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Biomedical subjects

Nam-Ju Lee

Publications and source records attributed to Nam-Ju Lee.

11 recordsLinked to original sources
PubMed2006

Development, validation, and use of English and Spanish versions of the telemedicine satisfaction and usefulness questionnaire.

OBJECTIVES: To describe the development and validation of low literacy English and Spanish versions of the 26-item Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), report telemedicine satisfaction and usefulness ratings of urban and rural participants in the Informatics for Diabetes Education and Telemedicine (IDEATel) project, and explore relationships between utilization and perceptions of satisfaction and usefulness. METHODS: Data sources included TSUQ, utilization data from IDEATel log files, and sociodemographic data from the annual IDEATel interview. Psychometric analyses were conducted to examine the reliability and validity of TSUQ. Data were analyzed using descriptive, correlational techniques. RESULTS: The principal components factor analysis extracted two factors (Video Visits, alpha=.96, and Use and Impact, alpha=.92) that explained 63.6% of the variance in TSUQ satisfaction scores. All satisfaction and usefulness items had mean scores of greater than 4 on a 5-point scale. Those from urban areas reported significantly higher ratings on both factors than rural participants as did those who did not know how to use a computer at baseline. Mean frequency of utilization of IDEATel components was highest for blood sugar testing followed by web site for reviewing results, blood pressure testing, video visits, and ADA educational Web pages. Associations between utilization and perceptions of satisfaction and usefulness varied among IDEATel components. CONCLUSION: Psychometric analyses support the construct validity and internal consistency reliability of TSUQ, which is available in both English and Spanish at a readability level of 8th grade. Both rural and urban participants reported high levels of satisfaction and found all IDEATel components useful. Further work is needed to examine the relationships between utilization and perceptions of satisfaction and usefulness and to explore the effects of location (urban versus rural) and ethnicity on satisfaction with telemedicine services.

Diabetes Mellitus↗
PubMed2006

Preliminary analysis for the development of a PDA-based decision support system for the screening and management of obesity.

This preliminary study toward the development of a Mobile Decision Support System for Advanced Practice Nursing (MODS-APN) for the management of obesity compared APN students' current electronic clinical log (CL-APN) documentation to an obesity clinical practice guideline (CPG) and examined the extent to which concepts related to the screening and management of obesity could be represented with standardized terminologies. The data that were documented by APN students with the CL-APN were retrieved using the Structured Query Language (SQL) and were compared to the CPG using a scoring tool developed for this study. Only 1.4 % of the encounters had obesity as an assessment diagnosis and about 40 % of those encounters did not have any plans of care related to the CPG's main treatment recommendations. Fifty-six concepts related to the screening and management of obesity were extracted from the CPG and were mapped to 36 terms using standardized terminologies.

Computers, Handheld↗
PubMed2006

Usefulness of a personal digital assistant-based advanced practice nursing student clinical log: Faculty stakeholder exemplars.

The number of health sciences educational programs that are integrating personal digital assistants (PDAs) into their curricula is on the rise. In this paper, we report an evaluation of the usefulness of a PDA-based advanced practice nursing (APN) student clinical log through faculty stakeholder exemplars in three areas: pediatric asthma care; procedures of Acute Care Nurse Practitioner (NP) students; and diagnostic and screening procedures of Women's Health NP students. We generated descriptive data through routine queries and through custom SQL queries at the request of a specific faculty member who wished to examine a particular aspect of an educational program. In addition, we discussed the potential implications of the data with the respective faculty members. The exemplars provide evidence that faculty stakeholders found the APN student clinical log to be useful for a variety of purposes including monitoring of student performance, benchmarking, and quality of care assessments.

Computers, Handheld↗
PubMed2006

Mobile decision support for advanced practice nurses.

Mobile Decision Support for Advanced Practice Nurses (MODS-APN) is a PDA-based decision support tool designed to assist APNs in the diagnosis and management of smoking cessation, obesity, and depression. It is currently being tested in a randomized, controlled trial (RCT) in a sample of APN students to determine the effect on adherence to clinical practice guideline (CPG) recommendations. Tools such as MODS-APN have the potential to increase CPG adherence, enhance evidence-based practice, promote patient safety, and in the long term improve patient outcomes.

Computers, Handheld↗
PubMed2005

Using patient data to retrieve health knowledge.

BACKGROUND: We sought to study a variety of terminologic approaches to the use of clinical data for searching on-line information resources. METHODS: We used a collection of narrative text and coded data to search a variety of text-based, concept-based, and concept-indexed resources. RESULTS: Automated retrievals using original terms could be accomplished and technically produced ample results. However, quality of the results varied with the resource. Terminology translations were difficult to accomplish and produced variable results. CONCLUSIONS: Current resources support automated retrieval; however, achieving quality results varies with the terms and the resources, with term translation productive only in select situations.

Abstracting and Indexing↗
PubMed2004

Scirrhous gastric carcinoma: endoscopy versus upper gastrointestinal radiography.

