OBJECTIVES: This study was conducted to examine the educational needs of elderly hypertensive or diabetes patients and educators for the education program development of cardiocerebrovascular high-risk group in community. METHODS: This study was conducted with 60 hypertensive or diabetes patients aged 65 years or above (cardiocerebrovascular high-risk group) who had registered KHyDDI(Korea Hypertension Diabetes Daegu Initiative) Project and attended Hypertension-Diabetes Intervention Center Program, and with 44 educators in the center between June and August, 2009. Data were collected using questionnaires including general characteristics, educational objectives, curriculum, contents, and methods. RESULTS: The major findings of this study were as follows: In education methods, cardiocerebrovascular high-risk group and educators both preferred small-grouped(5-9 persons) or individual education, 30min-1 hour, 50%-50% of theory-practice ratio, 3 months of education. In education contents, both groups needed all the suggested contents. Five categories would be suggested for the development of education program. The first category was that there was no significant difference between cardiocerebrovascular high-risk group's needs and knowledge. The second was category of low knowledge level in cardiocerebrovascular high-risk group's knowledge. The repeated education would be necessary for this category. The third was category with large standard deviation in cardiocerebrovascular high-risk group's knowledge. Individual education would be necessary for this category. The fourth category was that there was significant difference between cardiocerebrovascular high-risk group's knowledge and knowledge assessed by educators. The improvement of educator's education skill would be necessary for this category. The fifth category was that there was significant difference between cardiocerebrovascular high-risk group and educator's needs. CONCLUSIONS: Small group or individualized and staged education reflecting above cardiocerebrovascular high risk group and educators' needs should be developed for more effective education to prevent and manage the cardiocerebrovascular disease.
Aged ; Curriculum ; Humans ; Hypertension ; Program Development ; Surveys and Questionnaires

OBJECTIVES: To develop and evaluate time series models to predict the daily number of patients visiting the Emergency Department (ED) of a Korean hospital. METHODS: Data were collected from the hospital information system database. In order to develop a forecasting model, we used, 2 years of data from January 2007 to December 2008 data for the following 3 consecutive months were processed for validation. To establish a Forecasting Model, calendar and weather variables were utilized. Three forecasting models were established: 1) average; 2) univariate seasonal auto-regressive integrated moving average (SARIMA); and 3) multivariate SARIMA. To evaluate goodness-of-fit, residual analysis, Akaike information criterion and Bayesian information criterion were compared. The forecast accuracy for each model was evaluated via mean absolute percentage error (MAPE). RESULTS: The multivariate SARIMA model was the most appropriate for forecasting the daily number of patients visiting the ED. Because it's MAPE was 7.4%, this was the smallest among the models, and for this reason was selected as the final model. CONCLUSIONS: This study applied explanatory variables to a multivariate SARIMA model. The multivariate SARIMA model exhibits relativelyhigh reliability and forecasting accuracy. The weather variables play a part in predicting daily ED patient volume.
Crowding ; Emergencies ; Emergency Medical Services ; Forecasting ; Hospital Information Systems ; Humans ; Models, Statistical ; Seasons ; Weather

OBJECTIVES: This study was conducted to determine whether or not newly proposed high-resolution activity features could provide a superior analytic foundation compared to those commonly used to assess transitions in children's activities, under circumstances in which the types of courses attended exert different situational effects on activity levels. METHODS: From 153 children at a local elementary school, 10 subjects with attention deficit hyperactivity disorder (ADHD) and 7 controls were recruited. Their activity data was collected using an actigraph while they attended school. Ratios of partitioned activity ranges (0.5-2.8 G) during the entire activity were extracted during three classes: art, mathematics, and native language (Korean). Extracted activity features for each participant were compared between the two groups of children (ADHD and control) using graphs and statistical analysis. RESULTS: Activity distributions between ADHD and control groups for each class showed statistically significant differences spread through the entire range in art class compared to native language and mathematics classes. The ADHD group, but not the control group, experienced many significantly different intervals (> 50%) having low to very high activity acceleration regions during the art and languages courses. CONCLUSIONS: Class content appears to influence the activity patterns of ADHD children. Monitoring the actual magnitude and activity counts in a wide range of subjects could facilitate the examination of distributions or patterns of activities. Objective activity measurements made with an actigraph may be useful for monitoring changes in activities in children with ADHD in a timely manner.
Acceleration ; Actigraphy ; Activities of Daily Living ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Mathematics ; Motor Activity ; Pilot Projects

