• Title/Summary/Keyword: e-clinical data

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Efficiency of Footwear and Ventilation Systems of Operating Rooms : How to Choose Suitable Shoes? (환기정도에 따른 수술실용 신발 종류가 수술실 오염에 미치는 영향)

  • Nam, Kyung-Dong;Chung, Hye-Seon;Park, Young-Shin;Won, Jin-Hee;Ju, Mi-Ja;Seong, Hwa-Shin;Lee, Ji-Hyui;Lee, Byung-Hee;Cho, Kyung-Sook;Bae, Jae-Chun
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.72-89
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    • 2000
  • Background : Various types of protective footwear have been used to minimize bacterial contamination in operating rooms. In recent years, debate has arisen concerning the need for use of such protective footwear. This study was designed to provide useful data about choosing shoes most suitable for the surgical environment. Methods : Between November, 1999 and January, 2000, we performed this experimental study by comparing effect of three types of shoes (i.e., disposable shoescover, operating room-restricted shoes, and ordinary shoes) on bacterial contamination of operating rooms equipped with two different ventilation systems (i.e., high air-change, low air-change) respectively. Data were collected during two- hour sham operations in which subjects and their activities were strictly standardized. Bacterial flora were sampled from the study area floor and air colony counts were measured. Results : In experiments involving high air-change ventilation system, there was a significant difference of floor contamination between three types of shoes, but no difference of air contamination. Under low air-change system, there was a significant difference of both floor and air contamination between three types of shoes. Conclusion : The results show that protective footwear would be unnecessary in the operating room with high air-change ventilation system, but it is important to choose suitable shoes carefully under low air-change system. Therefore, the use of outdoor shoes can be considered under high air-change system, but it would seem sensible to apply their first use in less bloody operations at the day surgery center or out-patient department to prevent transfer of body fluid into the outside environment.

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Factors affecting patient safety behavior and performance of infection control among nursing students (간호대학생의 환자안전행위 및 감염관리 수행도에 영향을 미치는 요인)

  • Lee, Suzy;Shin, Gisoo;Cho, Mi-Kyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.8
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    • pp.343-352
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    • 2018
  • This study was conducted to identify the factors influencing patient safety behavior and performance of infection control in nursing students. This study was a descriptive survey based on data collected from August 28, 2017, to September 22, 2017 from 174 third and fourth year nursing students at E university located in S city of Gyeonggi. The collected data were analyzed using the PASW 23.0 program to conduct an independent t-test, one-way ANOVA, post-hoc Scheffe's test, Pearson's correlation, and multiple regression. The average scores of patient safety behavior and performance of infection control were $4.00{\pm}0.55$ and $4.31{\pm}0.50$, respectively. Patient safety behavior and performance of infection control showed a strong positive correlation. Patient safety behavior was positively influenced by confidence levels of patient safety and awareness of the infection control, and the explanatory power of the model (R2)[ED highlight - should this be R2? If so, change throughout the paper.] was 55.1%. Predictors of the performance of infection control were patient safety knowledge, confidence levels regarding patient safety, and awareness of infection control, and the R2 was 68.1%. Common factors influencing patient safety behavior and infection control performance were patient safety confidence and development of effective clinical practicum education programs to increase confidence in patient safety and infection control.

Does Process Quality of Inpatient Care Serve as a Guide to Reduce Potentially Preventable Readmission (PPR)? (의료서비스의 과정적 질과 잠재적으로 예방 가능한 재입원율과의 관계)

  • Choi, Jae-Young
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.87-106
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    • 2018
  • Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

The Current Status of Music Therapy Centered on 54 Hospice and Palliative Care Settings Designated by the Ministry of Health and Welfare in 2014 (2014년 보건복지부 지정 54개 호스피스·완화의료 기관 내 음악치료 현황)

