• Title/Summary/Keyword: Direct care index

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Diagnosis of Abusive Head Trauma : Neurosurgical Perspective

  • Kwak, Young Ho
    • Journal of Korean Neurosurgical Society
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    • v.65 no.3
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    • pp.370-379
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    • 2022
  • Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

Development of a Human Biomonitoring Empirical Model for Health Promotion Value Evaluation of Organic Foods (유기농식품의 건강증진가치 평가를 위한 Human Biomonitoring 실증모형 개발)

  • Choi, Deog-Cheon
    • Korean Journal of Organic Agriculture
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    • v.21 no.4
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    • pp.569-588
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    • 2013
  • The organic foods is the terminology calling the organic products, the organic livestock and the organic processing food. The value of organic food may be evaluated as the index of the nutrient content, the safety and the health promotion. The reason why consumers prefer the organic food in the market is because the value of health promotion to be obtained through its consumption is expected to be bigger than the expense according to the purchase of organic food. This study has the significance in developing the direct evaluation model like the human biomonitoring method. The hypothesis for this study is summarized, "If the metabolome of metabolic syndrome of decreases, the exposure of substance of health harm decreases, the number of hospital care decreases and the quality of life shall be improved if the organic food is incepted in the long term and the health care is managed well". The consumer's cooperative and the health consumer's cooperative select the experimental group of 100 persons and the comparative group of 100 persons in 5 areas in the whole country at the same time to verify this hypothesis. Its rate of change is compared and analyzed by measuring the blood and urine of each biomarkers such as the exposed agriculture pesticides, the nitrate in the body at intervals of 2 months for 1 year. Also, by letting participants in the experiment record the major activity such as the dietary intake and the exercise, etc., in the questionnaire and the performance evaluation form, the statistical analysis for the correlation of this with the metabolome, etc., is conducted. The time that is called minimum 1 year and a lot of expense are required to implement this model. Accordingly, the cooperative study by composing the consortium of the interdisciplinary and the interagency is desirable.

Breast Cancer Survival at a Leading Cancer Centre in Malaysia

  • Abdullah, Matin Mellor;Mohamed, Ahmad Kamal;Foo, Yoke Ching;Lee, Catherine May Ling;Chua, Chin Teong;Wu, Chin Huei;Hoo, LP;Lim, Teck Onn;Yen, Sze Whey
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8513-8517
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    • 2016
  • Background: GLOBOCAN12 recently reported high cancer mortality in Malaysia suggesting its cancer health services are under-performing. Cancer survival is a key index of the overall effectiveness of health services in the management of patients. This report focuses on Subang Jaya Medical Centre (SJMC) care performance as measured by patient survival outcome for up to 5 years. Materials and Methods: All women with breast cancer treated at SJMC between 2008 and 2012 were enrolled for this observational cohort study. Mortality outcome was ascertained through record linkage with national death register, linkage with hospital registration system and finally through direct contact by phone or home visits. Results: A total of 675 patients treated between 2008 and 2012 were included in the present survival analysis, 65% with early breast cancer, 20% with locally advanced breast cancer (LABC) and 4% with metastatic breast cancer (MBC). The overall relative survival (RS) at 5 years was 88%. RS for stage I was 100% and for stage II, III and IV disease was 95%, 69% and 36% respectively. Conclusions: SJMC is among the first hospitals in Malaysia to embark on routine measurement of the performance of its cancer care services and its results are comparable to any leading centers in developed countries.

A Study on the IADL Affecting Subjective Health Index of the Aged in Some Area (일부지역(一部地域) 노인(老人)들의 주체적(主體的) 건강수준(健康水準)에 영향을 미치는 IADL에 관한 연구(硏究))

