• Title/Summary/Keyword: death concern

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Guideline of Improvement and Evaluation of Prescribing Errors in Colorectal Chemotherapy (대장암 항암 화학요법의 처방 오류 평가 및 개선안 제시)

  • Lim, Hyun-Soo;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.158-166
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    • 2013
  • Background: Colorectal cancer shows a significant increase in South Korea due to westernization of diet, lack of dietary fiber, drinking and smoking, irregular defecation. There are surgery, chemotherapy, radiation therapy in treatment of colorectal cancer. There may be a medication errors in the process of chemotherapy because of its high toxicity, narrow therapeutic index and the health status of cancer patients. Consequently medication errors can cause increasing the risk of death, prolonging hospital stay and increasing the cost. Among medication errors on medication use process, prescribing errors are of particular concern due to higher risk of serious consequences. It is important for pharmacist to prevent the prescribing errors before reaching patient. Therefore we analyzed the prescriptions of colorectal cancer, classified prescribing errors, suggested guideline to reduce prescribing errors and verified the importance of pharmacist's role in prevention of medication errors activity. Methods: We collected the numbers of prescriptions of colorectal cancer(n=2,373) through anti cancer management program and EMR and analyzed the errors of prescriptions by categories from Oct 1st 2011 to Sep 30th 2012 at Chungbuk National University Hospital. We reviewed the prescriptions as follows - patients' characteristics, the result of test, previous prescriptions, characteristics of antineoplastic agents and patients' allergy, drug sensitivity, adverse events. Prescriptions are classified into inpatient and outpatient and analyzed the errors of prescriptions by categories (dosage form, dose, input, diluents, regimen, product). Results: Total prescription number of inpatient and outpatient of colorectal cancer was 1,193 and 1,180 and that of errors was 107(9%) and 22(1.9%), respectively. In case of errors of categories, the number of errors of dosage form is 69 and 8, errors of dose is 15 and 5, errors of input is 9 and 9 in inpatient and outpatient prescriptions, respectively. Errors of diluents is 8, errors of regimen is 3, errors of product is 3 in only inpatient prescriptions. In case of errors of categories by inpatient department, the number of errors of dosage form is 34 and 35, errors of dose is 7 and 8, errors of input is 6 and 3, errors of diluents is 4 and 4, errors of regimen is 2 and 1, errors of product is 2 and 1 in SG and HO, respectively. In case of outpatient department, the number of errors of dosage form is 8 in HO, errors of dose is 5 in HO, errors of input is 5 and 4 in SG and HO, respectively. Conclusions: The rate of errors of inpatient is higher than that of outpatient. Junior doctors are engaged in prescriptions of inpatient and pharmacist need to pay attention to review all prescriptions. If prescribing errors are discovered, pharmacist should contact the prescriber and correct the errors without delay. The guideline to reduce prescribing errors might be upgrading software of anti cancer management program, education for physicians as well as pharmacists and calling prescriber's attention to preventing recurrence of errors.

2D-QSAR analysis for hERG ion channel inhibitors (hERG 이온채널 저해제에 대한 2D-QSAR 분석)

  • Jeon, Eul-Hye;Park, Ji-Hyeon;Jeong, Jin-Hee;Lee, Sung-Kwang
    • Analytical Science and Technology
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    • v.24 no.6
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    • pp.533-543
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    • 2011
  • The hERG (human ether-a-go-go related gene) ion channel is a main factor for cardiac repolarization, and the blockade of this channel could induce arrhythmia and sudden death. Therefore, potential hERG ion channel inhibitors are now a primary concern in the drug discovery process, and lots of efforts are focused on the minimizing the cardiotoxic side effect. In this study, $IC_{50}$ data of 202 organic compounds in HEK (human embryonic kidney) cell from literatures were used to develop predictive 2D-QSAR model. Multiple linear regression (MLR), Support Vector Machine (SVM), and artificial neural network (ANN) were utilized to predict inhibition concentration of hERG ion channel as machine learning methods. Population based-forward selection method with cross-validation procedure was combined with each learning method and used to select best subset descriptors for each learning algorithm. The best model was ANN model based on 14 descriptors ($R^2_{CV}$=0.617, RMSECV=0.762, MAECV=0.583) and the MLR model could describe the structural characteristics of inhibitors and interaction with hERG receptors. The validation of QSAR models was evaluated through the 5-fold cross-validation and Y-scrambling test.

