• Title/Summary/Keyword: tailored medicine

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Development of Internet Information Push-Delivery System Design of Smoking Cessation for Health Promotion (지역주민의 건강증진을 위한 인터넷 금연 강화 프로그램 개발)

  • Kim, Young-Bok;Shin, Jun-Ho;Kim, Shin-Woel
    • Journal of agricultural medicine and community health
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    • v.29 no.2
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    • pp.287-301
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    • 2004
  • Objectives: The development of internet programs for smoking cessation was motivated to quit smoking in the large group of smokers. This personalized program consisted of tailored message to consider the smokers characteristics, and contain the informations on the outcomes of smoking cessation and the skills to be used in the quit attempts. The purpose of this study was to develop the internet management program and information push-delivery system for smoking cessation to encourage the personal intention to quit smoking. Methods: We conducted in 3 steps as developing push service to encourage intention of smoking cessation, analyzing problems of smoking cessation program through the pilot test and suggesting improvements by implication stages. Results: This program is delivered for 30 days. if the participants do not fail to quit smoking. The contents consisted of 13 stages which were divided on starting period. practical period, maintenance period and success period. And push service afforded the tailored message to participants using their e-mail. According to the evaluation of pilot test, the problems of internet information push-delivery service for smoking cessation were the over-tasks per visiting time, recording style of participants, difficulty of terms and sentences, lack of visual effects, absence of follow-up module and unsuitable link with main homepage. Improvements were divided on 3 stages by implication period. The first stage included the immediate improvements as improving link with homepage, modifying menu of smoking information and upload file of notice part. The second stage included the short term improvements as alleviating condition of withdrawal, coordinating start stage of retrial, modifying errors of information push-delivery service and addition of educational materials. The third stage included the long term improvements as development of follow-up module, cost-effectiveness evaluation, reducing contents quantity, introduction of checking style, compensation of graphics effect and review for SMS utilization. Conclusions: This program contribute to improving smoking cessation rate. Therefore this program should be tested in a community to evaluate the effectiveness. To promote the effectiveness, this program should be developed the contents and the strategies for various targets, and established the follow-up system for ex-smokers.

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Study Protocol for the Most Effective Recall Method in a Cervical Cancer Screening Program in Klang, Malaysia

  • Rashid, Rima Marhayu Abdul;Dahlui, Maznah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5867-5870
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    • 2013
  • Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

Artificial Intelligence-Based Identification of Normal Chest Radiographs: A Simulation Study in a Multicenter Health Screening Cohort

  • Hyunsuk Yoo;Eun Young Kim;Hyungjin Kim;Ye Ra Choi;Moon Young Kim;Sung Ho Hwang;Young Joong Kim;Young Jun Cho;Kwang Nam Jin
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.1009-1018
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    • 2022
  • Objective: This study aimed to investigate the feasibility of using artificial intelligence (AI) to identify normal chest radiography (CXR) from the worklist of radiologists in a health-screening environment. Materials and Methods: This retrospective simulation study was conducted using the CXRs of 5887 adults (mean age ± standard deviation, 55.4 ± 11.8 years; male, 4329) from three health screening centers in South Korea using a commercial AI (Lunit INSIGHT CXR3, version 3.5.8.8). Three board-certified thoracic radiologists reviewed CXR images for referable thoracic abnormalities and grouped the images into those with visible referable abnormalities (identified as abnormal by at least one reader) and those with clearly visible referable abnormalities (identified as abnormal by at least two readers). With AI-based simulated exclusion of normal CXR images, the percentages of normal images sorted and abnormal images erroneously removed were analyzed. Additionally, in a random subsample of 480 patients, the ability to identify visible referable abnormalities was compared among AI-unassisted reading (i.e., all images read by human readers without AI), AI-assisted reading (i.e., all images read by human readers with AI assistance as concurrent readers), and reading with AI triage (i.e., human reading of only those rendered abnormal by AI). Results: Of 5887 CXR images, 405 (6.9%) and 227 (3.9%) contained visible and clearly visible abnormalities, respectively. With AI-based triage, 42.9% (2354/5482) of normal CXR images were removed at the cost of erroneous removal of 3.5% (14/405) and 1.8% (4/227) of CXR images with visible and clearly visible abnormalities, respectively. In the diagnostic performance study, AI triage removed 41.6% (188/452) of normal images from the worklist without missing visible abnormalities and increased the specificity for some readers without decreasing sensitivity. Conclusion: This study suggests the feasibility of sorting and removing normal CXRs using AI with a tailored cut-off to increase efficiency and reduce the workload of radiologists.

Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.

Assessment of the Effect of a Public Health Clinics' Home-Based Terminal Cancer Patient Management in Collaboration with a Regional Cancer Center (경남 지역 암센터와 보건소 재가암환자 관리 서비스와의 연계 사업)

  • Song, Haa-Na;Kang, Myoung Hee;Lee, Gyeong Won;Kim, Hoon Gu;Lee, Won Sup;Kang, Jung Hun;Kang, Yoon Sik;Eun, Young
    • Journal of Hospice and Palliative Care
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    • v.16 no.1
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    • pp.10-19
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    • 2013
  • Purpose: Home-based care providers were surveyed to assess the effect of collaborative service between Gyeongnam Regional Cancer Center (GRCC) and public health centers (PHCs) in Gyeongnam province. Methods: Twenty home-based care providers who had previously participated in the GRCC-PHC care project were recruited from nine PHCs and were surveyed using a questionnaire developed by specialists. Questions were rated using the 5-point Likert scale ranging from "strongly disagree (-2)" to "strongly agree (+2)" and each score was multiplied by the corresponding number of respondents (n=20) with the maximum score of 40. Results: Between January 2008 and December 2011, 73 patients were registered to the collaborative service: 72 by GRCC and one by PHC. Home-based care providers marked the highest score (23 points) to "The collaborative service contributed to patients and their family's psychological stability" and the lowest score (11 points) to "The collaborative service was generally helpful for home-based cancer management." For possible suggestions to improve the service, the highest score (35 points) was given to "Simplification of the hospitalization process" followed by "Substantial benefits for patients at their visit to the hospital" (34 points). Conclusion: The results revealed several limitations of the GRCC-PHC collaborative care service for terminal cancer patients. The service could be further improved by developing measures to address the limitations and a service model tailored to region-specific needs.

Clinical Characteristics of Bacteremia in Children with Cancer (단일기관에서 소아암 환자에서 화학요법 중 발생한 균혈증의 임상 양상)

  • Chang, Mi Sun;Sung, Ki Woong;Kim, Yae Jean
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.201-206
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    • 2011
  • Purpose : Bacteremia is one of the most common causes of morbidity and mortality in children with cancer. The aim of this study was to evaluate the clinical features of bacteremia in pediatric cancer patients. Methods : We retrospectively analyzed bacteremia episodes occurred in pediatric cancer patients at Samsung Medical Center from January 2008 to December 2010. We excluded bacteremia episodes after hematopoietic stem cell transplantation. Results : A total of 141 blood cultures were positive in 121 patients. Thirteen cultures due to contamination were excluded. For analysis, 128 bacteremia episodes in 108 children were included. Gram-positive organisms accounted for 46.9% (60/ 128) and gram-negative organisms for 53.1% (68/128). The source of bacteremia was identified in 21.1% of episodes. Bacteremia due to catheter related infection was observed in 9.4% of episodes (12/128 episodes) and gram-positive organisms were isolated in 75% of episodes (9/12). There were 10 cases (7.8%) of bacteremia associated with septic shock and gramnegative organisms were isolated in 80% of episodes (8/10). Relapses were documented within 30 days in 2 patients who cleared bacteremia which was confirmed after negative blood cultures. Mortality associated with bacteremia was not observed. Conclusion : Continuous monitoring is needed to maintain the tailored strategies to manage pediatric cancer patients with neutropenic fever who are at high risk of developing bacteremia in each institution.

