• Title/Summary/Keyword: multi-institutional study

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Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach (전자간호기록 시스템의 사용성 수준 및 관련 요인 분석: Time-motion 방법 적용을 통한 다기관 접근)

  • Cho, Insook;Choi, Won-Ja;Choi, WoanHeui;Hyun, Misuk;Park, Yeonok;Lee, Yoona;Cho, Euiyoung;Hwang, Okhee
    • Journal of Korean Academy of Nursing
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    • v.45 no.4
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    • pp.523-532
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    • 2015
  • Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

The development of CAl Courseware for Basic Life Support - Centered on the Foreign-Body Airway Obstruction in Adult- (기본 인명구조술 교육을 위한 CAI 코스웨어 개발 - 성인의 이물질에 의한 기도폐쇄를 중심으로 -)

  • Kim, Mi-Seon
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.109-118
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    • 2003
  • With the rapid development of information and communication technology, a lot of multi-media learning programs are being developed and reported in the field of Emergency medicine both home and abroad. In this connection, this study was aimed at developing a foreign-body airway obstruction courseware in adults for EMT. The development period of CAI courseware lasted from May 2003 through November 2003. Among CAI courseware patterns, private instruction and repeat practice and simulation patterns were used as an instruction-learning strategy. The learning contents of the CAI courseware consisted of five chapters concerning (1) A relief of partial FBAO in the responsible victim, (2) A relief of complete FBAO in the responsible victim, (3) In case of unconsciousness in the responsible victim without removing all foreign body, (4) In case of consciousness in all victims after getting removed all foreign body and (5) A complete airway obstruction in victims without consciousness on the basis of assess responsiveness and the degree of airway obstruction. The way to use this courseware, with just a click on one specific chapter, was developed to proceed a course with progressive algorithm, a method of solving problems by choosing one between two situations. A characteristic of this CAI courseware is the enhanced efficiency of an instruction-learning method by providing an opportunity of choice based on situations in its effort to encourage learners to use a self-initiated learning method, not one-way method and to enhance problem solving skills among situations. Moreover, this courseware went through the diverse phases such as development, application, feedback in connection with learning process by practicing teachers, so that the courseware could be used frequently in the future. The contents of this courseware were written with the web, so that, if necessary, the contents could be continuously modified and complemented and handed out in the form of CD-ROM. This study indicates that the development of a variety of CAI courseware requires institutional and financial assistance and initiatives reflecting a reality in terms of learning process, technical assistance and resources.

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Political Implication on the Genetically Modified Crops (유전자(遺傳子) 변형(變形) 농산물(農産物)에 관한 정책적(政策的) 함의(含意))

  • Shin, Young In;Park, In Shik
    • Korean Journal of Agricultural Science
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    • v.26 no.2
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    • pp.116-129
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    • 1999
  • The objectives of the study mainly concentrated on identifying the political implication on genetically modified crops considering production potentials and problems. It is found that the comprehensive evaluation of the genetically modified crops could not be concluded and compromised in a word on account of the polarization and parallelism of the positive and negative benefits of genetically modified crops just like as the rail way. The genetically modified crops will be contributed to solving the food shortage problems in the world, when the issues such as food safety, ecological disturbance and loss and degradation of biodiversity can be guaranteed in transparency. And when the trade morality of the multi-national enterprises be accepted by the genetically modified crops consumers, the potentiality of genetically modified crops will be realized greatly. By the way, the first problems will be expected to be solved by scientific development. If the food safety of the genetically modified technology be verified in transparency, it will be greatly contributed to solve food problems of human beings in the world. But the second problem could not be expected to be easily solved from the view point of capital property. In conclusion, the genetically modified technology will be made a severe sense of incongruity and a seed of fire on it will be remained persistently. According to the results based on the analysing the genetically modified crops potentiality and problems, it was identified that the ex-ante preparation of counter-measures and actions on it should be necessary. Accordingly this study has recommended that how and what the R&D policy on genetically modified crops be established and suggested how to carried out the industrial and economic policy together with international negotiation, and organizational and institutional rearrangement and etc.

