• Title/Summary/Keyword: Medical Support

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Un-met Supportive Care Needs of Iranian Breast Cancer Patients

  • Abdollahzadeh, Farahnaz;Moradi, Narges;Pakpour, Vahid;Rahmani, Azad;Zamanzadeh, Vahid;Mohammadpoorasl, Asghar;Howard, Fuchsia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.9
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    • pp.3933-3938
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    • 2014
  • Background: Assessment of supportive needs is the requirement to plan any supportive care program for cancer patients. There is no evidence about supportive care needs of Iranian breast cancer patients. So, the aims of present study were to investigate this question and s predictive factors. Materials and Methods: A descriptive-correlational study was conducted, followed by logistic regression analyses. The Supportive Care Needs Survey was completed by 136 breast cancer patients residing in Iran following their initial treatment. This assessed needs in five domains: psychological, health system and information, physical and daily living, patient care and support, and sexuality. Results: Patient perceived needs were highest in the health systems and information (71%), and physical and daily living (68%) domains. Logistic regression modeling revealed that younger participants have more un-met needs in all domains and those with more children reported fewer un-met needs in patient care and support domains. In addition, married women had more un-met supportive care needs related to sexuality. Conclusions: The high rate of un-met supportive care needs in all domains suggests that supportive care services are desperately required for breast cancer patients in Iran. Moreover, services that address informational needs and physical and daily living needs ought to be the priority, with particular attention paid to younger women. Further research is clearly needed to fully understand supportive care needs in this cultural context.

Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Directions for Future Development of Preventive Medicine in Korea (예방의학의 발전방향)

  • Kim, Joon-Youn
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.3
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    • pp.185-189
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    • 2006
  • It is the actual state of the medical society in our country that many graduates of medical schools want to be clinicians, and accordingly Korea's medical situation is relatively too focused on curative medicine. However, this situation is changing due to several factors including a growing number of doctors, inappropriate regulations for medical fees, changes in social status of doctors themselves, and excessive competition between doctors. Furthermore, we expect more advances in medical field of Korea since Korean government started to attach great importance to sciences and produced policies to support sciences, and as a result, more and more interest and effort in the fields of basic research including preventive medicine is being attached especially by young doctors as compared against the past. However, decline of clinical medicine fields doesn't always mean bright future for the field of preventive medicine. True future is possible and meaningful only when we prepare for it by ourselves. In other words, as the promising future is closed to one who spares no effort, we shouldn't fear to oppose unknown challenges and simultaneously need to support colleagues who bear such a positive mind. It is the most important thing for our preventive medicine doctors to evaluate the past and the present of preventive medicine and to foster a prospective mind to prepare for the future of preventive medicine. I set forth my several views according to directions for the development of preventive medicine which we already discussed and publicized in the academic circle of preventive medicine. Those directions are recommendation of clinical preventive medicine, promotion of preventive medicine specialty, fostering the next generations, improving the quality of genetic epidemiologic study, participation in control of environmental pollution and food safety, contribution to chronic disease control, and preparation to role in medical services for unified Korea.

Development of Smart App to Support the Paramedics Activities (구급 활동을 지원하는 스마트 앱 개발)

  • Eum, Sang-Hee;Kim, Gwang-Nyeon;Kim, Gi-Ryon;Nam, Jae-Hyun
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.22 no.1
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    • pp.49-53
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    • 2018
  • In the recent years, an attempts have been made to convergence medical technology and IT technology to overcome the limitations of temporal, spatial in the medical technology applications. Emergency care is primarily intended to provide primary care and stabilization to the patient, thereby saving the patient's life and minimizing the risk until hospital care. In this study, we developed an application S/W to support emergency services for emergency medical services. Paramedics can easily keep a log of emergency activities and monitor the patient's condition in real time with this application S/W on smart devices. In particular, medical signals and information emergency status of emergency patients can be measured or photographs of affected areas can be taken. In addition, this report can be delivered to remote medical doctors for rapid emergency measures and immediate hospital response.

