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1.
Rev. ADM ; 78(6): 332-338, nov.-dic. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1354456

ABSTRACT

Staphylococcus aureus es la especie más común implicada en las enfermedades infecciosas que causan morbilidad y mortalidad a nivel mundial. Posee los genes hla, hlb, hld, hlg, hlg-v que codifican para hemolisinas. Las hemolisinas son reconocidas como un factor de virulencia potencial que ataca a la membrana y produce destrucción de las plaquetas y necrosis. Tienen la capacidad de sobrevivir por largos periodos en superficies inertes como en pantallas de teléfonos móviles. Estudio observacional de tipo transversal descriptivo. Se aislaron en un estudio previo 16 cepas de Staphylococcus aureus a partir de 92 muestras de pantallas de teléfonos móviles de estudiantes de odontología. Se utilizó la técnica de reacción en cadena de la polimerasa para detectar los genes que codifican para hemolisinas. El gen hla se detectó en 75% (12/16) de cepas de Staphylococcus aureus, hlb en 25% (4/16), hld 75% (12/16), hlg 75% (12/16), hlg-v 13% (2/16). Este estudio evidencia el alto porcentaje de cepas virulentas que poseen genes que codifican para hemolisinas en pantallas de teléfonos móviles, lo que puede contribuir a la diseminación de este patógeno. Es imperioso implementar medidas para la desinfección de teléfonos móviles (AU)


Staphylococcus aureus is the most common species implicated in infectious diseases causing morbidity and mortality worldwide. It has the hla, hlb, hld, hlg, hlg-v genes encoding for hemolysins. Hemolysins are recognized as a potential virulence factor that attacks the membrane and causes platelet destruction and necrosis. They have the ability to survive for long periods on inert surfaces such as cell phone screens. Observational descriptive cross-sectional study. Sixteen strains of Staphylococcus aureus were isolated in a previous study from 92 samples of cell phone screens of dental students; the polymerase chain reaction technique was used to detect genes coding for hemolysins. The hla gene was detected in 75% (12/16) of Staphylococcus aureus strains, hlb in 25% (4/16), hld 75% (12/16), hlg 75% (12/16), hlg-v 13 % (2/16). This study evidences the high percentage of virulent strains that possess genes encoding for hemolysins in cell phone screens, which may contribute to the dissemination of this pathogen. It is imperative to implement measures for the disinfection of cell phones (AU)


Subject(s)
Staphylococcus aureus , Students, Dental , Cell Phone , Hemolysin Proteins , Polymerase Chain Reaction , Epidemiology, Descriptive , Communicable Diseases , Cross-Sectional Studies , Ecuador , Clinical Coding
2.
Vaccimonitor (La Habana, Print) ; 30(2)mayo.-ago. 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1252324

ABSTRACT

La trazabilidad es la capacidad para rastrear la historia, aplicación o ubicación de un objeto bajo consideración. En el ámbito farmacéutico, el rastreo y seguimiento de los medicamentos, incluyendo las vacunas y otros medicamentos biológicos, a lo largo de la cadena de suministro constituye un requisito obligatorio establecido por las autoridades sanitarias a nivel internacional, que se exige en mayor o menor magnitud en las reglamentaciones vigentes. En este artículo se analiza el sistema de codificación y clasificación en el sector de la salud y su estado actual en la cadena de suministro de medicamentos de Cuba. Se presenta un procedimiento para la implementación de las tecnologías de auto-identificación e intercambio electrónico de datos, mediante el uso de GS1 en el sistema de codificación y clasificación empleado en el sector de salud, que permita la trazabilidad en toda la cadena de suministro en Cuba(AU)


Traceability is the capability to track the history, application or location of an object under consideration. In the pharmaceutical field, the tracking and monitoring of medicines, including vaccines and other biological medicines, along the supply chain constitutes a mandatory requirement established by the sanitary authorities at an international level, which is demanded to a greater or lesser extent in the regulations in force. This research was carried out involving different links in the drug supply chain in Cuba, ranging from drug suppliers, drug distribution company, to healthcare centers and pharmacies. An analysis is carried out on the current coding and classification system, detecting the ineffectiveness of the identification of the drugs as the main deficiency. A procedure is proposed for the implementation of the auto-identification and electronic data interchange technologies using GS1 in the coding and classification system used in the health sector that allows traceability throughout the supply chain in Cuba(AU)