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Birth Outcomes among Native-born and Foreign-born Women in Korea: Focusing on Preterm Birth and Low Birth Weight (외국인 여성과 한국인 여성의 출산결과 비교: 조산아 및 저체중아를 중심으로)

  • Ryu, Jungkyun;Choi, Yool
    • Journal of health informatics and statistics
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    • v.43 no.4
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    • pp.255-266
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    • 2018
  • Objectives: This study compared the risk of preterm birth and low birth weight between native-born and foreign-born women. Methods: By Using the birth registration data, every woman who gave birth between 2010 and 2016 in Korea was included in the analysis. Duration from marriage to pregnancy was measured by month and multiple socioeconomic and demographic characteristics were controlled. Preterm birth (<37 weeks) and low birth weight (<2.5 kg) were used for outcome variables. Descriptive statistics and logistic regression were used for data analysis with Stata. Results: The risks of preterm birth and low birth weight for native-born and foreign-born women differed according to the duration of marriage or birth order. For the first infant, foreign-born women were more likely to have pereterm birth or low birth weight than the native-born in the early stage of marriage but nativeborn women had higher risks than the foreign-born in the middle and later stage of marriage. For the second infant, foreign-born women were less likely to have pereterm birth or low birth weight than the native-born regardless of the duration of marriage. Conclusions: The results of this study demonstrates that the risk of preterm birth and low birth weight for foreign-born women is concentrated on the early stage of marriage. Institutional and cultural supports should be given to foreign-born women to help their early settlement in the Korean society.

The Risk of Rosacea According to Chronic Diseases and Medications: A 5-Year Retrospective, Multi-Institutional Case-Control Study

  • Son, Jee Hee;Chung, Bo Young;Jung, Min Je;Choi, Yong Won;Kim, Hye One;Park, Chun Wook
    • Annals of dermatology
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    • v.30 no.6
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    • pp.676-687
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    • 2018
  • Background: Rosacea is associated with chronic systemic disease. However, research is lacking in Asian countries. Objective: To evaluate the association between rosacea and cardiovascular diseases (CVDs) related systemic comorbidities, and the use of antihypertensive and antihyperlipidemic drugs in Korea. Methods: A five-year retrospective study, using hospital database, was conducted in five medical centers for five years. Totally 1,399,528 patients were evaluated. Results: The overall frequency for diagnosed rosacea was 0.18% over five years (2,536 rosacea patients). Patients with diabetes and patients with dyslipidemia were more likely to have rosacea (odd ratio [OR] 2.724, 95% confidence interval [CI] 1.295~5.730, p=0.016; OR 1.788, 95% CI 1.445~2.212, p<0.001). Patients with CVD were less likely to have rosacea (OR 0.431, 95% CI 0.244~0.760, p=0.003). Patients with ${\alpha}$-blocker prescriptions and patients with ${\beta}$-blocker prescriptions showed a tendency diagnosed with rosacea frequently (OR 1.963, 95% CI 1.200~3.212, p=0.006; OR 3.939, 95% CI 3.512~4.419, p<0.001). Patients with [beta]-hydroxy-[beta]-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, and those with fibrate, were prone to have rosacea (OR 1.599, 95% CI 1.390~1.839, p<0.001; OR 1.660, 95% CI 1.056~2.609, p=0.026). As adjusted results, among the patients who took HMG-CoA reductase inhibitor without dyslipidemia, rosacea was less likely to be diagnosed (OR 0.780, 95% CI 0.620~0.982, p=0.034). Conclusion: Rosacea is associated with chronic diseases and drugs.

