PURPOSE: The aim of this study was to explore characteristics of and risk factors for accidental inpatient falls. METHODS: Participants were classified as fallers or non-fallers based on the fall history of inpatients in a tertiary hospital in Seoul between June 2014 and May 2015. Data on falls were obtained from the fall report forms and data on risk factors were obtained from the electronic nursing records. Characteristics of fallers and non-fallers were analyzed using descriptive statistics. Risk factors for falls were identified using univariate analyses and logistic regression analysis. RESULTS: Average length of stay prior to the fall was 21.52 days and average age of fallers was 61.37 years. Most falls occurred during the night shifts and in the bedroom and were due to sudden leg weakness during ambulation. It was found that gender, BMI, physical problems such elimination, gait, vision and hearing and medications such as sleeping pills, antiarrhythmics, vasodilators, and muscle relaxant were statistically significant factors affecting falls. CONCLUSION: The findings show that there are significant risk factors such as BMI and history of surgery which are not part of fall assessment tools. There are also items on fall assessment tools which are not found to be significant such as mental status, emotional unstability, dizziness, and impairment of urination. Therefore, these various risk factors should be examined in the fall risk assessments and these risk factors should be considered in the development of fall assessment tools.
Accidental Falls* ; Dizziness ; Gait ; Hearing ; Humans ; Inpatients* ; Leg ; Length of Stay ; Logistic Models ; Nursing Records ; Patient Safety ; Risk Assessment ; Risk Factors* ; Seoul ; Tertiary Care Centers* ; Urination ; Vasodilator Agents ; Walking

OBJECTIVES: This study analyzed smartphone obesity-management applications developed in Korea and the quality of the information that they provide. METHODS: Obesity-management smartphone applications were searched using the keywords 'obesity + management,' 'weight + management,' 'weight + loss,' 'weight + exercise,' 'weight + diet,' 'weight + calories,' and 'diet,' with a search application programming interface (provided by Apple) between September 23 and September 27, 2013. These applications were then classified according to their main purpose, type of interventions used, price, type of developer, and user ratings. The information quality of the applications was analyzed using the Silberg scale. RESULTS: In total, 148 smartphone applications for obesity management were found. The main purpose of most of these applications (70.95%) was to provide information regarding weight control. The most frequently used intervention (34.62%) was to provide information on exercise management. More than half of the applications (58.78%) were free of charge. The mean of users' rating of these applications was 3.68 out of 5. The quality of information provided by these applications was evaluated as 4.55 out of 9: specifically, 1.79 out of 3 for authorship, 0.22 out of 2 for attribution, 1.29 out of 2 for disclosure, and 1.25 out of 2 for currency. Only three of the applications (2.88%) had a score on the Silberg scale greater than or equal to 7 points. CONCLUSIONS: The findings of this study suggest that the quality of information provided by smartphone applications in the healthcare domain urgently need to be evaluated to prevent users being misinformed by these applications.
Authorship ; Delivery of Health Care ; Disclosure ; Korea ; Mobile Health Units ; Obesity ; Telemedicine ; Weight Loss

Around the world electronic health records data are being shared and exchanged between two different systems for direct patient care, as well as for research, reimbursement, quality assurance, epidemiology, public health, and policy development. It is important to communicate the semantic meaning of the clinical data when exchanging electronic health records data. In order to achieve semantic interoperability of clinical data, it is important not only to specify clinical entries and documents and the structure of data in electronic health records, but also to use clinical terminology to describe clinical data. There are three types of clinical terminology: interface terminology to support a user-friendly structured data entry; reference terminology to store, retrieve, and analyze clinical data; and classification to aggregate clinical data for secondary use. In order to use electronic health records data in an efficient way, healthcare providers first need to record clinical content using a systematic and controlled interface terminology, then clinical content needs to be stored with reference terminology in a clinical data repository or data warehouse, and finally, the clinical content can be converted into a classification for reimbursement and statistical reporting. For electronic health records data collected at the point of care to be used for secondary purposes, it is necessary to map reference terminology with interface terminology and classification. It is necessary to adopt clinical terminology in electronic health records systems to ensure a high level of semantic interoperability.
Dietary Sucrose ; Electronic Health Records ; Electronics ; Electrons ; Health Personnel ; Humans ; Patient Care ; Policy Making ; Public Health ; Semantics