  • Kim, Eun Jung;Choi, Youn Seon;Kim, Won-chul;Kim, Kyung Suk
    • Journal of Music and Human Behavior
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    • v.13 no.1
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    • pp.19-40
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    • 2016
  • This study provides numerical data on the status of music therapy practices in 54 hospice and palliative care settings in Korea. Two different questionnaires for music therapists and coordinators were sent to 54 coordinators via email, and 47 (87%) hospitals and centers replied by email or post. The survey period was October 30 through December 5, 2014. Music therapists were asked to respond to 65 questionnaire items regarding working conditions, environment, session process, and personal competence. Coordinators were asked to complete 28 questionnaire items regarding the status of music therapy in their perspective setting. Twenty-two (46.8%) hospitals and centers were running music therapy programs with 28 music therapists, and 19 (67.9%) of these music therapists majored in music therapy. There was a significant difference between music therapists (M= 3.43, SD = 0.96) and coordinators (M= 2.73, SD = 0.77) regarding conditions and environment of music therapy sessions (p < .05). The circumstances and conditions for music therapy are inad quate for optimal implementation of music therapy practice. However, the perceived benefits of music therapy by coordinators suggest that music therapists do play an important role in hospice and palliative care. This research provides the first quantitative baseline data of music therapy status in hospice and palliative care settings in Korea.

Inspection on the acoustic output of the focused extracorporeal focused shock wave therapeutic devices approved by MFDS (식약처에서 허가된 집속형 ESWT 치료기의 음향 출력 분석)

  • Choi, Min Joo;Jeon, Sung Joung;Kwon, Oh Bin;Lee, Min Young;Cho, Jin Sik;Kim, Han Soo;Maeng, Eun Ho
    • The Journal of the Acoustical Society of Korea
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    • v.39 no.4
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    • pp.303-317
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    • 2020
  • Extracorporeal Shock Wave Therapy (ESWT) is an innovative treatment in chronic musculoskeletal pain management and cardiovascular diseases. In this study, we surveyed the acoustic shock wave outputs from the domestically used focal type ESWT devices. The survey data were collected through 30 technical documents registered to the Ministry of Food and Drug Safety (MFDS), Rep. Korea. The results show that the focusing geometry varies largely, 5 mm to 65 mm in the focal length, 3 mm to 30 mm in focal width, and 4 mm to 108 mm in focal depth. The maximum positive pressure (P+) ranges from 7 MPa to 280 MPa, the focal Energy Flux Density (EFD) from 0.0035 mJ/㎟ to 35 mJ/㎟, and the energy per pulse (E) from 0.737 mJ to 80.86 mJ. All domestic PE-type (five) and one EM-type domestic devices included in the analysis of the correlation between P+ and EFD are shown to be far beyond the usual ranges and do not comply with expected correlation so that the reliability of their data was suspected. For the suspected, post-performance tests are required by a recognized testing agency. MFDS guidelines need to be revised so that the pass criteria for the shock wave acoustic outputs can be based on the clinical tests for indications.

Comparative evaluation to select optimal adjuvant of novel type Salmonella Typhimurium inactivated bacteria for protecting Salmonella infections in a murine model (마우스에서 살모넬라 감염증 예방을 위한 신개념 Salmonella Typhimurium 불활화 사균체에 최적 adjuvant 선택을 위한 효능 비교 시험)

  • Moon, Ja-Young;Ochirkhuyag, Enkhsaikhan;Kim, Won-Kyong;Lee, Jun-Woo;Jo, Young-Gyu;Kwak, Kil Han;Park, Byung Yong;Hur, Jin
    • Korean Journal of Veterinary Service
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    • v.43 no.2
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    • pp.89-97
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    • 2020
  • This study was carried out to examine a novel inactivated Salmonella Typhimurium (S. Typhimurium) vaccine candidate for protection of mice against salmonellosis by immunization of BALB/c mice using various type adjuvant. The novel type-inactivated vaccine candidate was constructed by adding Chlorhexidine digluconate solution. BALB/c mice were divided into 6 groups of 15 mice apiece. The mice were intramuscularly (IM) primed at 6 weeks of age and were IM boosted 8 weeks of age. Groups A and B mice were injected with sterile phosphate-buffered saline as controls; group C mice were inoculated with 5×108 cells/100 µL of formalin-inactivated S. Typhimurium cells and adjuvant ISA70; groups D~F mice were immunized with 5×108 cells/100 µL of the inactivated vaccine candidate and adjuvant ISA70, adjuvant IMS1313 and adjuvant IMS1313 containing 30 ㎍/mL of GI24, respectively. All mice (except group A mice) were orally challenged with a virulent S. Typhimurium strain at 10 weeks of age. Mice from groups C-F had significantly increased IgG levels compared to control groups (A-B) mice. The levels of splenocyte IFN-γ and IL-4 in mice of all groups were measured by ELISA, resulting in increased immunity in group F mice compared to those of groups A-E mice. These data suggested that systemic and cell-mediated immune responses were highly induced by IM immunization with the vaccine candidate and adjuvant IMS1313 containing GI24. Furthermore, clinical signs such as death were observed in only 20% of group F mice after virulent Salmonella strain challenge, however, groups B and C (100%), and groups D and E (60%) mice died. This data suggested that mice immunized by intramuscular prime and booster with this vaccine candidate and adjuvant IMS1313 containing GI24 effectively protected mice from salmonellosis.

