• Title/Summary/Keyword: medical manager

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Efficacy and Safety of OnabotulinumtoxinA in Patients With Neurogenic Detrusor Overactivity Caused by Spinal Cord Injury: A Systematic Review and Meta-Analysis

  • Li, Guang-Ping;Wang, Xiao-Yan;Zhang, Yong
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.275-286
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    • 2018
  • Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.

Factors of Stress and Rehabilitation Motivation among Orthopedic Hospital Inpatients at a Military Hospital (군병원 정형외과 입원환자의 스트레스 및 재활동기 영향 요인)

  • Kim, Ha Na;Kim, Seung Won
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.2
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    • pp.195-207
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    • 2022
  • Objectives: The purpose of this study was to identify the factors affecting rehabilitation motivation in hospitalized orthopedic patients. Methods: Data were collected from June 1th to July 31th, 2019 and structured questionnaires were used. Study subjects were 97 orthopedic patients who received fixed treatment more than two weeks and started rehabilitation exercise in a military hospital. The data were summarized using descriptive statistics and analyzed by t-test or one way ANOVA, Pearson's correlation analysis and multiple regression analysis were run in SPSS 20.0 program. Results: The results of this study may be summarized as follows. (1) The demographic characteristics that showed differences in rehabilitation motivation were marital status, age and the ranks of the armed forces. The rehabilitation motivation of married, older than 31, officer ranked soldiers turned out to be higher than those of singles, younger than 30, non-officers, respectively. (2) The results of Pearson's correlation analysis showed that independent variables were all correlated significantly each other. (3) The results of stepwise multiple regression analysis showed that the factors influencing rehabilitation motivation were family social support, medical personnel's social support and the level of military life adaption. Conclusions: The rehabilitation motivation of hospitalized soldiers may be improved by receiving supports from family members and medical personnels and by adapting to military life. Military medical workers need to explore nursing strategies that help hospitalized orthopedic patients increase their own rehabilitation motivation.

Association Between ERCC2 Polymorphisms and Glioma Risk: a Meta-analysis

  • Huang, Li-Ming;Shi, Xi;Yan, Dan-Fang;Zheng, Min;Deng, Yu-Jie;Zeng, Wu-Cha;Liu, Chen;Lin, Xue-De
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4417-4422
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    • 2014
  • ERCC2 is an essential component of the nucleotide excision repair pathway which is involved in the effective maintenance of genome integrity. Association studies on ERCC2 polymorphisms and glioma risk have yielded inconclusive results. This meta-analysis was performed to gain a better insight into the relationship between ERCC2 polymorphisms and glioma risk. A systematic literature search updated to December 2, 2013 was performed in the Pubmed and EMBASE databases. Crude pooled odds ratios (ORs) with their corresponding 95% confidence intervals (95% CIs) were used to estimate the association between ERCC2 polymorphisms and glioma risk under a suitable effect model according to heterogeneity. All analyses were performed using Review Manager 5 (version 5.2) and STATA (version 12.0). The combined results demonstrated rs13181 to be significantly associated with glioma risk (G allele versus T allele: OR=1.15, 95% CI=1.05-1.26, P=0.002; dominant model: OR=1.22, 95% CI=1.07-1.39, P=0.002; recessive model: OR=1.18, 95% CI=0.98-1.41, P=0.070). We also found that rs13181 acts in an allele dose-dependent manner (GG versus TT: OR=1.30, 95% CI=1.07-1.57, P=0.009; TG versus TT: OR=1.20, 95%=CI 1.05-1.37, P=0.009; trend test, P=0.004). However, no evidence was found in analyses for the association between other 3 ERCC2 polymorphisms (rs238406, rs1799793, and rs1052555) and susceptibility to glioma development. Our meta-analysis suggests that rs13181 is significantly associated with glioma risk in an allele dose-dependent manner, whereas, 3 other ERCC2 polymorphisms (rs238406, rs1799793, and rs1052555) may have no influence.

A Study on the Health Information Management Practice Program Model for EMR Certification System Education -Focus on Patient Information Management- (EMR 인증제 교육을 위한 보건의료정보관리 실습 프로그램 모델 연구 -환자정보관리 중심-)

  • Choi, Joon-Young
    • Journal of the Health Care and Life Science
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    • v.9 no.1
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    • pp.1-9
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    • 2021
  • In this study, a model in which certification standards were added to the health information management practice program was studied and presented in order to understand the EMR certification standards implemented by the Korea Health and Medical Information Service. In the practice program, the certification standard function for patient information management was added to the health information management education system to practice and understand patient information management that corresponds to the functional standard of the EMR certification system. The EMR certification standard practice program for patient information management is composed of the following certification standards. registration number and personal information management, treatment reservation schedule management, personal information revision history management, identification of people with the same name, integrated management of multiple registration numbers, patient search by identification information, patient search by health care type, surgical procedure consent record and inquiry, record/inquiry of consent form for personal information use, display of life-sustaining medical decision information, registration/inquiry of external medical institution documents, registration and inquiry of external examination results. In this way, by operating and practicing the functions of the health information system according to the certification standards, it is possible to understand and practice the certification standards and details of patient information management in the functional area of the certification standards. In addition, since the function of the EMR certification standard can be checked, it will be possible to improve the management ability of the electronic medical record system of the health information manager in the medical institution.