Short-Term Effects of an Self-Management Support Intervention on Patient Activation, Joint Flexibiltiy and Health-related Quality of Life among Korean Medical Aid Beneficiaries with Osteoarthritis (지역사회기반의 자기관리지지중재가 골관절염 의료급여수급자의 환자활력, 관절유연성 및 건강 관련 삶의 질에 미치는 단기효과)

  • Ahn, Yang Heui;Hur, Jae Bock;Choi, Eun Hee
    • 한국노년학
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    • v.36 no.3
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    • pp.595-609
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    • 2016
  • The purpose of this study was to test the effectiveness of an eight session self-management support program for improvement of patient activation, joint flexibility and health-related quality of life among medical aid beneficiaries with osteoarthritis. This study was part of a randomized and controlled research of a self-management support intervention. Participants were 60 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=30) or control group (n=30). The 8-session and tailored program led by a trained case manager with the patient-centered approaches and cognitive-emotional-behavioral skills. Analysis included change in scores, ${\chi}^2-test$, Fisher's exact test, t-test and ANCOVA. The results showed significant increase in patient activation, joint flexibility (shoulder and right knee) except health-related quality of life in the experimental group compared to the control group. The self-management support program indicated an effect on patient activation and joint flexibility. Further research is needed to examine the outcome in the long term(9 and 12-month follow up).

Health Promotion Lifestyle According to Self-Perception of Obesity and Objective Status Measured by Bioelectric Impedance Analysis in College Women (여대생의 주관적 체형지각과 생체전기 임피던스법으로 측정한 비만도에 따른 건강증진 생활양식)

  • Chang, Eun-Young;Kim, Jeong-Sun;Shin, Su-Jin
    • Journal of Korean Academy of Nursing
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    • v.39 no.5
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    • pp.693-699
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    • 2009
  • Purpose: The purpose of this study was to identify congruence between self-perception and objective status of obesity according to %Fat, and to investigate health promotion lifestyle in college women. Methods: The participants were a convenience sample of 392 college women who were eligible and agreed to participate in this study. Respondents were asked questions using a health promotion lifestyle profile and were evaluated for their body composition using InBody 3.0. The data were analyzed with SPSS 14.0 program, which was used for Chi square, ANOVA, and post-hoc comparison with Scheffe. Results: The major findings were as follows; 1) Overall, 41.8% of participants misclassified their perceived status of weight by %Fat standards and kappa was 0.329. 2) Two percent were underweight by BMI but overweight by %Fat and 39.0% normal weight by BMI but overweight by %Fat. 3) There were significant differences in health promotion lifestyle according to self-perception of body weight but there was no difference in health promotion lifestyle according to %Fat standards. Conclusion: These findings suggest the necessity for development and application of tailored health promotion program based on self-perception of body weight and %Fat in order to reform incorrect body image and health behavior in college women.

Trends in Protein Engineering for Gene Targeting: Homing Endonucleases and Zinc Finger Nucleases (유전자 표적화를 위한 단백질공학 연구동향: Homing Endonucleases and Zinc Finger Nucleases)

  • Cheong, Dea-Eun;Kim, Geun-Joong
    • KSBB Journal
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    • v.25 no.3
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    • pp.215-222
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    • 2010
  • Monogenic diseases are resulted from modifications in a single gene of human cells. Because their treatment with pharmacological medicine have a temporary effect, continuous nursing care and retreatment are required. Gene therapy, gene targeting and induced pluripotent stem cell (iPSC) are considered permanent treatment methods of them. In gene therapy, however, retroviral vectors that have potential toxicity caused by random insertion of harmful virus are used as vehicles for transferring genetic materials. On the other hand, gene targeting could replace and remove the modified gene though homologous recombination (HR) induced by site-specific endonucleases. This short review provides a brief overview on the recently tailored endonucleses with high selectivity for HR.

Factors Affecting the Length of Time to College Students' Employment (대학생 취업 소요기간에 영향을 미치는 요인 분석)

  • Kim, Min-Seok;An, Eun-Bi;Yu, Gyeong-Suk;Jeong, Hyo-Sook
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.27-35
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    • 2018
  • The purpose of this study is to analyze the effects of personal characteristics, characteristics of college, and educational experience at college on the length of employment and length of employment for regular college students. As a result, it was found that the length of employment required for social studies, education, engineering, and medicine major was shorter than that of major in humanities. Also, it was confirmed that the longer the time required for the job, the more the male and the university graduate in the metropolitan area. In this analysis, it was confirmed that the length of time required for employment could be explained more by individual characteristics than the characteristics of college, and educational experience at college. Based on the analysis results, differentiated support for each major and the necessity of supporting programs tailored to the needs of students respectively.