Polymorphisms of the CTLA-4 promoter(-318) and exon 1(+49) genes with atopic dermatitis in Korean children (아토피피부염 환아에서 CTLA-4 exon 1과 promoter 유전자 다형성)

  • Song, Tae Won;Yang, Hea Sun;Lee, Kyung Eun;Kim, Kyung Won;Kim, Eun Soo;Sohn, Myung Hyun;Kimc, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.545-551
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    • 2006
  • Purpose : The gene-encoding cytotoxic T lymphocyte-associated antigen-4(CTLA-4) is one of the candidate genes for conferring susceptibility to atopic dermatitis(AD). The aim of the study was to investigate the association between Korean children with AD and the polymorphisms of CTLA-4 gene promoter(-318) and exon 1(+49). Methods : The CTLA-4 promoter(-318 T/C) and exon 1(+49 A/G) polymorphisms were genotyped via restriction fragment length polymorphism methods in 145 children with atopic eczema, 69 children with non-atopic eczema, and 96 healthy controls. Results : There was no significant difference in genotype and allele frequencies of the CTLA-4 promoter -318 T/C and exon 1 +49 A/G polymorphisms when the atopic eczema, non-atopic eczema, and control groups were compared. Additionally the CTLA-4 promoter -318 T/C and exon 1 +49 A/G polymorphisms were not shown to be associated with severity, IgE level, or eosinophil counts. Conclusion : Our data show that the polymorphisms within the CTLA-4 promoter(-318 T/C) and exon 1(+49 A/G) genes are not associated with susceptibility to AD in Korean children.

Clinical Observation of Western Medical Treatment and Acupuncture Treatment on Frozen Shoulder Patients (유착성 관절낭염 치료에 있어서 한방 치료와 양방 치료의 임상적 고찰 - 동서협진 모델 개발을 위한 기초 연구를 중심으로 -)

  • Nam, Dong-Woo;Jung, In-Tae;Kim, Joo-Hee;Park, You-Seon;Lim, Sabina;Lee, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.23 no.5
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    • pp.177-185
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    • 2006
  • Objectives : To observe the effect of acupuncture treatment and western medical treatment on frozen shoulder patients. Methods : 39 voluntary patients were randomly assigned to the Eastern treatment group(E group, n=22) and the Western treatment group(W group, n=17). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. Both groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment using Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 5.67 on a scale of 10. The W group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 7.73. But the difference between the two groups were insignificant according to CSA and SPADI. Conclusion : Both acupuncture and nerve block treatment significantly improved frozen shoulder. But the difference of the two treatments was insignificant.

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The Effect of Dextranase-Containing Mouthwash in Human Experimental Gingivitis (실험적 치은염에서 dextranase 함유 구강 세정액의 양치 효과)