Subject(s)
Humans , Biological Products , Drug Labeling/methods , National Drug Policy , Clinical Coding/methods , Vaccines , Cuba
3.
Article in Spanish | LILACS, CUMED | ID: biblio-1280432

ABSTRACT

Introducción: Varias enfermedades neurodegenerativas están asociadas a alteraciones en el metabolismo del folato, lo que tiene sustanciales implicaciones fisiopatológicas, clínicas y terapéuticas potenciales. Objetivo: Reflejar la relevancia del metabolismo del folato para enfermedades neurodegenerativas, destacando su significación fisiopatológica y clínica, y sus implicaciones terapéuticas. Material y métodos: Se consultaron las bases de datos especializadas en busca de artículos publicados hasta marzo de 2020. Se emplearon descriptores específicos y operadores booleanos. Se empleó la estrategia de búsqueda avanzada para la selección de los artículos, teniendo en cuenta la calidad metodológica o validez de los estudios. Desarrollo: Fueron identificadas evidencias de asociación entre alteraciones del metabolismo del folato y enfermedades neurodegenerativas. Se han identificado variantes en genes que codifican enzimas involucradas en el metabolismo del folato, y modificaciones en patrones de metilación de ADN, asociadas al riesgo o a la gravedad clínica de las enfermedades de Alzheimer, Parkinson, Huntington, Temblor Esencial y Ataxia Espinocerebelosa tipo 2. Fueron encontradas asociaciones entre enfermedades neurodegenerativas y alteraciones en los niveles de metabolitos del folato, y la frecuencia de micronúcleos. Se han realizado varios estudios observacionales o experimentales que indican que la suplementación con ácido fólico y vitaminas B6 y B12, tiene utilidad terapéutica potencial en el contexto de enfermedades neurodegenerativas. Conclusiones: El metabolismo del folato es de relevancia fisiopatológica, clínica y terapéutica para enfermedades neurodegenerativas. El uso de estrategias dirigidas a restaurar los niveles normales de folatos o de co-factores enzimáticos involucrados en el metabolismo del folato, o a reducir la acumulación de homocisteína, tiene potenciales aplicaciones terapéuticas en el contexto de estas enfermedades(AU)


Introduction: Several neurodegenerative disorders are associated with alterations in folate metabolism, having essential physiopathological, clinical and therapeutic implications. Objective: To assess the relevance of folate metabolism in neurodegenerative disorders, highlighting its physiopathological, clinical and therapeutic significance. Material and Methods: Specialized biomedical databases were searched for studies published up to March 2020. Descriptors and Boolean operators were used. Advanced search strategy was used for the selection of articles, taking into account the methodological quality and validity of the studies. Results: Strong evidence of the association between folate metabolism and neurodegenerative disorders were identified. Enzyme-coding genes involved in folate metabolism and epigenetic DNA modifications associated with increased risk or disease severity in Alzheimer´s, Parkinson´s, and Huntington´s diseases, Essential Tremor, and Spinocerebellar ataxia type 2 were also identified. Associations between neurodegenerative disorders and altered levels of folate metabolites and the frequency of micronuclei were found. A number of observational and experimental studies have demonstrated that the supplementation with folic acid and vitamin B6 and B12 has therapeutic potential in the context of neurodegenerative disorders. Conclusions: Folate metabolism is of physiopathological, clinical and therapeutic relevance for neurodegenerative disorders. The use of strategies to normalize folate levels or enzyme cofactors involved in folate metabolism or to reduce homocysteine levels has potential therapeutic applications for these disorders(AU)


Subject(s)
Humans , Severity of Illness Index , DNA , Neurodegenerative Diseases/prevention & control , Spinocerebellar Ataxias , Epigenomics , Clinical Coding , Folic Acid/therapeutic use , Metabolism , Epidemiology, Experimental , Folic Acid/metabolism
4.
Saúde Soc ; 30(1): e190995, 2021. tab, graf
Article in English | LILACS | ID: biblio-1156898

