• Title/Summary/Keyword: Adult Day Care

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Development of a Critical Pathway for Patients with Lumbar Laminectomy (요추척추궁 절제술 환자의 표준관리지침서 개발)

  • Park, Jae Jung;Park, Hyoung Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.517-532
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    • 2000
  • The purpose of this study was to develop a critical pathway for case management of patients who have received Lumbar Laminectomy because of low back pain, arm and leg numbness, and radiating pain in the leg. For this study, a preliminary critical pathway was developed through a review of the literature including five critical pathways which are currently being used in the USA. In order to identify the overall service contents required by these patients, 30 cases were analyzed. These cases were taken from medical records of those with Lumbar Laminectomy between January, 1998 and December, 1998 in the department of neurosurgery at the Pusan National University Hospital in Pusan. An expert validity test was done for the preliminary critical pathway, a clinical validity test was also done using 12 patients with Lumbar Laminectomy between October 1, 1999 and January 31, 2000. After these processes, the final critical pathway was developed. The results are summarized as follows. 1. The vertical axis of the critical pathway includes the following eight items: assessment, consultation, diet, test, medication, treatment, activity, education/ discharge planning. The horizontal axis includes the time from the start of hospitalization to discharge. Analysis of the 30 medical records was done. analysis of the service contents showed the horizontal axis of the preliminary critical pathway was set from hospitalization to the 12th post operation day and the vertical axis was set to include eight items, the contents which should have occurred, according to the time frames of the horizontal axis. 2. As a result of the expert validity test, it was found that among the 233 items, 203 showed over 88% agreement and 30 of them showed less than 88% agreement, which were then revised or deleted from the critical pathway. At the preliminary meeting for the clinical validity test, the time of hospitalization on the horizontal axis was shortened to the 10th post operation day. A clinical validity test was done with 12 patients with Lumbar Laminectomy. All the cases progressed according to the critical pathway although some variances were noted in assessment, consultation, test, medication, and treatment. 3. Based on these results, a final critical pathway was determined. In conclusion, this critical pathway is partially applicable to the care of patients with Lumbar Laminectomy and needs further investigation.

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Influence of Powdered Velvet Antler on Growth and Intestinal Organ Development in Sprague-Dawley Rats (녹용분말 급여가 성장기별 흰쥐의 성장 및 장기발육에 미치는 효과)

  • Sung, H.G.;Kim, D.K.;Shin, H.T.
    • Journal of Animal Science and Technology
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    • v.45 no.5
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    • pp.749-758
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    • 2003
  • The velvet antler of Korean sika deer has been used to the important resources for human health care with ginseng in Korea and Chinese. For studying on biological function of deer velvet being recorded in many ancient literatures, this experiment was conducted to evaluate the effects of powdered velvet antler on growth, feed intake, feed efficiency and intestinal organ development in growing and adult Sprague-Dawley Rats. Experiments were designed by adding amount of powdered velvet antler such as control (non- supplementation), powdered velvet antler I (PVA I, recommended dose) and powdered velvet antler II (PVA II, thrice recommended dose). The recommended dose of powdered velvet in this experiment was calculated with metabolic body weight of rats, which based on the recommended amounts for 70 kg of human. The growths of growing and adult rats generally appeared advantage in PVA supplementation. The final body weight of control, PVA I and II were respectively 470${\pm}$39.00g, 478${\pm}$30.33g and 475${\pm}$22.72g in growing rats, and 485${\pm}$38.50g, 521${\pm}$38.67g and 508${\pm}$34.44g in adult rats. The average daily feed intake were not significantly influenced but the feed efficiency ratios (feed/gain) were improved by PVA supplementation. The feed/gain ratios of control, PVA I and II were respectively 5.99, 5.47 and 5.54 in growing rats, and 9.04, 7.73 and 8.18 in adult rats. In case of developments of liver, heart, kidney and stomach, we obtained favorable results in both PAC I and II, but their results were not significantly different according to amount of PVA supplementation. Because liver and heart are important organs in the circulation of blood, their favorable effects suggest that velvet antler may have factors contributing hematopoiesis. Conclusively, supplementation of powdered velvet antler resulted in an improved growth, feed efficiency and development of some intestinal organs in growing and adult rat. Even if further investigation of dose in human health care are should be performed, this experiment appeared the best desirable results in PVA I, recommended dose of powdered velvet antler.