A Study on the International Recognition of the COVID-19 Vaccination Certificates (코로나19 예방접종증명서의 국제적 인정에 관한 연구)

  • Jang, Su Yun;Kwon, Hun Yeong
    • Journal of Information Technology Services
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    • v.20 no.6
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    • pp.45-62
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    • 2021
  • After the COVID-19 outbreak in 2019, the spread of COVID-19 has not been easily caught despite preventive measures in each country. The spread of COVID-19 has hit the world, especially in the economic and tourism sectors. Countries around the world are easing restrictions on the movement of vaccinated people in preparation for the post-corona era. Under the name of "Vaccine Passport," "Vaccination Certificate," and "Digital Health Pass," vaccination measures are being implemented to allow vaccination recipients to use multi-use facilities. However, there is no international agreement on the movement of countries, and each country has its own immigration policy. In order to return to pre-corona daily life, global agreements must be reached from the movement of vaccinated people between countries, and standards and implementation methods must be determined. This study focuses on the implementation and utilization of vaccination certificates suitable for the COVID-19 era. We will look at the spread of COVID-19 and its international response policies. In the case of COVID-19, we will investigate why vaccination certificate installation should be standardized and how far the current standardization has been discussed, and discuss the characteristics of vaccination certificate installation and considerations. In order for the immunization certificate discussed in the previous chapter to be recognized internationally, institutional and technical considerations are identified and security factors that may occur in each implementation are also presented. Finally, the international recognition case of vaccination certificate is discussed, and the method of installation and utilization of vaccination certificate is proposed. This paper can be used as a policy because of its timeliness in studying the standards of vaccination certificates and considerations for international recognition to restore movement between countries in the spread of COVID-19. In addition, if other infectious diseases occur in the future or similar cases where movement between countries is restricted, it can be used as a reference to support the movement of verified people.

Effect of Four Main Gastrectomy Procedures for Proximal Gastric Cancer on Patient Quality of Life: A Nationwide Multi-Institutional Study

  • Koji Nakada;Akitoshi Kimura;Kazuhiro Yoshida;Nobue Futawatari;Kazunari Misawa;Kuniaki Aridome;Yoshiyuki Fujiwara;Kazuaki Tanabe;Hirofumi Kawakubo;Atsushi Oshio;Yasuhiro Kodera
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.275-288
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    • 2023
  • Purpose: This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Materials and Methods: We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. Results: Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (-1 point). Conclusions: The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.

The Case and Implications of Terminology Mapping for Development of Dankook University Hospital EHR-Based MOA CDM (단국대학교병원 EHR 기반 MOA CDM 구축을 위한 용어 매핑 사례와 시사점)

  • Yookyung Boo;Sihyun Song;Jihwan Park;Mi Jung Rho
    • Korea Journal of Hospital Management
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    • v.29 no.1
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    • pp.1-18
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    • 2024
  • Purposes: The Common Data Model(CDM) is very important for multi-institutional research. There are various domestic and international CDM construction cases to actively utilize it. In order to construct a CDM, different terms from each institution must be mapped to standard terms. Therefore, we intend to derive the importance and major issues of terminology mapping and propose a solution in CDM construction. Methodology/Approach: This study conducted terminology mapping between Electronic Health Record(EHR) and MOA CDM for constructing Medical Record Observation & Assessment for Drug Safety(MOA) CDM at Dankook University Hospital in 2022. In the process of terminology mapping, a CDM standard terminology process and method were developed and terminology mapping was performed by applying this. The constructions of CDM mapping terms proceeded in the order of diagnosis, drug, measurement, and treatment_procedure. Findings: We developed mapping guideline for CDM construction and used this for mapping. A total of 670,993 EHR data from Dankook University Hospital(January 1, 2013 to December 31, 2021) were mapped. In the case of diagnosis terminology, 19,413 were completely mapped. Drug terminology mapped 92.1% of 2,795. Measurement terminology mapped 94.5% of 7,254 cases. Treatment and procedure were mapped to 2,181 cases, which are the number of mapping targets. Practical Implications: This study found the importance of constructing MOA CDM for drug side effect monitoring and developed terminology mapping guideline. Our results would be useful for all future researchers who are conducting terminology mapping when constructing CDM.