ABSTRACT

Abstract Moral hazard clearly exists among doctors, and it has a dramatic impact on doctor-patient relationships, medical costs and medical risks. This study explored the factors that lead to doctor moral hazard, as well as the interrelationships and internal regularity of these factors. This study takes doctor moral hazard as the research content and the inducing factors as the core theme, conducting grounded theory research on the causes of doctor moral hazard. Scientific understanding of doctor behavior would facilitate the prevention and control of doctor moral hazard behavior. This study used the principles and methodology of Glaser and Strauss's grounded theory. Theoretical and snowball samplings were used to identify 24 subjects. Semi-structured in-depth interviews were conducted with each subject. Themes were identified through substantial (open) coding and theoretical coding. The factors that lead to doctor moral hazard were categorized into five dimensions, i.e. motivation, opportunity, self-rationalization, exposure and punishment. These five factors influence each other, forming the inducing mechanism of doctor moral hazard. This will provide useful theoretical support and method guidance for the follow-up prevention and control of moral hazard for doctors.


Resumo O risco moral existe claramente entre os médicos e tem um impacto dramático nas relações médico-paciente, custos e riscos médicos. Este estudo explorou os fatores que levam ao risco moral por parte do médico, bem como as inter-relações e a regularidade interna desses fatores. Este estudo considera o risco moral do médico como o conteúdo da pesquisa e os fatores indutores como o tema central, conduzindo pesquisas de teoria fundamentada sobre as causas do risco moral do médico. A compreensão científica do comportamento do médico facilitaria a prevenção e o controle do comportamento de risco moral do médico. Este estudo usou os princípios e a metodologia da teoria fundamentada de Glaser e Strauss. Amostragens teóricas e em snowball foram utilizadas para identificar 24 sujeitos. Entrevistas semiestruturadas em profundidade foram realizadas com cada sujeito. Os temas foram identificados por meio de codificação substancial (aberta) e codificação teórica. Os fatores que levam ao risco moral do médico foram categorizados em cinco dimensões: motivação, oportunidade, autorracionalização, exposição e punição. Esses cinco fatores influenciam-se mutuamente, formando o mecanismo indutor do risco moral médico. Isso fornecerá suporte teórico útil e orientação metodológica para o acompanhamento da prevenção e controle de risco moral para os médicos.


Subject(s)
Humans , Male , Female , Physician-Patient Relations , Physicians , Risk Factors , Interview , Clinical Coding , Moral Risk in Supplementary Health Insurance
5.
Ciênc. Saúde Colet ; 25(4): 1241-1250, abr. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1089522

ABSTRACT

Resumo A Classificação Internacional de Atenção Primária-2 (CIAP-2) é fruto de quarenta anos de desenvolvimento contínuo. Tem origem na segunda metade do século XX, a partir da inquietação de médicos gerais com a necessidade de se registrar e codificar dados especificamente relacionados à atenção primária, tanto nos motivos de consulta quanto nos procedimentos e nas condições ou diagnósticos. A Organização Mundial de Saúde chancelou a classificação bem como o seu comitê desenvolvedor após o encontro de Alma-Ata, pois também identificou necessidades específicas. Hoje há essencialmente duas formas de uso na coleta de informações: por encontro ou por episódio de cuidado. A segunda forma é mais complexa e controversa. Recentemente foi lançada a décima primeira versão da Classificação Internacional de Doenças, enquanto que a CIAP-3 esta sendo desenvolvida. Não há como prever como vão interagir com as novas tecnologias, as classificações e os organismos internacionais. O protagonismo dos profissionais da ponta e dos pacientes tem potencial de definir a direção.


Abstract The International Classification of Primary Care-2 (ICPC-2) is the result of forty years of continuous development. It originates in the second half of the twentieth century after the concern of general practitioners about the need to record and encode data specifically related to primary care, both in the reasons for encounter and procedures and conditions or diagnoses. The World Health Organization endorsed the classification, as did the developer committee after the Alma Ata meeting, since it also identified specific needs. Two forms of use are employed now in gathering information: by encounter or by an episode of care. The latter is more complex and controversial. Recently, an eleventh version of the International Classification of Diseases has been released, and the third edition of ICPC is being developed. One cannot predict how new technologies, classifications, and international organizations will interact. The role of front line health professionals and patients will define the course.