The Level of Job Satisfaction and Organizational Commitment of Medical Record Technicians (의무기록사의 직무만족도 및 조직몰입도)

  • Choei, Eun-Mi;Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.72-91
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    • 2003
  • The purpose of this study is to investigate the recognition of health information managers, and to analyze the level of job satisfaction and organizational commitment of medical record technicians. The data for this study were collected through a self-administered survey with a structured questionnaire to 172 subjects from medical record technicians working in hospitals in Seoul and Gyeonggi Province as well as the faculty of medical schools across South Korea. In this analysis frequency, t-test, ANOVA, factor analysis and structural equation model were used. The main findings of this study are as follows: 1. As for recognition of the seven dimensions in the role of health information managers, the role as clinical data specialist received the most positive feedback, followed by document & repository managers, patient information coordinators, health information managers, data quality managers, security officers and research & decision support analyst. 2. The level of job satisfaction among medical information handlers and managers averaged 3.14. In terms of the factors in the work environment concerned with job satisfaction, being able to work independently and as team players reached the top among 6 factors with the average of 3.39, followed by professional position, salary & rewards, expectations for job performance and administration. 3. The average rate of organizational commitment stood at 3.09. Respondents tend to be focused on present tasks rather than future-oriented tasks. 4. The result of the analysis based on the relationship between recognition as health information managers, job satisfaction and organizational commitment found that all analysis are statistically meaningful. The more the respondents were aware of their roles as health information managers, the more they tended to be committed to their work and satisfied with their work. The more the respondents were committed to their work, the more satisfaction was seen. The effects of recognition as health information managers on organizational commitment measured 0.27 and for job satisfaction it was 0.17. The effects of organizational commitment on job satisfaction stood at 0.71. The feasibility of the model meets the standard at Chi-square value of 66.755 and the P value of 0.057. The Normed Fit Index (NFI) of 0.930 was in compliance with the standard for model feasibility and the squared multiple correlation coefficient of this model was 8% in organizational commitment and 60% in job satisfaction.

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Association Between XRCC5, 6 and 7 Gene Polymorphisms and the Risk of Breast Cancer: A HuGE Review and Meta-analysis

  • Zhou, Li-Ping;Luan, Hong;Dong, Xi-Hua;Jin, Guo-Jiang;Man, Dong-Liang;Shang, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3637-3643
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    • 2012
  • Objective: Non-homologous end joining (NHEJ) is a pathway for repairing DNA double-strand breaks. Recent publications indicated that XRCC5, XRCC6 and XRCC7 genes may participate in the pathogenesis of breast cancer. The aim of this Human Genome Epidemiology (HuGE) review and meta-analysis was to investigate associations between XRCC5, XRCC6 and XRCC7 genetic polymorphisms in the NHEJ pathway and breast cancer risk. Methods: Studies focusing on the relationship between genetic polymorphisms in XRCC5, XRCC6 and XRCC7 genes and susceptibility to breast cancer were selected from the Pubmed, Cochrane library, Embase, Web of Science, Springerlink, CNKI and CBM databases. Data were extracted by two independent reviewers. The meta-analysis was performed with Review Manager Version 5.1.6 and STATA Version 12.0 software. The odds ratio (OR) with 95% confidence interval (95%CI) was calculated based on the extracted data. Results: According to the inclusion criteria, we final included seven studies with a total of 2,864 breast cancer cases and 3,060 healthy controls. Meta-analysis results showed that rs3835 (G>A) and rs828907 (G>T) in XRCC5 gene, and rs132793 (G>A) in XRCC6 gene might increase the risk of breast cancer, while rs132788 G>T and rs6002421 (A>G) might be protective factors. However, there was no relationship between XRCC7 genetic polymorphisms and the risk of breast cancer. Conclusion: This meta-analysis suggests that the rs3835 G>A and rs828907 G>T in XRCC5 gene, rs6002421 (A>G), rs132788 (G>T) and rs132793 (G>A) in XRCC6 gene might be risk factors for breast cancer, while the rs132788 (G>T) and rs6002421 (A>G) in XRCC6 gene might be protective.