  • Son, Eun-Ju;Kim, Young-Jun;Kim, Do-Man;Chung, Hyun-Ju
    • Journal of Periodontal and Implant Science
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    • v.31 no.2
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    • pp.401-420
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    • 2001
  • A novel glucanhydrolase from a mutant of Lipomyces starkeyi(KSM 22)has been shown effective in hydrolysis of mutan, reduction of mutan formation by Streptococcus mutans and removal pre-formed sucrose-dependent adherent microbial film and Lipomyces starkeyi KSM 22 dextranase has been strongly bound to hydroxyapatitie. These in vitro properties of Lipomyces starkeyi KSM 22 dextranase are desirable for its application as a dental plaque control agent. This study was performed to determine oral hygiene benefits and safety of dextranase(Lipomyces starkeyi KSM 22 dextranase)-containing mouthwash in human experimental gingivitis. This 3-week clinical trial was placebo-controlled double-blind design evaluating 1U/ml dextranase mouthwash and 0.12% chlorhexidine mouthwash. A total 39 systemically healthy subjects, who had moderate levels of plaque and gingivitis were included. At baseline, 1, 2 and 3 weeks, subjects were scored for plaque(Silness and $L{\ddot{o}e$ plaque index and plaque severity index), gingivitis($L{\ddot{o}e$ and Silness gingival index), and at baseline and 3 weeks of experiment, subjects were scored for plaque(Turesky-Quingley-Hein's plaque index and plaque severity index), tooth stain(Area and severity index system by Lang et al). Additionally, oral mucosal examinations were performed and subjects questioned for adverse symptoms. Two weeks after pre-experiment examinations and a professional prophylaxis, the subjects provided with allocated mousewash and instructed to use 20-ml volumes for 30s twice dailywithout toothbrushing. All the groups showed significant increase in plaque accumulation since 1 week of experiment. During 3 weeks' period, the dextranase group showed the least increase in plaque accumulation of Silness and $L{\ddot{o}e$ plaque index, compared to the chlorhexidine and placebo groups, but chlorhexidine group showed the least increase inplaque accumulation of Turesky-Quingley-Hein's plaque index. As for gingival inflammation, all the groups showed significant increase during 3 weeks of experiment. The dextranase group also showed the least increase in gingival index score, compared to the chlorhexidine as well as the placebo groups. Whereas the tooth stain was increased significantly in the chlorhexidine group, compared to the baseline score and the placebo group since 3 weeks of mouthrinsing. It was significantly increased after 3 weeks in the dextranase group, still less severe than the chlorhexidine group. As for the oral side effect, the dextranase group showed less tongue accumulation, bad taste, compared to the chlorhexidine group. From these results, mouthrinsing with Lipomyces starkeyi KSM 22 dextranase was comparable to 0.12% chlorhexidine mouthwashin inhibition of plaque accumulation and gingival inflammation and local side effects were if anything less frequent and less intense than chlorhexidine, in human experimental gingivitis. All data had provided positive evidence for Lipomyces starkeyi KSM 22 dextranase as an antiplaque agent and suggested that further development of dextranase formulations for plaque control are warranted.

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Prevalence of major enteric pathogens in different feeding groups of pig in Korean pig farms (국내 양돈장의 사육구간별 주요 소화기질병 원인체 유병율 조사)

  • Jung, Youn-Soo;Park, Yu-Ri;Kang, Dae-Young;Han, Do-Hyun;Yoon, Duhak;Jung, Byeong-Yeal;Park, Choi-Kyu
    • Korean Journal of Veterinary Service
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    • v.39 no.4
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    • pp.211-219
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    • 2016
  • For determining the prevalence of major enteric pathogens, clinical examination and etiological diagnosis were carried out on 75 Korean pig farms. Enteric disease-suspected signs were observed in 90.7% of the farms and the incidence and severity were higher in younger age groups of the pigs. Five of seven pathogens were detected in 375 fecal samples collected from the 75 farms, and the farm-level prevalence of porcine rotavirus group A (PoRVA), pathogenic Escherichia (E.) coli, Lawsonia (L.) intracelluraris, Salmonella spp., and Brachyspira (B.) hyodysenteriae was 54.7%, 54.7%, 16.0%, 10.7% and 2.7%, respectively. PoRVA was extensively infected in suckling and weaning pig groups. The prevalence of pathogenic E. coli was highest in suckling period, and after the period, it exhibited a tendency to decrease. Salmonella spp. and L. intracelluraris were detected in all feeding groups of pigs in a ratio of 1.3~6.7%. B. hyodysenteriae was detected in 1.3~2.7% of growing and fattening pig groups but not detected in suckling and weaning pig groups. At least one or more pathogens were detected in 30.1% of 375 fecal samples. Among these, 25.0% or 5.1% of cases were single or mixed infection. Enteric disease signs of the pigs were significantly co-related with the detection of PoRVA, pathogenic E. coli or Salmonella spp. (P<0.01) but not with L. intracelluraris or B. hyodysenteriae (P>0.05). Conclusively, it will be expected that these data obtained in this study are very useful for subsequent studies and prevention strategies for swine enteric disease in Korean pig farms.