Subject(s)
Humans , Primary Health Care , International Classification of Diseases , Episode of Care , Family Practice , Diagnosis , General Practice , Clinical Coding , Forms and Records Control , Terminology as Topic
6.
Paidéia (Ribeirão Preto, Online) ; 30: e3009, 2020. tab, graf
Article in English | LILACS, INDEXPSI | ID: biblio-1135433

ABSTRACT

Abstract This study aimed to show, by empirical evidence, that using different techniques of data analysis can contribute to the production of complementary knowledge about complex phenomena, such as emotions. The article discusses the results derived from using two textual analysis techniques and their articulation. Its main contribution is methodological, specifically in qualitative analysis supported by software. The study included 517 artists working in various artistic sectors, such as music and theater. ALCESTE and ATLAS.ti were used in the analysis. Results suggest convergences or complementarities between these two techniques. While ATLAS.ti allows for a dialogue between data and theory, through open coding, for better alignment between categorical theoretical system and data, ALCESTE organizes data in classes or categories, through calculations of word co-occurrence, which requires a theoretical frame to give them meaning.


Resumo O objetivo deste estudo foi trazer evidências empíricas de que o uso de técnicas de análises de dados variadas pode contribuir para produzir conhecimento complementar sobre fenômenos complexos, como o das emoções. O artigo discute os resultados oriundos da utilização de duas técnicas de análise textual e sua articulação. Sua principal contribuição é metodológica, especificamente em análise qualitativa com suporte de softwares. Participaram do estudo 517 artistas que trabalhavam em diversos setores artísticos, como música e teatro. O ALCESTE e o ATLAS.ti foram usados nas análises. Os resultados sugerem convergências ou complementaridades entre essas duas técnicas. Enquanto o ATLAS.ti permite estabelecer um diálogo dos dados com a teoria, pela via da codificação aberta, para melhor alinhamento entre sistema teórico categorial e dados, o ALCESTE organiza a base dados em classes ou categorias, mediante cálculos de coocorrência de palavras, que necessitam de frame teórico para lhes dar sentido.


Resumen El presente estudio propone aportar evidencias empíricas de que el uso de técnicas de análisis de datos variadas puede contribuir a la producción de conocimiento complementario sobre fenómenos complejos, como el de las emociones. El artículo discute los resultados del uso de dos técnicas de análisis textual y su articulación. Su principal contribución es metodológica, específicamente en el análisis cualitativo respaldado por softwares. En el estudio participaron 517 artistas que trabajaban en diversos sectores artísticos, como la música y el teatro. Para los análisis, se utilizaron el ALCESTE y ATLAS.ti. Los resultados apuntan convergencias o complementariedades entre estas dos técnicas. Mientras ATLAS.ti permite establecer un diálogo entre los datos y la teoría por medio de la codificación abierta para una mejor adecuación entre el sistema teórico categórico y los datos, ALCESTE organiza la base de datos en clases o categorías mediante cálculos de coocurrencia de palabras, que necesitan un frame teórico para darles significado.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Software , Analytical Methods , Knowledge , Qualitative Research , Economics , Emotions , Methodology , Clinical Coding
8.
Asia Pacific Allergy ; (4): 1-2020.
Article in English | WPRIM | ID: wpr-785464

ABSTRACT

BACKGROUND: In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.OBJECTIVE: Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.METHODS: Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the National Institute of Allergy and Infectious Disease and the Food Allergy and Anaphylaxis Network (NIAID/FAAN) were included. Data collected included demographics, signs and symptoms, triggers and management.RESULTS: A total of 105 cases were evaluated. Incidence of anaphylaxis for the 3-year study period was 0.03%. Of the 105 cases, 35 (33%) were diagnosed as “urticaria” or “hypersensitivity reaction” despite fulfilling the NIAID/FAAN anaphylaxis criteria. There was a significant difference in epinephrine administration between those given the diagnosis of anaphylaxis versus misdiagnosed cases (61 [87%] vs. 12 [34%], χ² = 30.77, p < 0.01); and a significant difference in time interval from arrival at the ED to epinephrine administration, with those diagnosed as anaphylaxis (48%) receiving epinephrine within 10 minutes, versus ≥ 60 minutes for most of the misdiagnosed group (χ² = 52.97, p < 0.01).CONCLUSION: Despite current guidelines, anaphylaxis is still misdiagnosed in the ED. Having an ED diagnosis of anaphylaxis significantly increases the likelihood of epinephrine administration, and at a shorter time interval.