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Examination of Dose Change at the Junction at the Time of Treatment Using Multi-Isocenter Volumetric Modulated Arc Therapy (용적조절호형방사선치료(VMAT)의 다중치료중심(Multi- Isocenter)을 이용한 치료 시, 접합부(Junction)의 선량 변화에 대한 고찰)

  • Jung, Dong Min;Park, Kwang Soon;Ahn, Hyuk Jin;Choi, Yoon Won;Park, Byul Nim;Kwon, Yong Jae;Moon, Sung Gong;Lee, Jong Oon;Jeong, Tae Sik;Park, Ryeong Hwang;Kim, Se young;Kim, Mi Jung;Baek, Jong Geol;Cho, Jeong Hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.9-14
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    • 2021
  • This study examined dose change depending on the reposition error of the junction at the time of treatment with multi-isocenter volumetric modulated arc therapy. This study selected a random treatment region in the Arccheck Phantom and established the treatment plan for multi-isocenter volumetric modulated arc therapy. Then, after setting the error of the junction at 0 ~ 4 mm in the X (left), Y (upper), and Z (inner and outer) directions, the area was irradiated using a linear accelerator; the point doses and gamma indexes obtained through the Phantom were subsequently analyzed. It was found that when errors of 2 and 4 mm took place in the X and Y directions, the gamma pass rates (point doses) were 99.3% (2.085) and 98% (2.079 Gy) in the former direction and 98.5% (2.088) and 95.5% (2.093 Gy) in the latter direction, respectively. In addition, when errors of 1, 2, and 4 mm occurred in the inner and outer parts of the Z direction, the gamma pass rates (point doses) were found to be 94.8% (2.131), 82.6% (2.164), and 72.8% (2.22 Gy) in the former part and 93.4% (2.069), 90.6% (2.047), and 79.7% (1.962 Gy) in the latter part, respectively. In the X and Y directions, errors up to 4 mm were tolerable; however, in the Z direction, error values exceeding 1 mm were beyond the tolerance level. This suggests that for high and low dose areas, errors in the direction same as the progress direction in the treatment region have a more sensitive dose distribution. If the guidelines for set-up errors are established at the institutional level through continuous research in the future, it will be possible to provide good quality treatment using junctions.

Spinal Cord Subependymoma Surgery : A Multi-Institutional Experience

  • Yuh, Woon Tak;Chung, Chun Kee;Park, Sung-Hye;Kim, Ki-Jeong;Lee, Sun-Ho;Kim, Kyoung-Tae
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.233-242
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    • 2018
  • Objective : A spinal cord subependymoma is an uncommon, indolent, benign spinal cord tumor. It is radiologically similar to a spinal cord ependymoma, but surgical findings and outcomes differ. Gross total resection of the tumor is not always feasible. The present study was done to determine the clinical, radiological and pathological characteristics of spinal cord subependymomas. Methods : We retrospectively reviewed the medical records of ten spinal cord subependymoma patients (M : F=4 : 6; median 38 years; range, 21-77) from four institutions. Results : The most common symptoms were sensory changes and/or pain in eight patients, followed by motor weakness in six. The median duration of symptoms was 9.5 months. Preoperative radiological diagnosis was ependymoma in seven and astrocytoma in three. The tumors were located eccentrically in six and were not enhanced in six. Gross total resection of the tumor was achieved in five patients, whereas subtotal or partial resection was inevitable in the other five patients due to a poor dissection plane. Adjuvant radiotherapy was performed in two patients. Neurological deterioration occurred in two patients; transient weakness in one after subtotal resection and permanent weakness after gross total resection in the other. Recurrence or regrowth of the tumor was not observed during the median 31.5 months follow-up period (range, 8-89). Conclusion : Spinal cord subependymoma should be considered when the tumor is located eccentrically and is not dissected easily from the spinal cord. Considering the rather indolent nature of spinal cord subependymomas, subtotal removal without the risk of neurological deficit is another option.