The New in vitro Oral Irritation Test Method for Toothpaste using YD-38 Oral Mucosal Cell Line (치약에 대한 YD-38 세포주를 활용한 새로운 구강 점막 자극 시험방법)

  • Nam, Gi Baeg;Cho, Sun-A;Cho, Jun-Cheol;Kim, Chanho;Kim, Yoo-Jin;Lee, John Hwan;Shin, Kyeho
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.38 no.4
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    • pp.305-310
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    • 2012
  • Through our entire life, oral care products such as toothpaste are used. Thus the safety of oral care products used every day to our mouth is very important. As the previous study in animal tests or clinical trials, surfactant in toothpaste may cause the oral irritation. However, EU cosmetics legislation prohibits animal testing of cosmetics and its ingredient for animal welfare. Therefore the development of alternative in vitro test has been actively performed to replace or reduce using the animal in many areas. However, the way to evaluate oral mucosal toxicity has been done using animal models or clinical trials from now on. Even more, the experiment with human oral 3D tissue or human oral cell line is used recently. The aim of this study is the development of oral mucosal irritation method without using animal for the safety of the oral care product. We developed in vitro test method for oral irritation by using human oral cell line (YD-38 cell) acceptable to toothpaste which contains insoluble material. By the results of this assay, we could discriminate toothpaste with or without irritating substance as same manner in animal studies reported previously. In addition, we confirmed that toothpaste for babies and children toothpaste irritated oral musoca lower than the general adult toothpaste. The present study suggest that this new in vitro method by using human oral cell line (YD-38 cell) could be used for evaluation of oral irritation without using animal.

Nutrition Survey in Koje Island (거제도(巨濟島) 주민(住民)의 영양실태조사(營養實態調査))

  • Oh, Seoung-Ho;Chang, Soo-Kyung;Park, Michael Myung-Yun
    • Journal of Nutrition and Health
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    • v.10 no.4
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    • pp.43-58
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    • 1977
  • Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

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Effects of Robot-Mediated Gait Training Combined with Virtual Reality System on Muscle Activity: A Case Series Research

  • Heo, Seoyoon;Kim, Mooki;Choi, Wansuk
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.2
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    • pp.2021-2027
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    • 2020
  • Background: Previous robot-mediated gait training has been proven several limitations such as pointless repeated motion training, decreased presence, etc. In this research, adult stroke patients were participated in robot-mediated gait training accompanied with or without virtual reality program. Objectives: Exploring whether the results indicated virtual reality system has contribution to muscle strength and balance ability. Design: A case series research, cross-over trial. Methods: Eleven participants (male 4, female 7) with adults diagnosed as stroke from medical doctor ware engaged. The participants received 2 treatment sessions of identical duration, robot-assisted gait training with virtual reality and robot-assisted gait training with screen-off randomly crossed over include 1-day for each person of wash-out period. The parameter was muscle activity, the researchers assessed sEMG (surface electromyography). Results: The result showed less muscle activities during training in robot-assisted gait training with virtual reality circumstances, and these indicated muscles were gluteus medius muscle, vastus medialis muscle, vastus intermedius and vastus lateralis muscle, semimembranosus muscle, gastrocnemius-lateral head, and soleus muscle (P<.05). Conclusion: In this study, we analyzed the outcome of muscle activity for clinical inference of robot-assisted gait training with virtual reality (VR). Less muscle activity was measured in the treatment accompanied by VR, therefore, a more systematic, in-depth and well-founded level of follow-up research is needed.

Difference of Prescription Services between the Health Center and the Private Clinic (일부 보건소와 일반의원에서의 투약서비스 비교연구)

  • 이선희;조공민;손명세;김한중
    • Health Policy and Management
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    • v.2 no.2
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    • pp.131-151
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    • 1992
  • The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

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Survey on community occupational therapy awareness in occupational therapy majors (작업치료 전공자의 지역사회 작업치료 인식도 조사)

  • Lee, Sun-myung
    • Journal of Korean Clinical Health Science
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    • v.12 no.1
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    • pp.1668-1677
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    • 2024
  • Objective: This study investigated the awareness of occupational therapy in the community in occupational therapy majors through a survey. This purpose is to investigate the awareness of occupational therapy in the community among occupational therapy majors and establish a theoretical foundation. Methods: The research subjects were surveyed among occupational therapy majors at M University living in Gyeongsangnam-do, and analyzed 141 questionnaires from September 2023 to December 2023. Results: The results of this study that education and awareness improvement are needed to increase awareness of occupational therapy in the community, and it was found that continuing education and case sharing are effective. Activation of home rehabilitation and continuous health management. This institutional development can induce employment activity through community rehabilitation, and activate programs in connection with adult day care centers. For the development of community occupational therapy, participation in education and development of customized treatment are necessary, and patient It should be developed to help with movement and movement, and it has been shown that it can also affect the quality of life of patients. In addition, cutting-edge technologies such as artificial intelligence are expected to be applied to remote support, telemedicine, etc., and are applied to dementia, cognitive patients, and central nervous system patients. In order to institutionalize occupational therapy in the community, it is helpful in daily life, nursing, and management. It was said that this would be helpful for community participation. Conclusion: This study investigated the awareness of occupational therapy in the community among occupational therapy majors. Education and awareness improvement are needed to increase awareness of occupational therapy in the community. Education to improve the professionalism of occupational therapists, strengthening connectivity with other majors, and local organizations. It is believed that collaboration with the local community and institutional supplementation tailored to the needs of the local community were necessary.

Clinical Midterm Results of Surgical Aortic Valve Replacement with Sutureless Valves

  • Soonchang Hong;Jung-Woo Son;Yungjin Yoon
    • Journal of Chest Surgery
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    • v.57 no.3
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    • pp.255-262
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    • 2024
  • Background: Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. Methods: Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG). Results: The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up. Conclusion: The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.