Subject(s)
Anaphylaxis , Classification , Clinical Coding , Communicable Diseases , Demography , Diagnosis , Emergencies , Emergency Service, Hospital , Epinephrine , Food Hypersensitivity , Hospitals, Urban , Humans , Hypersensitivity , Incidence , Philippines , Retrospective Studies , Tertiary Care Centers
9.
Lima; Perú. Ministerio de Salud; 1 ed; 20191200. 25 p. ilus, tab.
Monography in Spanish | MINSAPERU, LILACS, MINSAPERU | ID: biblio-1046297

ABSTRACT

El manual describe y homogeniza los criterios en la recopilación y codificación de diagnósticos CIE 10. Asimismo, describe la metodología de registros estadísticos sanitarios en salud del adulto mayor, el cual se convierte en un sistema de información necesaria para la toma de decisiones en la solución de los problemas sanitarios en el marco del sistema de coordinación.


Subject(s)
National Health Strategies , Aged , Registries , Health Statistics , Adult Health , Data Interpretation, Statistical , Comprehensive Health Care , Clinical Coding
11.
Article in English | WPRIM | ID: wpr-759901

ABSTRACT

PURPOSE: The purpose of this study is to explore what the students experienced in short filmmaking class performed to 1st grade premedical students of a medical school, and to trace educational effects of the class. METHODS: Taking a qualitative approach, the authors used semi-structured interviews to collect the data. This study employed the quota sampling method to purposefully select students to interview. Data coding and analysis were performed based on the grounded theory. The filmmaking experiences consistently described by the interviewees were labeled and reorganized into categories through the open, axial, and selective coding. RESULTS: The students experience the group filmmaking class as a participatory class. Learners also experienced the procedure of performing complicated group tasks according to detailed and scheduled processes. Participation leads to collaboration. Collaboration here is through communication and participation, not through mechanical cooperation. Students also experience various dimensions of communication. The students learned that successful performance of the group filmmaking process is enabled through consideration towards others, and experience a sense of connectedness resulting in a type of community spirit. Having fun and interest, finally, the students experience the sense of accomplishment and sharing through joint screening. CONCLUSION: Students' shared experiences and their education effects of the filmmaking class can be explained in terms of the above mentioned seven closely intertwined categories. In this class, the students were able to express emotions they would not normally express. Through this, the students were able to find the true character and new aspects of their fellow students, forming intimacy, which led to a sense of belonging and connectedness.


Subject(s)
Clinical Coding , Cooperative Behavior , Education , Education, Medical, Undergraduate , Grounded Theory , Humans , Joints , Mass Screening , Methods , Schools, Medical , Students, Medical , Students, Premedical
12.
Article in English | WPRIM | ID: wpr-763611

ABSTRACT

BACKGROUND: Medicines and Healthcare products Regulatory Agency (MHRA) guidance for patients with metal-on-metal (MoM) hip replacements was provided in 2012 and updated in 2017 to assist in the early detection of soft-tissue reactions due to metal wear debris. A large number of MoM hip replacements were undertaken at our hospital trust. A program of recall for all patients with MoM hip replacements was undertaken and MHRA guidelines were implemented. In this study, we aimed to investigate the effectiveness of the revised MHRA guidelines in the detection of early adverse reactions to metal debris and to re-evaluate the indications for metal artifact reduction sequence magnetic resonance imaging (MARS-MRI) and revision surgery. METHODS: Identification and recall of all patients with MoM hip replacements from 2001 were conducted by using theatre logs, patient records, clinical coding information, and consultant logbooks. Two senior arthroplasty consultants reviewed X-rays and patient records. Postal questionnaires were forwarded to patients, together with requests for general practitioners to complete cobalt and chromium blood tests. The two consultant-led review of MOM replacements was undertaken with further radiological investigations (X-rays, MARS-MRI) performed according to the 2017 guidance with support of consultant radiologists. RESULTS: Of 674 identified patients, 297 were available for review: 26 patients did not have MoM implants, 36 were untraceable, 59 refused follow-up, 87 moved out of area, 147 had died, and 22 already had revision. Of 297 patients, 126 were women and 171 were men; age range was 39 to 95 years (mean age, 69 years); 126 had resurfacing and 171 had MoM replacements. Twenty-six patients had elevated metal ions. Thirty-three patients underwent MARS-MRI: MARS-MRI results were positive in 17 and negative in 16. Of 17 patients with positive MARS-MRI, 10 patients were asymptomatic and seven were waiting revision. CONCLUSIONS: Positive MARS-MRI can often occur in the absence of elevated metal ion levels; elevated blood metal ion levels do not mean MARS-MRI will be positive. All patients with MoM replacements were at risk. It is imperative to assess patients regularly for symptoms that may raise clinical suspicion and maintain a low threshold to performing MARS-MRI.


