• Title/Summary/Keyword: technical intervention

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A Hybrid Intervention for Post-infarction Papillary Muscle Rupture with Severe Mitral Regurgitation: A Case Report

  • Nakamae, Kosuke;Oshitomi, Takashi;Uesugi, Hideyuki
    • Journal of Chest Surgery
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    • v.55 no.3
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    • pp.239-242
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    • 2022
  • Papillary muscle rupture with severe acute mitral regurgitation is a rare complication of acute myocardial infarction (AMI) that causes pulmonary congestion and cardiogenic shock. Moreover, it has a poor prognosis. Surgical intervention, including revascularization, is indicated; however, surgical mortality remains high. We report the case of an 85-year-old woman with cardiogenic shock from severe acute mitral regurgitation, in whom a hybrid intervention, combining percutaneous coronary intervention with mitral valve replacement via minithoracotomy, was performed after post-infarction papillary muscle rupture. She was discharged in a favorable clinical condition. We describe a novel hybrid intervention for treating a rare complication of AMI, which could minimize surgical invasion in elderly patients, prevent disuse syndrome after the intervention, and improve prognosis. However, mitral valve surgery via minithoracotomy for emergency cases requires technical proficiency, as well as collaboration with other healthcare professionals, and the choice to perform this procedure requires careful consideration.

Why Learners Found Transfer Pricing Difficult? Implications for Directors

  • Abeysekera, Indra;Jebeile, Sam
    • The Journal of Asian Finance, Economics and Business
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    • v.6 no.1
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    • pp.9-19
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    • 2019
  • A recent survey of Australian directors conducted by the Financial Reporting Council found that directors require a detailed understanding of technical accounting issues. With the aim of understanding learner difficulties in learning and applying higher learning material relevant to directors, this study explores the transfer pricing topic taught as a case presentation in an undergraduate accounting program at an Australian university. Before intervention with improvements, this study invited 25 students to take part in the study after they had learned the topic and been given one week to understand it. By adopting a transfer pricing problem presented in their essential reading and interviewing those students to gain further insights, the study found that learners experienced conceptual difficulties at various stages in attempting to learn. Intervention to ease learning difficulties was addressed through instructor training. The intervention improvements included using guided workbooks to develop a better understanding of concepts among learners, and representing the problem at hand with diagrams. After intervention with improvements, this study repeated the same procedures with 25 students who had not taken part in the previous study and found that interventions increased the learning. Results have implications for most directors, who are novices to the detailed technical accounting issues of transfer pricing.

A Study on the Internal Characters of Gambling Games (사행성게임의 내재적 특성에 관한 고찰)

  • Park, Tae-Soon
    • Journal of Korea Game Society
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    • v.7 no.3
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    • pp.1-12
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    • 2007
  • This paper attempts to pursue the internal characters of gambling games. After examining the concepts of gambling and arranging related theories, we found that gambling games have 3 factors of technical intervention, betting and ratio of payment. The betting is subdivided 3 factors of existence of betting, unit speed of betting and extendibility of betting. These factors may be used to a framework of conceptual analysis to gambling games. If social and cultural factors can be added to these factors, gambling games can be comprehensively and empirically analyzed.

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Aseismic protection of historical structures using modern retrofitting techniques

  • Syrmakezis, C.A.;Antonopoulos, A.K.;Mavrouli, O.A.
    • Smart Structures and Systems
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    • v.4 no.2
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    • pp.233-245
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    • 2008
  • For historical masonry structures existing in the Mediterranean area, structural strengthening is of primary importance due to the continuous earthquake threat that is posed on them. Proper retrofitting of historical structures involves a thorough understanding of their structural pathology, before proceeding with any intervention measures. In this paper, a methodology is presented for the evaluation of the actual state of historical masonry structures, which can provide a useful tool for the seismic response assessment before and after the retrofitting. The methodology is mainly focused on the failure and vulnerability analysis of masonry structures using the finite element method. Using this methodology the retrofitting of historical structures with innovative techniques is investigated. The innovative technique presented here involves the exploitation of Shape Memory Alloy prestressed bars. This type of intervention is proposed because it ensures increased reversibility and minimization of interventions, in comparison with conventional retrofitting methods. In this paper, a case study is investigated for the demonstration of the proposed methodologies and techniques, which comprises a masonry Byzantine church and a masonry Cistern. Prestressed SMA alloy bars are placed into the load-bearing system of the structure. The seismic response of the non-retrofitted and the retrofitted finite element models are compared in terms of seismic energy dissipation and displacements diminution.

Effect of Lifestyle Intervention Program for Overweight and Obesity Pregnant Women (과체중 및 비만임부를 위한 생활습관중재 프로그램의 효과)

  • Choi, Hye Kyung;Kim, Hyeon Ok
    • Journal of Korean Academy of Nursing
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    • v.50 no.3
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    • pp.459-473
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    • 2020
  • Purpose: This study was conducted to identify the effects of a lifestyle intervention program on weight gain, dietary habits, fatigue and pregnancy stress, blood pressure, and neonatal birth weight, using Cox's interaction model of client health behavior for overweight and obese women. Methods: This was a quasi-experimental research with a non-equivalent control group pre-post test design. A total of 52 patients who met the selection criteria, including 25 in the experimental group and 27 in the control group, were the subjects of the study; they comprised overweight and obese pregnant women who were receiving prenatal care at A and B women's hospital in J province. The lifestyle intervention program ran for 12 weeks in total and consisted of interactions involving affective support, health information, and professional/technical competencies. The data collection period was from February 1, 2017 to August 31, 2017. Results: This study showed differences in the appropriate weight gain rate (χ2=6.17, p=.013), suppression of an increase in fatigue (t=-2.32, p=.012), and an increase in pregnancy stress (t=-1.87, p=.034). Yet, no differences in physical activity, dietary habits change, blood pressure, and neonatal birth weight (p>.05) were found. Conclusion: The study findings indicate that this program could be an effective intervention for the control of appropriate weight gain, fatigue, and pregnancy stress. Therefore, a lifestyle intervention program based on Cox's interaction model of client health behavior could be an efficient strategy for a positive health outcome of overweight and obesity pregnant women.