Effects of Biomedical Ethics Education using Movies on Biomedical Ethics Awareness of Nursing Students (영화를 이용한 생명의료윤리교육이 간호대학생의 생명의료윤리의식에 미치는 효과)

  • Kim, Seon Young
    • The Journal of the Korea Contents Association
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    • v.14 no.7
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    • pp.281-290
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    • 2014
  • This study is a quasi-experimental research using non-equivalent control group pre-post design in order to understand the effectiveness of biomedical ethics education using movies. This study selected the first-year 45 students and 63 students who were attending at two 4-year-course nursing colleges as an experimental group and control group, respectively. Then, this study provided the experimental group with the lecture on biomedical ethics for 16 weeks using the movie related to the ethical issues covering 10 areas. Data collection was done for 5 days from August 26, 2013 until December 5, 2013, and conducted pre-post questionnaire survey on the 1st week session and 16th session after explaining there search purpose and getting a written agreement from the subjects. As a result of analysis of the collected data using SPSS Statistics 18, it was found that students' average point of biomedical ethics awareness improved to 3.31 from 3.07; additionally, in the analysis of the data by sub-area, the point in artificial abortion improved to 3.69 from 3.08; artificial insemination from 2.99 to 3.57; fetal diagnosis from 3.10 to 3.45; a newborn's right to life from 3.39 to 3.55 and organ transplant from 3.26 to 3.53, respectively(P<.001). On the contrary, the research results showed that there was no change in the point of the mercy-killing, brain death, and human biotechnology areas, respectively(p>.05). Conclusively, movie-aided education could be diversely used for nursing education provided movie contents should be in accord with a lecture subject in a way that can arouse students' interest and concern, and improve educational satisfaction.

A Phenomenological Study for the Inquiry into Long Life Factors in Persons of One Hundred and Above on Cheju Island (제주도 100세이상 노인의 장수요인 규명을 위한 현상학적 연구)

  • Kim, Seong-Hyuk
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.40-63
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    • 1998
  • A long life is the desire of many people. The purpose of this study was to describe long life factors for people aged one hundred and above on Chju island. The research was conducted using a phenomenological method to add understanding to this subject. The field work for this study was done from July, 1997 to February, 1998 on Cheju island. The sample consisted of 10 persons of one hundred or above and 12 families. They were audio-recorded and analyzed using Colaizzi's (1978) method. The results of the present study shows the following: The thoughts of the persons one hundred and above showed ten important concepts; 'dietary regimen', 'mental regimen', 'sleep regimen', 'residence regimen', 'health regimen', 'labor regimen', 'exercise regimen', 'being born', 'filial piety and posterity', 'attachment to life'. Concerning 'Dietary Regimen': Dietary regulation, Preferential food intake, Living on vegetables, Light eating, and concern for longevity in food intake were important. Concerning 'Mental Regimen' : Harmony, Clearheadedness, Mildness, Abstinence, Generosity, Relaxation, Gaiety, Inspiration and Strength were important. Concerning 'Sleep Regimen'; Enough sleeping hours, Sound sleep, Curved sleeping posture, and Comfortable bedding were important. Concerning 'Residence Regimen' ; Clean dwelling, Pleasant surroundings, Thatched house life, Living in the village with good-hearted people, and Regular life were important. Concerning 'Health Regimen'; Temperance of drug, use Proper temperature, Proper humidity, and a Clean body were important. Concerning 'Labor Regimen'; Agricultural labor, Diligence, and Domestic labor were important. Concerning Exercise Regimen': Proper exercise, and Sunbathing were important. Concerning 'Being Born' ; Strong physical constitution, Longevity lineage, and Destiny were important. Concerning 'Filial Piety and Posterity' : Showing respect to a long-lived elder and Reducing anxiety were important. Concerning 'Attachment to Life' ; The desire to live long was important. The following conclusion was made from the above results. Human beings cannot avoid death, but the span of life can be prolonged to the maximum span of human life by wisdom, health care, and proper environmental conditions. As a result, a health regimen must be imposed for longevity such as controling food intake, having positive thoughts, being relaxed, sleeping enough, clean dwelling, taking care of oneself which can improve immunity and resistance to decrease, as well as proper labor and exercise. In addition, when filial piety is served, the desire of longevity and retaining one's youthfulness for a long time can be achieved. These should be done to live long and lead a qualitative life. By the results of this research, the following is suggesed for nursing. To satisfy the basic nursing principle that nursing must be practiced to help people live long, education must be spread to people who are nursed and their family so that they can lead a healthy life. And in nursing elders, nurses must recognize that elders have a strong desire for life, even though they may have negative thoughts about life at times. Therefore nurses have to respect the elders' value of life, and help them improve their self-esteem and self -fulfilment.