The Effect of Pelvic Muscle Exercise Program on Women with Stress Urinary Incontinence in the Degree and Amount of Urinary Incontinence and Maximum Vaginal Contraction Pressure (골반저근육 운동 프로그램이 긴장성 요실금 여성의 요실금정도, 요실금량 및 최대 질수축압에 미치는 영향)

  • Kim, So Young;Park, Jeong Sook
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.267-277
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    • 2000
  • The purpose of this study was to help the women with stress urinary incontinence lead more comfortable life, by letting them to do pelvic muscle exercise and to learn by direct experience the effect that urinary incontinence is controlled. The research design was a one-group pretest-posttest design. The subjects were 16 middle-aged women(over 38) with stress urinary incontinence. The study was conducted from August 1, to October 11, 1999. Women trained themselves for muscular strength and endurance, every the other day for each exercise for six weeks at home(that means each exercise for more than three days a week) in the pelvic muscle exercise program which was developed by Dougherty et al., and filled out exercise participation card every week. They visited laboratory once a week to get visual feedback, by means of Perineometer, of how the pelvic muscle exercise was going on. Stress Urinary Incontinence Scale that Lee, Young-Sook revised and supplemented Hendrickson's original scale was used for measuring the frequency and situation scores of urinary incontinence, "30 minute pad test" was carried out for measuring the amount of urinary incontinence, and Perineometer was used for measuring maximum vaginal contraction pressure. Percentage, mean, standard deviation and Wilcoxon signed ranks test were used for data analysis by means of SPSS/PC+ WIN 9.0 program. The results were summarized as follows : The hypothesis 1 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the weekly degree of urinary incontinence would reduce compared to before the exercise was supported. The hypothesis 1-1 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the weekly frequency of urinary incontinence would reduce compared to before the exercise was supported (p=.003). The hypothesis 1-2 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the situation scores of urinary incontinence would reduce compared to before the exercise was supported(p=.044). The hypothesis 2 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the amount of urinary incontinence would reduce compared to before the exercise was supported(p=.001). The hypothesis 3 that after carrying out pelvic muscle exercise program on women with stress urinary incontinence, the maximum vaginal contraction pressure would increase compared to before the exercise was supported (p=.012). These results suggest that pelvic muscle exercise program has an effect on women with stress urinary incontinence in the degree and amount of urinary incontinence and maximum vaginal contraction pressure. So it is judged that training women with stress urinary incontinence for pelvic muscle exercise is an effective nursing intervention strategy in order to care urinary incontinence.

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Surgical Outcome of Tetralogy of Fallot in Adolt -Implication of Preoperative Cyanosis- (수술 전 청색증 정도에 따른 성인 활로씨 4징증의 임상 양상)

  • Kim Sang-hwa;Park Soon-Ik;Park Jung-Jun;Song Hyun;Lee Jae-Won;Seo Dong-Man;Song Meong-Gun;Song Jong-Min;Kang Duck-Hyun;Song Jae-Kwan;Jang Wan-Sook;Kim Young-Hwue;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.271-276
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    • 2005
  • We analysed differences in operative methods and postoperative outcome according to the severity of preoperative cyanosis in adult ToF (Tetralogy of Fallot) patients. Material and Method: From August 1989 to June 2001, thirty three adult patients, 18 females and 15 males, underwent total correction for ToF. Their age ranged from 15 years to 54 years (median: 34). Patients were divided into 2 groups by preoperative $SaO_2$ (arterial oxygen saturation): group I$(n=cyanotic,\;SaO_2\;\geq94\%)$ and group II $(acyanotic,\; SaO_2\geq95%)$. Preoperative median hemoglobin level was higher in group I compared to group II (17.5 g/dl vs 15 g/dl). Postoperative follow-up duration ranged from 1 to 94 months (670 patient-month, median: 14 months), and 63 two-dimensional echocardiographic examinations were done during this period. Result: There were no early or late mortality. With regard to RVOT (right ventricular outflow tract) reconstruction, trans-annular patch and RV-PA extracardiac conduit were used in 7 and 3 patients respectively, and all of them belonged to group I. In group I, cardiopulmonary bypass time, aortic cross-clamping time, ICU day, hospital day were significantly longer than in group II, and postoperative inotropic support was significantly greater than in group II. There was no ventricular arrhythmia in both groups, and one patient in group I suffered from atrial arrhythmia, which was resolved spontaneously after tricuspid and pulmonary valve replacement. During follow-up periods, functional class, residual RVOT stenosis and pulmonary regurgitation, tricuspid regurgitation, occurrence of ventricular and atrial arrhythmias were comparable between two groups. Conclusion: In adult ToF patients with severe preoperative cyanosis, more aggressive RVOT reconstruction and careful postoperative care are mandatory. However intermediate-term outcome of this group of patients is comparable to the patients with minimal or no preoperative cyanosis.