The Frequency of Job Performance of the Korean Professional Medical Support Staff at Medical Institutions over 500 Beds (500병상 이상 의료기관에서의 전문지원인력의 직군별 업무 수행빈도 분석)

  • Kim, Min Young;Choi, Su Jung;Seol, Miee;Kim, Jeong;Kim, Hee Young;Byun, Sook Jin
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.15-27
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    • 2018
  • Purpose : This study was intended to investigate the frequency of job performance of the Korean professional medical support staffs (PMSS). Method : The data of 1,666 PMSS from 36 hospitals and over 500 beds were analyzed. The participants were divided into 5 groups: advanced practice nurses (APN), clinical nurse experts, physician assistants (PA), coordinators, and others. Results : Among the 5 main domains of job performance, advanced clinical practice has the highest frequency (111.36 d/y), followed by consultation/collaboration (75.66 d/y), education/counseling (53.54 d/y), leadership (23.90 d/y), and research (19.14 d/y). There was a significant difference in the frequency of job performance between the 5 groups of participants. The invasive activities were more frequent in the PA group. In the education and counseling domain, APNs had a higher level of job frequency than others (p < .001). In the research and leadership domains, APNs and coordinators had more prominent performance frequency than other groups (p < .01). However, there are some ambiguities in the job performance of the 5 groups depending on institutional characteristics. Conclusion : To establish the scope of work of PMSS, organizational and individual efforts are needed to promote and expand the leadership and research domains. To resolve the ambiguities of PMSS' roles, it is necessary to reorganize their titles.

The Research of Design Development for Strengthening Competitiveness of Domestic Medical Instrument Industry -Focused on C-Arm Surgical X-Ray Design- (국내 의료기기산업 경쟁력 강화를 위한 디자인개발에 관한 연구 -이동형 영상진단기기 디자인을 중심으로-)

  • Han, Il-Woo
    • Archives of design research
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    • v.17 no.4
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    • pp.51-60
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    • 2004
  • The medical instrument industry which is one of the high value added industry has been neglected on the various system and political support because it has been recognized as an unknown field to the public although it is the very easy-approaching field for the export market that minimize a technological gap between advanced country and Korea. Especially, the product design that is very important element for the efficient medical treatment and the psychological stabilization of patient is a typical field of lack of investment and support by the unconcern and lack of understanding of design. Therefore this research suggests the current problem of design with the general inquiry of internal and external market situation and domestic medical instrument industry and also it has the conclusion of an alternative proposal for the solution with the design development processing of a moving type-image diagnostic equipment. We will emboss the importance of design competitiveness, suggest the model and basic data to the medical instrument company that starts later, and be a role of inspiration for the lasting investible desire with this research.

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The Radiation Exposure of Radiographer Related to the Location in C-arm Fluoroscopy-guided Pain Interventions

  • Chang, Young Jae;Kim, Ah Na;Oh, In Su;Woo, Nam Sik;Kim, Hae Kyoung;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.162-167
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    • 2014
  • Background: Although a physician may be the nearest to the radiation source during C-arm fluoroscope-guided interventions, the radiographer is also near the fluoroscope. We prospectively investigated the radiation exposure of radiographers relative to their location. Methods: The effective dose (ED) was measured with a digital dosimeter on the radiographers' left chest and the side of the table. We observed the location of the radiographers in each procedure related to the mobile support structure of the fluoroscope (Groups A, M and P). Data about age, height, weight, sex, exposure time, radiation absorbed dose (RAD), and the ED at the radiographer's chest and the side of the table was collected. Results: There were 51 cases for Group A, 116 cases for Group M and 144 cases for Group P. No significant differences were noted in the demographic data such as age, height, weight, and male to female ratio, and exposure time, RAD and ED at the side of the table. Group P had the lowest ED ($0.5{\pm}0.8{\mu}Sv$) of all the groups (Group A, $1.6{\pm}2.3{\mu}Sv$; Group M, $1.3{\pm}1.9{\mu}Sv$; P < 0.001). The ED ratio (ED on the radiographer's chest/ED at the side of the table) of Group A was the highest, and the ED radio of Group P was the lowest of all the groups (Group A, $12.2{\pm}21.5%$; Group M, $5.7{\pm}6.5%$; Group P, $2.5{\pm}6.7%$; P < 0.001). Conclusions: Radiographers can easily reduce their radiation exposure by changing their position. Two steps behind the mobile support structure can effectively decrease the exposure of radiographers by about 80%.