Subject(s)
Arthroplasty , Artifacts , Chromium , Clinical Coding , Cobalt , Consultants , Delivery of Health Care , Female , Follow-Up Studies , General Practitioners , Hematologic Tests , Hip , Hospitals, District , Humans , Ions , Magnetic Resonance Imaging , Male
13.
Article in English | WPRIM | ID: wpr-763360

ABSTRACT

OBJECTIVE: Vitamin D-binding protein (VDBP) mediates various biological processes in humans. The goal of this study was to investigate whether VDBP gene polymorphisms could predispose Korean women to endometriosis. METHODS: We prospectively enrolled women with endometriosis (n = 16) and healthy controls (n = 16). Total serum 25-hydroxyl vitamin D (25(OH)D) concentrations were measured using an Elecsys vitamin D total kit. Levels of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using a vitamin D BP Quantikine ELISA kit. DNA was extracted using a DNeasy blood & tissue kit. Two single-nucleotide polymorphisms (SNPs; rs4588 and rs7041) in GC, the gene that codes for VDBP, were analyzed using a TaqMan SNP genotyping assay kit. The functional variant of VDBP was determined based on the results of the two SNPs. RESULTS: Gravidity and parity were significantly lower in the endometriosis patients than in the control group, but serum CA-125 levels and the erythrocyte sedimentation rate were significantly higher. Total serum 25(OH)D levels in the endometriosis patients were significantly lower than in the control group. However, serum bioavailable 25(OH)D, free 25(OH)D, and VDBP levels did not differ significantly between the endometriosis and control groups. The genotypes and allele frequencies of GC were similar in both groups. CONCLUSION: Korean women with endometriosis had lower total serum 25(OH)D concentrations than controls. Neither serum VDBP concentrations nor polymorphisms in the gene coding for VDBP were associated with endometriosis. Further studies are needed to investigate the pathophysiology and clinical implications of 25(OH)D and VDBP in endometriosis.


Subject(s)
Biological Phenomena , Blood Sedimentation , Clinical Coding , DNA , Endometriosis , Enzyme-Linked Immunosorbent Assay , Female , Gene Frequency , Genotype , Gravidity , Humans , Parity , Polymorphism, Genetic , Polymorphism, Single Nucleotide , Prospective Studies , Vitamin D , Vitamin D-Binding Protein , Vitamins
14.
Article in Korean | WPRIM | ID: wpr-764703

ABSTRACT

PURPOSE: This study aimed to introduce and elucidate changes in Strauss and Corbin's grounded theory and discuss its application to the field of nursing in South Korea. METHODS: The changes in grounded theory by Strauss and Corbin were examined through a literature review of grounded theory from its inception. RESULTS: Strauss and Corbin acknowledged their philosophical backgrounds of symbolic interactionism and pragmatism; however, their methodology based on positivism overwhelmed their epistemology and ontology. This inconsistency has been represented by the coding paradigm and the premise of “emergent from the data.” In the revised version of Basics, Strauss and Corbin modified their theory to weaken the coding paradigm and strengthen the strategies for the development of substantive theory. CONCLUSION: Strauss and Corbin's revised grounded theory did not fully address the inconsistency of their epistemology and ontology between their acknowledgement and methodology. However, these changes constitute a meaningful step toward resolving inconsistencies and highlight the development of substantive theory. This has implications for Korean nursing researchers who have utilized methodologies in grounded theory with dogmatic approaches; grounded theory, with its evolving nature, is not a finalized method and calls for open approaches for the development of a grounded theory that fits Korean nursing.