PURPOSE: To compare the accuracy of upper gastrointestinal (UGI) series and endoscopic examination in the diagnosis and localization of scirrhous gastric carcinoma. MATERIALS AND METHODS: Seventy-two patients with pathologically proved scirrhous gastric carcinoma in surgical specimens were included. Preoperative reports at UGI series and endoscopic examination, which included impressions on the location and extent of the tumor, were compared with pathology reports, and the accuracy of the preoperative reports was calculated. Two gastrointestinal radiologists retrospectively reviewed the appearance of mucosa at UGI series. RESULTS: Preoperative diagnoses at endoscopy were Borrmann type IV carcinoma in 28 patients (39%), type III carcinoma in 29 (40%), early gastric carcinoma in seven (10%), lymphoma in six (8%), atrophic gastritis in one (3%), and type II carcinoma in one (3%). Preoperative diagnoses at UGI series were type IV carcinoma in 44 patients (61%), type III carcinoma in 25 (35%), lymphoma in two (3%), and early gastric carcinoma in one (1%). Pathology reports were compared with the preoperative reports, and tumor location and extent were correct in the endoscopic examination reports of 24 patients (33%) and the UGI series reports of 49 patients (68%). In 68 patients, UGI series revealed thickened and irregular folds in 62 (91%), ulceration in 42 (62%), and nodularity in 22 (32%) at consensus review. Endoscopic biopsy samples were positive for malignancy in 66 patients (93%). CONCLUSION: UGI series is superior to endoscopic examination in the diagnosis and localization of scirrhous gastric carcinoma.

Adenocarcinoma, Scirrhous↗
PubMed2004

Practical considerations for exploiting the World Wide Web to create infobuttons.

BACKGROUND: We are studying ways to provide automated, context-specific links (called "infobuttons") between clinical information systems (CIS) and other information resources available on the World Wide Web. As part of this work, we observed the information needs that arose when clinicians used a CIS and we classified those needs into generic questions. We then sought general methods for accessing information resources to answer the questions. METHODS: For each generic question, we identified a satisfactory resource and then developed a method for retrieving from it the information relevant to the question. We then studied these methods to characterize them into general approaches. RESULTS: We identified six general approaches and describe them in detail. These approaches range in complexity from simple, hard-coded links to intelligent agents and calculators. CONCLUSION: Web-based information resources can be exploited using a relatively small number of methods, although the specific methods require custom solutions. Standard methods for accessing Web-based resources would simplify the task of linking to CISs.

Decision Support Systems, Clinical↗
PubMed2004

Representing public health nursing intervention concepts with HHCC and NIC.

PURPOSE: It is imperative that public health nurses define their services and provide evidence supporting the effectiveness of interventions. The purpose of this paper is to examine the ex-tent to which two standardized nursing terminologies--Home Health Care Classification (HHCC) and Nursing Interventions Classification (NIC)--represent public health nursing practice according to core public health function in Public Health Nursing Intervention model. METHODS: First, we divided all HHCC and NIC interventions into intervention focus levels: individual/family-focused, community-focused, and system-focused. Second, we categorized HHCC and NIC interventions according to core public health functions: assessment, policy development, and assurance and the categories of interventions in the PHI Model. RESULTS: We identified HHCC and NIC Nursing interventions that represented public health nursing concepts across core public health functions and categories of the PHI model. Analysis of the findings demonstrated that HHCC and NIC have terms for the concepts in the PHI model. CONCLUSION: Although HHCC and NIC cover many concepts in public health nursing practice, additional research is needed to extend these terminologies and to evaluate other standardized terminologies that can reflect more comprehensively public health nursing interventions.

Home Care Services↗
PubMed2002

Native-feather degradation by Fervidobacterium islandicum AW-1, a newly isolated keratinase-producing thermophilic anaerobe.

A native-feather-degrading thermophilic anaerobe was isolated from a geothermal hot stream in Indonesia. Isolate AW-1, identified as a member of the species Fervidobacterium islandicum, was shown to degrade native feathers (0.8%, w/v) completely at 70 degrees C and pH 7 with a maximum specific growth rate (0.14 h(-1)) in Thermotoga- Fervidobacterium(TF) medium. After 24 h of culture, feather degradation led to an increase in free amino acids such as histidine, cysteine and lysine. Moreover, nutritionally essential amino acids such as tryptophan and methionine, which are rare in feather keratin, were also produced as microbial metabolites. A homomultimeric membrane-bound keratinolytic protease (>200 kDa; 97 kDa subunits) was purified from a cell extract of F. islandicum AW-1. The enzyme exhibited activity toward casein and soluble keratin optimally at 100 degrees C and pH 9, and had a half-life of 90 min at 100 degrees C. The enzyme showed higher specific activity for the keratinous substrates than other proteases and catalyzed the cleavage of peptide bonds more rapidly following the reduction of disulfide bridges in feather keratin by 10 mM dithiothreitol. Therefore, the enzyme from F. islandicum AW-1 is a novel, thermostable keratinolytic serine protease.

Amino Acids↗
PubMedDate not supplied

Economic evaluations and usefulness of standardized nursing terminologies.

PURPOSE: To review different types of economic analyses commonly found in healthcare literature, discuss methodologic considerations in framing economic analyses, identify useful resources for economic evaluations, and describe the current and potential roles of standardized nursing terminologies in providing cost and outcome data for economic analysis. DATA SOURCES: The Advanced Billing Concepts Code Resource-based Relative Value Scale and Nursing Outcomes Classification. DATA SYNTHESIS: Using case studies, the applicability of standardized nursing terminologies in cost-effectiveness analysis is demonstrated. While there is potential to inform specific questions, comparisons across analyses are limited because of the many outcome measures. CONCLUSIONS: Including a standardized quality-of-life measure in nursing terminologies would allow for the calculation of accepted outcome measures and dollars per quality adjusted life years gained. IMPLICATIONS FOR PRACTICE: The nurse's ability to assess and contribute to all aspects of rigorous economic evidence is an essential competency for responsible practice.

Cost-Benefit Analysis↗