Effects of Work-Related Stress on Work Ability Index among Iranian Workers

  • Gharibi, Vahid;Mokarami, Hamidreza;Taban, Abrahim;Aval, Mohsen Yazdani;Samimi, Kazem;Salesi, Mahmood
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.43-48
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    • 2016
  • Background: Work Ability Index (WAI) is a well-known and valid self-report tool that has been widely used in various studies to identify and avoid early retirement and work-related disability. Nevertheless, very few studies have been carried out to evaluate work ability in Iran. We aimed to investigate the WAI and the effect of work-related stress on it among Iranian workers. Methods: A cross-sectional, descriptive and analytic study was carried out among 449 workers from five working sectors in three big cities of Iran. Work ability and work-related stress were measured using the Persian version of WAI and the Persian version of Health and Safety Executive Stress Indicator Tool. Results: More than a third of the workers surveyed (34.70%) did not have an appropriate level of work ability (WAI < 37). There was a significant correlation between subscales of work-related stress and the mean score of WAI. Furthermore, the variables of body mass index, sleep quality, exercise activity, job tenure, and three subscales of work-related stress including demands, supervisor support, and role were significant predictors of WAI. Conclusion: According to the results of this study, the interventional programs must be focused on improving supervisors support, eliminating ambiguity and conflicts in the role of workers in their job and organization, reducing job demands, improving sleep quality, and increasing exercise activity.

Artificial Intelligence Technology Trends and IBM Watson References in the Medical Field (인공지능 왓슨 기술과 보건의료의 적용)

  • Lee, Kang Yoon;Kim, Junhewk
    • Korean Medical Education Review
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    • v.18 no.2
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    • pp.51-57
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    • 2016
  • This literature review explores artificial intelligence (AI) technology trends and IBM Watson health and medical references. This study explains how healthcare will be changed by the evolution of AI technology, and also summarizes key technologies in AI, specifically the technology of IBM Watson. We look at this issue from the perspective of 'information overload,' in that medical literature doubles every three years, with approximately 700,000 new scientific articles being published every year, in addition to the explosion of patient data. Estimates are also forecasting a shortage of oncologists, with the demand expected to grow by 42%. Due to this projected shortage, physicians won't likely be able to explore the best treatment options for patients in clinical trials. This issue can be addressed by the AI Watson motivation to solve healthcare industry issues. In addition, the Watson Oncology solution is reviewed from the end user interface point of view. This study also investigates global company platform business to explain how AI and machine learning technology are expanding in the market with use cases. It emphasizes ecosystem partner business models that can support startup and venture businesses including healthcare models. Finally, we identify a need for healthcare company partnerships to be reviewed from the aspect of solution transformation. AI and Watson will change a lot in the healthcare business. This study addresses what we need to prepare for AI, Cognitive Era those are understanding of AI innovation, Cloud Platform business, the importance of data sets, and needs for further enhancement in our knowledge base.

Implementation of Venoarterial Extracorporeal Membrane Oxygenation in Nonintubated Patients

  • Kim, Hyeon A;Kim, Young Su;Cho, Yang Hyun;Kim, Wook Sung;Sung, Kiick;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.54 no.1
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    • pp.17-24
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    • 2021
  • Background: Although extracorporeal membrane oxygenation (ECMO) is generally performed percutaneously, the technology is deployed under sedation and necessitates endotracheal intubation. However, in some patients, the use of venoarterial (VA) ECMO without intubation may be beneficial. Herein, we describe our experiences with VA ECMO performed without prior endotracheal intubation. Methods: A total of 783 patients treated with VA ECMO at a single center between January 2013 and July 2018 were reviewed retrospectively. We included patients who underwent successful VA ECMO implementation without prior endotracheal intubation, and excluded those who were younger than 18 years, had ongoing cardiopulmonary resuscitation status, and had poor quality of the vessels needed for percutaneous cannulation. The primary study outcome was in-hospital survival. Results: In total, 50 patients were included in this study, 94% of whom showed cardiogenic shock. The mean age of the study participants was 56.3±14.5 years. The median VA ECMO support time was 7 days (range, 2-13 days). Twenty-one patients (42%) did not receive ventilator care during the VA ECMO support period, while 29 patients (58%) progressed to intubation after VA ECMO implementation. The rates of survival at discharge and weaning success were 82% (n=41) and 92% (n=46), respectively, and 80% (n=40) of patients presented good Glasgow-Pittsburgh Cerebral Performance Categories scores at discharge. Conclusion: Even in patients with cardiogenic shock, percutaneous VA ECMO can be introduced safely without prior endotracheal intubation by an experienced care team. The application of nonintubated VA ECMO might be a feasible strategy in selected cases.