Subject(s)
Clinical Coding , Grounded Theory , Korea , Methods , Nursing , Nursing Research
15.
Article in Korean | WPRIM | ID: wpr-764679

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis. METHODS: Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment. RESULTS: Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was −0.62 (95% Cl: −0.92 to −0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes. CONCLUSION: Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.


Subject(s)
Adult , Clinical Coding , Dementia , Depression , Humans , Information Dissemination , Information Services , Mental Recall , Methods , Nursing
16.
Article in English | WPRIM | ID: wpr-758906

ABSTRACT

The 4a and 4b proteins of the Middle East respiratory syndrome coronavirus (MERS-CoV) have been described for their antagonism on host innate immunity. However, unlike clustering patterns of the complete gene sequences of human and camel MERS-CoVs, the 4a and 4b protein coding regions did not constitute species-specific phylogenetic groups. Moreover, given the estimated evolutionary rates of the complete, 4a, and 4b gene sequences, the 4a and 4b proteins might be less affected by species-specific innate immune pressures. These results suggest that the 4a and 4b proteins of MERS-CoV may function against host innate immunity in a manner independent of host species and/or evolutionary clustering patterns.


Subject(s)
Camelus , Clinical Coding , Coronavirus Infections , Evolution, Molecular , Humans , Immunity, Innate , Middle East Respiratory Syndrome Coronavirus , Middle East , Open Reading Frames , Phylogeny , Zoonoses
17.
Article in Korean | WPRIM | ID: wpr-761395

ABSTRACT

OBJECTIVE: Myeloproliferative neoplasm (MPN) is considered as one of the risk factors of ischemic stroke. Some MPN patients manifest stroke as their first symptom. Our purpose was to assess diagnostic rate of MPN in newly diagnosed acute ischemic stroke patients. METHODS: This study was performed using National Health Insurance Service Ilsan Hospital dataset. Data retrieving was performed by defining by defining the patient with coding of acute ischemic stroke from January 2013 to June 2017. We selected only the patients who had checked brain magnetic resonance imaging and complete blood cell count (CBC) in emergency room or on admission. Among the results of CBC finding, hemoglobin and platelet count were analyzed. Erythrocytosis was defined >16.5 g/dL (male), >16 g/dL (female) according to revised World Health Organization (WHO) classification of polycythemia vera (PV) criteria. Thrombocytosis was >450,000/µL according to revised WHO classification of essential thrombocythemia (ET). RESULTS: Total number of newly diagnosed acute ischemic stroke was 1,613 patients. Seven patients (0.43%) were diagnosed MPN (ET=2, PV=5) after ischemic stroke. Patients who had thrombocytosis and erythrocytosis were 18 and 105, respectively. Three patients who had thrombocytosis were diagnosed MPN (ET=2, PV=1). Two patients with erythrocytosis were diagnosed MPN (PV=2). Two patients had both thrombocytosis and erythrocytosis, and two of them were diagnosed PV. Seventy-one patients who had erythrocytosis were normalized in follow-up period. Six patients who had thrombocytosis and 30 patients who had erythrocytosis did not further evaluate. CONCLUSION: CBC has to be carefully read and MPN can be suspected. Diagnosis must be confirmed by hematologist to initiate appropriate treatment. It is important to recognized suspected MPN patients to prevent stroke.


Subject(s)
Blood Cell Count , Brain , Classification , Clinical Coding , Dataset , Diagnosis , Emergency Service, Hospital , Follow-Up Studies , Humans , Magnetic Resonance Imaging , National Health Programs , Platelet Count , Polycythemia , Polycythemia Vera , Risk Factors , Stroke , Thrombocythemia, Essential , Thrombocytosis , World Health Organization
18.
Psychiatry Investigation ; : 645-653, 2019.
Article in English | WPRIM | ID: wpr-760984