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Post Discharge Nursing Needs of Patients with Open Heart Surgery (개심술 환자의 퇴원후 간호요구에 대한 조사연구)

  • 김명희
    • Journal of Korean Academy of Nursing
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    • v.23 no.4
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    • pp.664-677
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    • 1993
  • The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1% of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

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Effects of the Severe Asian Dust Events on Daily Mortality during the Spring of 2002, in Seoul, Korea (2002년 봄 서울 지역에 발생한 심한 황사가 일별 사망에 미치는 영향)

  • Hwang, Seung-Sik;Kwon, Ho-Jang;Cho, Soo-Hun
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.2
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    • pp.197-202
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    • 2005
  • Objectives: During the spring of 2002, an unprecedented 2 Asian dust events were experienced in Seoul. On those days, the $PM_{10}$ was surprisingly increased, with daily $PM_{10}$ averages exceeding $600\;and\;700{\mu}g/m^3$ on March 21 and April 8, respectively. Accordingly, public concern relating to the possible adverse health effects of these dust events has increased, as the dust arrives in Korea after having flown over heavily industrialized eastern China. We investigated the effects of these Asian dust events on the mortality during the spring of 2002, in Seoul, Korea. Methods: The total number of deaths per day during the spring of 2002 in Seoul was extracted form the mortality records of the National Statistical Office. We constructed 14 Asian dust days (March 17-March 23, April 7-April 13) and 42 control days during the 56 day study period (March 3-April 27) with respect to the days of the week. The daily average numbers of deaths between the Asian dust and control days were analyzed, with adjustment for meteorological variables and pollutants. Results: The daily PM10 average during the Asian dust weeks was $295.2{\mu}g/m^3$, which was significantly higher than during the control days (p<0.001). The daily average number of deaths from all causes during the Asian dust days was 109.9; 65.6 for those aged 65 years and older, 6.7 from respiratory causes (J00-J99) and 25.6 from cardiovascular causes (I00-I99). The estimated percentage increases in the rate of deaths were 2.5% (95% CI=-5.0-10.6) from all causes; 2.2% (95% CI=-7.4-12.8) for those aged 65 years and older, and 36.5% (95% CI=0.7-85.0) from respiratory causes, but with a 6.1% (95% CI=-19.7-9.7) decrease in deaths from cardiovascular causes. Conclusion: The Asian dust events were found to be weakly associated with the risk of death from all causes. However, the association between dust events and deaths from respiratory causes was stronger. This suggests that persons with advanced respiratory diseases may be susceptible to Asian dust events.

An Overview and Implication of Apology Law and Disclosure Law in U.S.A. (미국의 사과법 및 디스클로져법의 의의와 그 시사점)