OBJECTIVE: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. METHODS: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. RESULTS: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001) and their self efficacy. CONCLUSION: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.
Aged ; Blood Glucose ; Blood Pressure ; Chronic Disease ; Curriculum ; Eating ; Follow-Up Studies ; Humans ; Hypertension ; Motor Activity ; Tobacco ; Waist Circumference

OBJECTIVE: Post-marketing surveillance (PMS) is an adverse events monitoring practice of pharmaceutical drugs on the market. Traditional PMS methods are labor intensive and expensive to perform, because they are largely based on manual work including phone-calling, mailing, or direct visits to relevant subjects. The objective of this study was to develop and validate a PMS methodology based on the clinical data warehouse (CDW). METHODS: We constructed a archival DB using a hospital information system and a refined CDW from three different hospitals. Fluoxetine hydrochloride, an antidepressant, was selected as the target monitoring drug. Corrected QT prolongation on ECG was selected as the target adverse outcome. The Wilcoxon signed rank test was performed to analyze the difference in the corrected QT interval before and after the target drug administration. RESULTS: A refined CDW was successfully constructed from three different hospitals. Table specifications and an entity-relation diagram were developed and are presented. A total of 13 subjects were selected for monitoring. There was no statistically significant difference in the QT interval before and after target drug administration (p=0.727). CONCLUSION: The PMS method based on CDW was successfully performed on the target drug. This IT-based alternative surveillance method might be beneficial in the PMS environment of the future.
Electrocardiography ; Fluoxetine ; Hospital Information Systems ; Postal Service ; Retrospective Studies

BACKGROUND: The bispectral index (BIS) is a valuable indicator for measuring sedation levels and patient consciousness. Recent reports have highlighted its clinical value as an indicator for anesthesia-related cerebral hypoperfusion and ischemic brain damage. CASE REPORT: A 55-year-old female patient underwent right breast conservation surgery during general anesthesia. During surgery, the patient experienced abrupt bradycardia (heart rate of 36 bpm) without hypotension. During bradycardia, her BIS was severely reduced from 45 to 20 along with elvated suppression ratio (50). After injection of 0.5mg of atropine, her BIS level was recovered, her heart rate was increased, and her suppression ratio was decreased. CONCLUSION: The patient recovered from anesthesia without showing any signs of neurological sequelae based on BIS level monitoring.
Anesthesia ; Anesthesia, General ; Atropine ; Bradycardia ; Brain ; Breast ; Consciousness ; Consciousness Monitors ; Female ; Heart Rate ; Humans ; Hypotension ; Mastectomy, Segmental ; Middle Aged

This study was conducted to analyze the strengths and weaknesses of a 3-week family medicine clerkship program based on the results of an online survey taken by the students (N=127) and a structured interview with a focus group (n=10), aimed to improve the quality of the clerkship program. The online survey contained questions pertaining to goals, schedule, contents, arrangement, atmosphere, environment, evaluation, and satisfaction regarding the clerkship. The focus group interview addressed the schedule and achievements of the program. Scores were reported on a 5-point Likert scale. Most students were highly satisfied with the overall quality of the clerkship. The structured interview results showed that 97.6% of the clerkship program was executed according to the schedule. The focus group reported a perfect score of 5 points on several measures including: accomplishment of the educational goals of the family medicine clerkship, providing many chances to obtain medical histories and perform physical examinations on real patients, experience with various symptoms and diseases, positive attitudes of faculty members when teaching, notification of the guidelines for evaluation beforehand, well-constructed and effective clerkship schedule, and reflection of student feedback. However, the focus group gave low scores on: support for health accidents of students, access to patient information, enough opportunities to practice clinical skills, appropriate rest facilities for students, and fairness of clerkship evaluation process. In conclusion, the structured evaluation performed after the 3-week clerkship program motivated students and helped them ensure an efficient clerkship. This structured evaluation also suggested basic data to make the professor who is subject of the assessment. This study shows that structured assessment is an effective method which can be used to improve the quality of clerkships.
Appointments and Schedules ; Atmosphere ; Clinical Clerkship ; Clinical Competence ; Family Practice ; Focus Groups ; Humans ; Methods ; Physical Examination ; Self-Evaluation Programs ; Surveys and Questionnaires

This correction is being published to revise the acknowledgements of the above article.