PURPOSE: To evaluate the quality and scientific accuracy of internet information regarding precocious puberty. METHODS: We identified websites by entering "precocious puberty" or "early puberty" into 5 search engines from May to July 2011. The top 50 websites from each search engine were included, excluding websites that were duplicate, inaccessible, or had poor information (containing fewer than two subjects of definition, causes, diagnosis, or treatment); 60 sites were identified. We classified the websites according to website author, evaluated the quality with the DISCERN instrument, giving a scientific accuracy with information score (IS) ranging from 0 to 30 points. RESULTS: Analysis of the quality with the DISCERN instrument showed that the majority of websites received low overall ratings regardless of the authors. Assessing the scientific accuracy, the mean IS of oriental websites (10.82) was significantly low compared to that of academic authors (22.61), physician authors (21.50), commercial authors (22.88), and other authors (27.00). CONCLUSION: With the exception of oriental websites, scientifically accurate information was provided on the websites regarding precocious puberty. Most of the analyzed websites showed low reliability. It is important to provide reliable information as well as scientifically accurate information
Internet ; Puberty, Precocious ; Quality of Health Care ; Search Engine

We report a case of Turner syndrome associated with idiopathic central diabetes insipidus in a 12-year-old girl, who presented with polyuria and polydipsia after a year. The patient was very short and and centrally obese, and was initially diagnosed with Turner syndrome, hyperlipidema, and diabetes mellitus. A water deprivation test revealed central diabetes insipidus, and sellar magnetic resonance imaging (MRI) showed a thickening of the pituitary stalk, with normal high signal intensity in the posterior pituitary gland. Replacement therapy with desmopressin was initiated, and follow-up sellar MRI findings after two years showed spontaneous regression of the thickened pituitary stalk. There are only few reports of concomitant Turner syndrome with central diabetes insipidus worldwide. Further observation is needed in order to disclose the cause of central diabetes insipidus in patients having Turner syndrome.
Child ; Deamino Arginine Vasopressin ; Diabetes Insipidus, Neurogenic ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Posterior ; Polydipsia ; Polyuria ; Turner Syndrome ; Water Deprivation

We report a case of Turner syndrome associated with idiopathic central diabetes insipidus in a 12-year-old girl, who presented with polyuria and polydipsia after a year. The patient was very short and and centrally obese, and was initially diagnosed with Turner syndrome, hyperlipidema, and diabetes mellitus. A water deprivation test revealed central diabetes insipidus, and sellar magnetic resonance imaging (MRI) showed a thickening of the pituitary stalk, with normal high signal intensity in the posterior pituitary gland. Replacement therapy with desmopressin was initiated, and follow-up sellar MRI findings after two years showed spontaneous regression of the thickened pituitary stalk. There are only few reports of concomitant Turner syndrome with central diabetes insipidus worldwide. Further observation is needed in order to disclose the cause of central diabetes insipidus in patients having Turner syndrome.
Child ; Deamino Arginine Vasopressin ; Diabetes Insipidus, Neurogenic ; Diabetes Mellitus ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Posterior ; Polydipsia ; Polyuria ; Turner Syndrome ; Water Deprivation

The purpose of the study is to develop a Web-based health information service system for the disabled. To identify users' information needs, we conducted an online and offline survey of the disabled and their caregivers as well as welfare institutes' staff. Based on the user's information needs, a Web-site was developed. The Web-site was evaluated by users for their satisfaction with the Web-site and by experts for the quality of the site. Content of the Web-site includes information on rehabilitation, welfare, and diseases causing the disability, definition and classification of disability, prevention from disability, management of the disabled, and disability related policies. Besides this information, FAQ on the disabled, statistics, links to the disabled institutes and Web sites, risk factor appraisal tool, and aiding tools for the disabled are added. The Web site is a subsystem of the Healthguide. Users rated efficiency, convenience, and design of the site highly in their satisfaction rating. Staff at welfare institutes rated design, efficiency, and relevance of the site highly in their satisfaction rating. Experts rated easiness, reliability, clearness and appropriateness of the site highly in their site evaluation. It is expected that this Web-based health information service system for the disabled will contribute to the disabled's health promotion as well as provide a community for the disabled related researchers, professionals and experts to share information on the disabled's health.
Academies and Institutes ; Caregivers ; Classification ; Health Promotion ; Humans ; Information Services ; Information Systems ; Internet ; Rehabilitation ; Risk Factors