Poor Prognosis Significance of Pretreatment Thrombocytosis in Patients with Colorectal Cancer: a Meta-Analysis

  • Zhao, Jian-Meng;Wang, Yong-Hong;Yao, Nan;Wei, Kong-Kong;Jiang, Lei;Hanif, Shahbaz;Wang, Zi-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4295-4300
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    • 2016
  • Background: Recently, several studies have reported that elevated platelet counts may be associated with the poor prognosis of colorectal cancer. However, conclusions remain controversial. This meta-analysis was therefore designed to analyze and evaluate the prognostic role of preoperative or pretreatment thrombocytosis in patients with colorectal cancer. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library and Web of Science to March 29th, 2015. The citation lists of included studies were also hand-searched to identify further relevant trials. To investigate the association between thrombocytosis and prognosis of colorectal cancer, the 1-year, 3-year and 5-year survival of each studies were obtained. The odds ratio (OR) with its 95% confidence interval (CI) was used to evaluate the relation of overall survival (OS) between thrombocytosis and normal platelet counts (PLT). Likewise, disease free survival (DFS) was obtained and evaluated. The analysis was performed and assessed using Review Manager 5.2. Results: A total of 14 studies (N=5,566 participants, 11 including 4,468 for OS, 6 including 1,533 for DFS) were included in this meta-analysis, of which seven (N=3810) defined thrombocytosis as a platelet count ${\geq}400{\times}10^9/L$, and 375 (9.8%) patients exhibited pretreatment thrombocytosis. Thrombocytosis have a close relationship with the poor OS of colorectal cancer compared with normal PLT, with the pooled ORs of 1-year, 3-year and 5-year survival being 0.41 [95% CI 0.34-0.51; P<0.001], 0.28 [95% CI 0.21-0.38; P<0.001] and 0.26 [95% CI 0.20-0.34; P<0.001], respectively. For DFS, the same results were showed as the pooled ORs of 1-year, 3-year and 5-year survival respectively being 0.34 [95% CI 0.24-0.50; P<0.001], 0.31 [95% CI 0.23-0.43; P<0.001] and 0.25 [95% CI 0.18-0.34; P<0.001]. Conclusions: This meta-analysis indicated that thrombocytosis may predict poor prognosis for patients with colorectal cancer, and platelet counts may be a cost-effective and noninvasive marker.

Genetic Variants of CYP2D6 Gene and Cancer Risk: A HuGE Systematic Review and Meta-analysis

  • Zhou, Li-Ping;Luan, Hong;Dong, Xi-Hua;Jin, Guo-Jiang;Man, Dong-Liang;Shang, Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3165-3172
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    • 2012
  • Objective: Genetic polymorphisms in metabolic enzymes are associated with numerous cancers. A large number of single nucleotide polymorphisms (SNPs) in the CYP2D6 gene have been reported to associate with cancer susceptibility. However, the results are controversial. The aim of this Human Genome Epidemiology (HuGE) review and meta-analysis was to summarize the evidence for associations. Methods: Studies focusing on the relationship between CYP2D6 gene polymorphisms and susceptibility to cancer were selected from the Pubmed, Cochrane library, Embase, Web of Science, Springerlink, CNKI and CBM databases. Data were extracted by two independent reviewers and the meta-analysis was performed with Review Manager Version 5.1.6 and STATA Version 12.0 software. Odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated. Results: According to the inclusion criteria, forty-three studies with a total of 7,009 cancer cases and 9,646 healthy controls, were included in the meta-analysis. The results showed that there was a positive association between heterozygote (GC) of rs1135840 and cancer risk (OR=1.92, 95%CI: 1.14-3.21, P=0.01). In addition, we found that homozygote (CC) of rs1135840 might be a protective factor for cancer (OR=0.58, 95%CI: 0.34-0.97, P=0.04). Similarly, the G allele and G carrier (AG + GG) of rs16947 and heterozygote (A/del) of rs35742686 had negative associations with cancer risk (OR=0.69, 95%CI: 0.48-0.99, P=0.04; OR=0.60, 95%CI: 0.38-0.94, P=0.03; OR=0.50, 95%CI: 0.26-0.95, P=0.03; respectively). Conclusion: This meta-analysis suggests that CYP2D6 gene polymorphisms are involved in the pathogenesis of various cancers. The heterozygote (GC) of rs1135840 in CYP2D6 gene might increase the risk while the homozygote (CC) of rs1135840, G allele and G carrier (AG + GG) of rs16947 and heterozygote (A/del) of rs35742686 might be protective factors.

간호 업무 실태 분석 및 합리적인 병실 관리 개선 방향

  • 방용자;강흥순
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.111-132
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    • 1970
  • An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

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Development of Smartphone Application for Cognitive Behavioral Therapy-Based Case Management in Patients with Schizophrenia (조현병 환자의 인지행동치료 기반 사례관리를 위한 스마트폰 애플리케이션 개발)

  • Kim, Sung-Wan;Lee, Ga-Young;Yu, Hye-Young;Park, Ji-Hyun;Lee, Yong-Sung;Kim, Ju-Wan;Park, Cheol;Lee, Ju-Yeon;Lee, Yo-Han;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Schizophrenia Research
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    • v.19 no.1
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    • pp.10-16
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    • 2016
  • Objectives : This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. Methods : Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). Results : The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. Conclusion : The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.