  • Lee, Won;Park, Ji Yong;Jang, Seung-Gyeong
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.81-111
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    • 2018
  • Recently in Korea, public interest about patient safety has increased because patient safety incidents occurred continuously. In addition, as the way of coping with medical personnel and medical institutions after occurrence of patient safety incident became controversial, the necessity of introducing apology law and disclosure law was raised. We analyzed the contents of apology law and disclosure law in U.S.A and critically examined the legislative movements in Korea. First, the Apology law requires that a medical personnel provide apology, consolation, sympathy to the patient for discomfort, pain, damage or death, and that the expression of apology shall be inadmissible as evidence of an admission of liability in civil action or administrative proceeding. The Apology law is divided into 'full apology law' and 'partial apology law' depending on whether mistake, error, fault, liability, and legal liability shall be inadmissible. Meanwhile, Disclosure law enforces or voluntarily enforces the law to communicate with the patient regarding the disclosure of the incident, the cause of incident, the compensation plan, and the measures to prevent the recurrence in the adverse incident that serious harm to the patient. In Korea, the concern about patient safety incidents has been amplified, and as the importance of communication between the medical personnel and patient has been recognized, the revision bill for the "Patient Safety Act", which adopted the U.S.A apology or disclosure law, was submitted to the National Assembly. The purpose of this study was to critically review the contents of the revised legislation based on the analysis of the apology law and disclosure law in U.S.A. and to provide implications for future legislative direction.

Surveillance Evaluation of the National Cancer Registry in Sabah, Malaysia

  • Jeffree, Saffree Mohammad;Mihat, Omar;Lukman, Khamisah Awang;Ibrahim, Mohd Yusof;Kamaludin, Fadzilah;Hassan, Mohd Rohaizat;Kaur, Nirmal;Myint, Than
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3123-3129
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    • 2016
  • Background: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported age-standardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on non-mandatory notification in the registry. Under-reporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. Materials and Methods: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from Feb-May 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and re-abstracting of medical records by independent auditors. The re-abstracting portion comprised 15 data items. Self-administered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. Results: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. Conclusions: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.

Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model

  • Mohd Fazeli Sazali;Syed Sharizman Syed Abdul Rahim;Ahmad Hazim Mohammad;Fairrul Kadir;Alvin Oliver Payus;Richard Avoi;Mohammad Saffree Jeffree;Azizan Omar;Mohd Yusof Ibrahim;Azman Atil;Nooralisa Mohd Tuah;Rahmat Dapari;Meryl Grace Lansing;Ahmad Asyraf Abdul Rahim;Zahir Izuan Azhar
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.2
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    • pp.82-93
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    • 2023
  • Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

Usefulness of presepsin as a prognostic indicator for patients with trauma in the emergency department in Korea: a retrospective study

  • Si Woo Kim;Jung-Youn Kim;Young-Hoon Yoon;Sung Joon Park;Bo Sun Shim
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.13-19
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    • 2024
  • Purpose: Trauma is an important public health concern, and it is important to increase the survival rate of patients with trauma and enable them to return to society in a better condition. Initial treatment in the emergency department (ED) is closely associated with the prognosis of patients with trauma. However, studies regarding laboratory biomarker tests that can help predict the prognosis of trauma patients are limited. Presepsin is a novel biomarker of inflammation that can predict a poor prognosis in patients with sepsis. This study aimed to determine whether presepsin could be used as a prognostic indicator in patients with polytrauma. Methods: The study included patients with trauma who had visited a single regional ED from November 2021 to January 2023. Patients who had laboratory tests in the ED were included and analyzed retrospectively through chart review. Age, sex, injury mechanism, vital signs, surgery, the outcome of ED treatment (admission, discharge, transfer, or death), and trauma scores were analyzed. Results: Overall, 550 trauma patients were enrolled; 59.1% were men, and the median age was 64 years (interquartile range, 48.8-79.0 years). Patients in a hypotensive state (systolic blood pressure, <90 mmHg; n=39) had higher presepsin levels (1,061.5±2,522.7 pg/mL) than those in a nonhypotensive state (n=511, 545.7±688.4 pg/mL, P<0.001). Patients hospitalized after ED treatment had the highest presepsin levels (660.9 pg/mL), followed by those who died (652.0 pg/ mL), were transferred to other hospitals (514.9 pg/mL), and returned home (448.0 pg/mL, P=0.041). Conclusions: Serum presepsin levels were significantly higher in trauma patients in a hypotensive state than in those in a nonhypotensive state. Additionally, serum presepsin levels were the highest in hospitalized patients with trauma, followed by those who died, were transferred to other hospitals, and returned home.