PURPOSE: This study was conducted to examine the nurses' knowledge about and attitude toward cancer pain management. METHOD: Study subjects of this retrospective cross-sectional survey study were 343 nurses sampled conveniently in a tertiary teaching hospital in Seoul. Seven measurement tools were used to collect data on demographic data, knowledge about and attitude toward cancer pain management, barrier to cancer pain management, knowledge about and concerns for the opioid use, and professional education of cancer pain management. RESULT: Nurses showed knowledge deficit when their knowledge on the cancer pain management and the opiod use was evaluated using two case scenarios and the 15-item questionnaire respectively. Ninety-five percent of the nurses believed that cancer pain management is a major problem. However, inadequate staff knowledge of pain management was rated as the single most important barrier to adequate pain management by 20.4% of nurses. Only 10.9% and 23.2% of the nurses replied that nursing school's education and professional education in cancer pain management respectively, were adequate. CONCLUSION: This study confirms the existence of knowledge deficits and attitudinal barriers among Korean nurses that can impede cancer pain manage- ment. This study suggests a need for professional education for nurses on cancer pain management.
Analgesics, Opioid ; Cross-Sectional Studies ; Education ; Education, Professional ; Hospitals, Teaching ; Nursing ; Pain Management* ; Retrospective Studies ; Seoul ; Surveys and Questionnaires

The purpose of the study was to develop a Web site for the middle-aged women and test the usability of the site. Users' need for information were identified via online survey of 189 middle-aged women. It was found that they had various health problems but very few did any health prevention or health promotion activities. A web site for the middle-aged women was developed based on the result of needs assessment. The site includes content on exercise, diet including weight control, osteoporosis, climacteric, aging, breast and cervical cancer. Besides this health information, FAQ on women's health, my health knowledge test, statistics, link to related institutes and web sites, newspaper articles/mass media clips, journal articles, conferences, papers and other educational information were added. The site was developed as a subsystem of the Healthguide(http://healthguide.kihasa.re.kr). As a way of utilizing the homepage, twenty two women aged 40-50 were recruited at a community-based gathering and health promotion education program was conducted. To test the effectiveness of the education, knowledge, attitude and behavior changes of before and after education were compared. There were significant differences of knowledge and behavior in breast cancer, cervical cancer, osteoporosis, menopause and sexual life. It is expected that Web-based women's health information will contribute to women's health promotion and provide an effective learning media for health education.
Academies and Institutes ; Aging ; Breast ; Breast Neoplasms ; Climacteric ; Congresses as Topic ; Diet ; Education ; Female ; Health Education ; Health Promotion ; Humans ; Learning ; Menopause ; Middle Aged* ; Needs Assessment ; Periodicals ; Osteoporosis ; Program Development ; Uterine Cervical Neoplasms ; Women's Health

The purpose of the study is to develop a Web-ba sed health information se rvice system for the elderly. To identify user's information needs, we conducted an online survey of the caregivers and an offline survey of the elderly. Based on the user's information needs, a Web-site was developed. The Web-site was evaluated by users for their satisfaction with the Web-site and experts for the quality of the site. To test the usability of the site, knowledge, attitudes and behaviors of the elde rly were measured and compa red before and after an education using the content of the site. Content includes disease information of arthritis, dementia, and stroke; and health promotion information such as exercise, nutrition, management of declining hearing and visual abilities. Besides this health information, FAQ on the elderly health, statistics, links to related institutes and Web sites, risk factor appraisal tool, and nursing supplies for the elderly were added. The Web site is a subsystem of the Healthguide. Users rated usefulness, relevance, convenience, and eff iciency of the site highly in their satisf action rating. Experts ra ted purpose, update, appropriateness, reliability, and easiness highly in their site evaluation. There was statistically significant difference in the knowledge, attitudes, and behaviors of the elderly before and after education via the homepage. It is expected that this Web-based elderly health information service system will contribute to the elderly's health promotion as well as provide a community for the elderly health related researchers, professionals and experts to share information on the elderly's health.
Risk Factors