ABSTRACT

Depression leads the higher personal and socio-economical burden within psychiatric disorders. Despite the fact that over 40 antidepressants (ADs) are available, suboptimal response still poses a major challenge and is thought to be partially a result of genetic variation. Pharmacogenetics studies the effects of genetic variants on treatment outcomes with the aim of providing tailored treatments, thereby maximizing efficacy and tolerability. After two decades of pharmacogenetic research, variants in genes coding for the cytochromes involved in ADs metabolism (CYP2D6 and CYP2C19) are now considered biomarkers with sufficient scientific support for clinical application, despite the lack of conclusive cost/effectiveness evidence. The effect of variants in genes modulating ADs mechanisms of action (pharmacodynamics) is still controversial, because of the much higher complexity of ADs pharmacodynamics compared to ADs metabolism. Considerable progress has been made since the era of candidate gene studies: the genomic revolution has made possible to assess genetic variance on an unprecedented scale, throughout the whole genome, and to analyze the cumulative effect of different variants. The results have revealed key information on the biological mechanisms mediating ADs effect and identified hypothetical new pharmacological targets. They also paved the way for future availability of polygenic pharmacogenetic panels to predict treatment outcome, which are expected to explain much higher variance in ADs response compared to CYP2D6 and CYP2C19 only. As the demand and availability of AD pharmacogenetic testing is projected to increase, it is important for clinicians to keep abreast of this evolving area to facilitate informed discussions with their patients.


Subject(s)
Antidepressive Agents , Biomarkers , Clinical Coding , Cytochrome P-450 CYP2C19 , Cytochrome P-450 CYP2D6 , Cytochromes , Depression , Genetic Variation , Genome , Humans , Metabolism , Negotiating , Pharmacogenetics , Precision Medicine , Treatment Outcome
19.
Psychiatry Investigation ; : 513-523, 2019.
Article in English | WPRIM | ID: wpr-760959

ABSTRACT

OBJECTIVE: The aim of this study was to examine the experience of volunteer psychiatrists who provided mental health interventions to adolescents and teachers of Danwon High School from April 16, 2014, to November 30, 2014. METHODS: Data for this study were collected from 72 volunteer psychiatrists about their intervention experiences for 212 adolescents and 32 teachers during the eight months following the disaster. Developmental survey themes were identified, and coding was used to analyze the data. In addition, qualitative data analysis was performed using ATLAS.ti (version 8.2, 2018, ATLAS.ti GmbH). RESULTS: A volunteer prepared with appropriate mental health interventions may facilitate the emergency response to a disaster. Intervention services included psychological first aid, psychoeducation, screening, anxiety reduction techniques, and group therapy. CONCLUSION: In the acute aftermath of the Sewol Ferry disaster of April 16, 2014, volunteer psychiatrists were able to provide mental health interventions in a disaster response setting. The outcomes from this study have important policy and mental health system implications for volunteer psychiatrists. The results of this study constitute the basis of a better understanding of the essential mechanisms of crisis interventions after a disaster.


Subject(s)
Adolescent , Anxiety , Clinical Coding , Crisis Intervention , Disasters , Emergencies , First Aid , Humans , Mass Screening , Mental Health , Psychiatry , Psychotherapy, Group , Statistics as Topic , Volunteers
20.
Article in English | WPRIM | ID: wpr-740231

ABSTRACT

OBJECTIVES: This study proposes a method for classifying three types of resting membrane potential signals obtained as images through diagnostic needle electromyography (EMG) using TensorFlow-Slim and Python to implement an artificial-intelligence-based image recognition scheme. METHODS: Waveform images of an abnormal resting membrane potential generated by diagnostic needle EMG were classified into three types—positive sharp waves (PSW), fibrillations (Fibs), and Others—using the TensorFlow-Slim image classification model library. A total of 4,015 raw waveform data instances were reviewed, with 8,576 waveform images subsequently collected for training. Images were learned repeatedly through a convolutional neural network. Each selected waveform image was classified into one of the aforementioned categories according to the learned results. RESULTS: The classification model, Inception v4, was used to divide waveform images into three categories (accuracy = 93.8%, precision = 99.5%, recall = 90.8%). This was done by applying the pretrained Inception v4 model to a fine-tuning method. The image recognition model was created for training using various types of image-based medical data. CONCLUSIONS: The TensorFlow-Slim library can be used to train and recognize image data, such as EMG waveforms, through simple coding rather than by applying TensorFlow. It is expected that a convolutional neural network can be applied to image data such as the waveforms of electrophysiological signals in a body based on this study.


Subject(s)
Artificial Intelligence , Boidae , Classification , Clinical Coding , Electromyography , Membrane Potentials , Methods , Needles
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