Development of an Intervention List for Family Nursing Care (가족간호를 위한 중재목록 개발)

  • Kim, Young-Im;Kim, Hee-Gerl;Jung, Hye-Sun
    • Research in Community and Public Health Nursing
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    • v.20 no.2
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    • pp.123-133
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    • 2009
  • Purpose: This study aimed to classify nursing interventions by developing a list of interventions for family nursing care. Methods: A new intervention list was confirmed after the researchers' discussion and professional consult. All possible interventions were re-organized. Results: Five grand categories were identified, which include health education, providing direct nursing care, utilization and referral of community resources, reinforcing family resources, and stress management. The category of health education consists of anticipatory guidance, training and education, providing information, and consult and motivation. The category of providing direct nursing care consists of identifying problem, providing technical nursing, providing family tailored nursing care, family contract, monitoring or evaluation, and collaboration with experts. The utilization and referral of community services includes utilization of health care facilities, utilization of social welfare facilities, use of neighbors, friends, and relatives, connecting to professionals or supporting groups, and utilization of other sources. Reinforcing family resources includes reinforcing economic resources, reinforcing physical resources, and reinforcing human resources. Stress management includes reorganization of perception, resolving conflicts, division of role, preparing communication strategies, time management, creating familiarity, supporting spirituality, and developing sense of humor. Conclusion: This study provides useful resources to promote nursing activities by identifying possible family nursing interventions.

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Simulation of Vehicle Steering Control through Differential Braking (차동 제동을 이용한 조향 제어 시뮬레이션)

  • 제롬살랑선네;윤여흥;장봉춘;이성철
    • Journal of the Korean Society for Precision Engineering
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    • v.19 no.11
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    • pp.65-74
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    • 2002
  • This paper examines the usefulness of a Brake Steer System (BSS), which uses differential brake forces for steering intervention in the context of Intelligent Transportation Systems (ITS). In order to help the car to turn, a yaw moment can be achieved by altering the left/right and front/rear brake distribution. This resulting yaw moment on the vehicle affects lateral position thereby providing a limited steering function. The steering function achieved through BSS can then be used to control lateral position in an unintended road departure system. A 8-DOF nonlinear vehicle model including STI tire model will be validated using the equations of motion of the vehicle. Then a controller will be developed. This controller, which will be a PID controller tuned by Ziegler-Nichols, will be designed to explore BSS feasibility by modifying the brake distribution through the control of the yaw rate of the vehicle.

Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • v.12 no.6
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Analysis of the Contents and Importance of Clinical Practicum Education in Adult Health Nursing According to Nursing Intervention Classification (NIC) System (간호중재분류체계(NIC)에 따른 성인간호학 임상실습 내용 및 중요도 분석)

  • Kim, Eun Jung;Kim, Gwang Suk;Sung, Kyung Mi;Shin, Hyunsook;Shin, Hae Kyung;Lee, Yujeong;Jeong, Seok Hee;Kim, Nahyun
    • Health Communication
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    • v.13 no.2
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    • pp.205-216
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    • 2018
  • Background: The purpose of the study was to analyze the contents and importance of clinical practicum education in adult health nursing. Methods: This is a descriptive study using content analysis for identifying the items of clinical nursing checklists gathered from 13 university nursing programs accredited by Korean Accreditation Board of Nursing Education. Items in the checklist were standardized in accordance with the Nursing Intervention Classification (NIC) and categorized into simple-technical skill, complex-technical skill, and disease-specific care. The perceived significance of each item was examined by surveying nurses who in charge of nurse education from various clinical setting. Results: A total of 182 items in the clinical practicum contents were analyzed, and the terminologies of each item were variously described among nursing schools. Fifty percent of the total items were categorized into simple-technical skill. In terms of clinical importance, expert validity results showed that nurses considered infection control, infection protection, and fall prevention as the most significant items, which was not the same as the most common items in the clinical nursing checklist. Conclusion: These findings suggest that standardized nursing terminologies are needed to describe a nursing practicum checklist. Clinical importance of each item in the checklist should be taken into consideration in developing a clinical nursing checklist to assist the students in achieving the competencies as a clinical nurse.

Treatment of the infant with bilateral cleft lip and palate (양측성 구순구개열 신생아의 치료)

  • Kim Su Jung;Kang Seung Goo;Lee Young Jun;Park Young Guk
    • Korean Journal of Cleft Lip And Palate
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    • v.6 no.2
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    • pp.107-115
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    • 2003
  • The case unveils an early orthodontic intervention on 3-week old infant innately with bilateral cleft lip and palate. Presurgical Nasoalveolar Molding(PNAM) procedures were carried out for 2 months for the sake to diminish the anticipated strain of postsurgical scar by means of the retraction of protruded premaxilla and the extension of collapsed columella. The gap on the alveolar cleft decreased by 2,5 mm, and the columella manifested 1. 5 mm increase of its length, which yielded the consequent downward and backward movement of premaxilla, and expected to bring down the technical complexity of primary lip surgery. PNAM with sophisticated technical procedures at an optimal timing disclosed the passive molding of the alveolar segments and the formation of nasolabial soft tissue integuments and permitted one-time primary lip surgery.

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