ}$ and $2.3{\pm}1.0^{\circ}$, respectively for Y (Crania-Caudal) axis rotation, $3.9^{\circ}$ and $2.8{\pm}1.1^{\circ}$, respectively for Z (Anterior-Posterior) axis rotation. In addition, the average correlation error, which represents the treatment's accuracy was $1.1{\pm}0.7\;mm$. Conclusion: In this study real-time movement of a liver tumor during the radiosurgery could be verified quantitatively and the accuracy of the radiosurgery with the Synchrony Respiratory motion tracking system of robot could be evaluated. On this basis, the decision of treatment volume in radiosurgery or conventional radiotherapy and useful information on the movement of liver tumor are supposed to be provided.

A Recognition for community Based Rehabilitation by Public Health Center Physical Therapists in Seoul Province (서울시 보건소 물리치료사들의 지역사회중심재활에 대한 인식)

  • Kim, Chan-Mun;Hong, Wan-Sung;Bae, Sung-Il
    • Journal of Korean Physical Therapy Science
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    • v.5 no.1
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    • pp.549-556
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    • 1998
  • To survey the recognition of Community Based Rehabilitation(CBR) by Public Health Center(PHC) Physical Therapists in Seoul Province. This study analysed general characteristic of Physical Therapists and cognition, participation, education, problems and requirements for CBR. The subjects of this study were 31 therapists who work at PHC in Seoul Province and Seoul City Childerns Municipal Hospital. Data was collected for 18 days from April 13 to 31, 1998 and results computed from 25 responses. First, Female therapists outnumber males. The age category 30 to 35 old represented 44.0% of the total number studied. 48.0% of therapists had worked more than 7 years and therapists usually 84.0% worked from 3 to 4 years at the PHC. Junior colleage graduates were 72.0%, and respondents with family responsibility were 52.0%. Second, Recently pain control and therapeutic exercises has become the major requirement of patients at PHC(56.0%). If the offered expanded services, a rehabilitation programe at PHC(36.0%) was highly. When asked about a working guide book, nobody had one. Third, 64.0% of therapists were aware of the present level of CBR, 28.0% of them had gotten an information from newspaper and mass media. Fourth, For CBR, 72.0% had positive ideas in which they could participate. 56.0% wished to compose a team of various rehabilitation specialists. 52.0% wished for the meeting day to be flexible and 64.0% desired to meet once or twice a week. Fifth, Almost all(92.0%) desired more educational opportunity about CBR. Example, once or twice a year(48.0%) and training period of 4 to 7 day(44.0%). They wanted to learn theory and parctice together(88.0%) and 48.0% wanted national mutirehabilitation center as a educational managing organization. Sixth, The most important requirement for accomplishing CBR by Physical Therapists was job security and adequate number of therapists(48.0%). Required number of physical therapists in the PHC was 3(52.0%). The cooperative agency should be the distict govement(32.0%) and community welfare center of the disabled persons(32.0%). Factors inhibiting the execution of CBR were lack of physical therapists(56.0%), and equipments for pain control and for therapeutic exercises(68.0%).

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A Research Relative to the Subjective View on the Occupational Consciousness of the Dental Coordinator (Dental Coordinator의 직업의식에 관한 주관성 연구)

  • Han, Gyeong-Soon
    • Journal of Korean society of Dental Hygiene
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    • v.2 no.1
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    • pp.97-113
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    • 2002
  • This research is an attempt to establish a basic material in discovering the subjective types of the dental coordinators occupational consciousness, utilizing the Q-Method Theory, which is capable of measuring the subjective nature of human being by scientific and systematic method. The characteristics of each type were analyzed so as to have the dental coordinator to possess the desirable understanding of the occupational view together for them to have self-confidence as a lifetime specialty occupation. Upon completion of the study, it was found that there are three types of subjective views pertaining to the occupational consciousness on the dental coordinator. The result on the analysis of the characteristics is as follows : Type 1 is the Taking Serious View on the Patient Service, which priority is placed on kindness and looking after any difficulties of the patient, namely, it is the type that puts the importance on the high level medical examination and treatment based on good service. Because of the kind service to the patient, those under this category considered their job satisfaction have been improved. It goes without saying that they were developing the services, which satisfy themselves, and it was confirmed that they thought that they should make things smooth for any development of problems that may arise between the patient and the dentist. Type 2 is the Taking Serious View on Career and Organizational Strength. This is a type that aims on the systematic nature of the internal job, namely, organizational strength itself viewed from the stand point thai either self-confident or work merit is proportional to experience. This type is to actively treat the problem and endeavor to solve the issue when dissatisfaction is held by the dental hospital system, which is either followed according to the work responsibility or by an organization having an appropriate system on remuneration, Type 3 is the Placing of Importance on the Overall Circumstances. This is the type that places importance on the overall now of the dental hospital, and it is the type, that most greatly recognizes the importance of the role of the dental coordinator. The dental coordinator should provide the sense of reliability to both the dentist and to the staff of the medical examination and treatment and should be able to adjust smoothly the overall now of the medical treatment. The dental coordinator is expected to be a medical service specialist, who is capable to solve the problems of the staff of the medical treatment intuitively and to adjust the relation between the employees. With the above result, it was found that although there was no mutual exclusiveness between the respective types, there are particular characteristics among each type. Therefore, this research has discovered and analyzed the subjective view types relative to the occupational consciousness of the dental coordinator for the proper understanding on the characteristics of each type to enable the dental sanitary students and the graduates of the Dental Sanitary Department, who are aspiring to become dental coordinator, as the basic guide material to be actively utilized.

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