  • Kim, Keun-Jo;Park, Heung-Ki;Koon, Hyeok-Su;Bae, Soo-Chan
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.29-50
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    • 2001
  • This research have been made to define how the IADL (Instrumental Activity of Daily Living) performance and the subjective health index of the Aged are affected by their residential circumstance, gender and age, and how deeply these two factors are related and interact. For the period of June 1 to July 31, 2000, we had conducted a questionnaire and direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent area, grouping into three different residential types The Aged living at home, The Aged living at welfare facilities and The Aged living alone, and studied on how the IADL performance and the subjective health index of the Aged are influenced and interact as per their characteristics, daily activity and mentality. We had analyzed all the data obtained through this research by the method of : - analysis of frequency as per specific factors by SPSS 1O.0/PC+, - $x^2$ test, - t-test, - ANOVA, - multiple regression analysis by factors. The research concludes followings : a. It appears that the three (3) factors such as gender, age and residential circumstance of the Aged deeply affect the IADL performance and subjective health index of the Aged. (p<0.01) b. With regard to IADL performance of the Aged by the gender, it was analyzed that the female-Aged gains 23.8 point on average, which shows the performance of the female-Aged is less independent. (p<0.01). In addition, it was also found that the IADL performance is becoming less and less independent following their age increasing. In analyzing IADL performance by the residential type, it appears that the Aged living at welfare facilities gains the lowest 21.5 points and is least independent. It was also found that the Aged living at welfare facilities need some assistances from others for their performing IADL. (20-24 point) (p<0.001) c. With regard to the subjective health index of the all-Aged participated in this research, the analysis indicates 8.8 point and this is considered as a point of general standard (7-10 point). In analyzing this index by the gender, the female-Aged gains only 8.6 point which explains a lot of female-Aged consider they are not really healthy. (p<0.001) In analyzing this index by the residential type, the Aged living at welfare facilities and the Aged living alone gain the comparatively lower point, - respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged living at these two residential types express they are obviously in a bad situation of health. (p<0.001) d. With regard to the factors affecting the IADL performance and the subjective health index of the Aged, it was analyzed that the IADL performance can largely be affected by the factors such as depression, frequency of going-out and age rising, and that the subject health index can also deeply be affected by depression, pain and by how much they are satisfied with their current living conditions. e. It was analyzed that the interacting between the IADL performance and the subjective health index is not that strong but even weak. As a result, we were able to conclude that the IADL performance is less independent in case of the female-Aged, the Aged living at welfare facilities, and following the age rising. As for the subjective health state the Aged themselves are aware of, we concluded that the female-Aged, the Aged living at welfare facilities and the Aged living alone, are more critical about their health. From this research, we were able to realize that, when the OMT (Orthopedic Manual Therapy) needed, the physical therapists are really required to have a correct and cautious understanding of the situation in which the aged persons are, and take care of them with more concerns and more improved treatment.

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Curriculum Development for Inservice Training of School Health Nurses (양호교사 자격연수교과과정 개발에 관한 연구)

  • Kim, Hwa-Jung;Yoon, Soon-Nyoung;Kim, Young-Im
    • Journal of the Korean Society of School Health
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    • v.9 no.1
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    • pp.31-41
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    • 1996
  • School health promotion is related to reinforce on various roles of school health teachers including health instruction, health services, healthful school living. In this aspects, there would be necessory for qualified continous education proceed to activate roles of school health teachers. So the objectives of this study are first, to develop curriculum framework for inservice training of health school nurses, second, to descrive of curriculum objectives, third, to state of curriculum objectives and learning methods. There were used study methods as literature review, expert conferencing and workshop. Major results are as follows; 1. Curriculum framework for inservice training of health school nurses was constitute of major variables of health care model and direct services role of school health teacher such as health service, health instruction and healthful environment area. 2. The curriculum for health instruction were different from elementary school and middle school. 3. Time distribution for curriculum was composed of that health service is 12hours, health instruction is 96 hours and healthful environment is 12 hours. 4. The learning methods for inservice training were suggested to intensify positive attitude through the discussion and practical exercise. 5. The curriculum objectives were classified by total, area and a course of study and time summary table was suggested. In conclusion, the developed curriculum would be contribute to improve of practical ability for school health teachers. And to increase of inservice training effect, there should be operate in order to participate trainees activately and to be educate concurrently. Also, there are necessary for execute in series of the program such as standized text developing by course, evaluation index developing and instructor education etc.

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Bayesian Network Model to Evaluate the Effectiveness of Continuous Positive Airway Pressure Treatment of Sleep Apnea

  • Ryynanen, Olli-Pekka;Leppanen, Timo;Kekolahti, Pekka;Mervaala, Esa;Toyras, Juha
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.346-358
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    • 2018
  • Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

Engineering Properties of Uncemented Mudrock from Yeoju Area, Gyeonggi-Do (경기도 여주지역 미고결 이암의 공학적 특성)

  • Ban, Hoki;Lee, Huiyoun;Bae, Kyujin;Cho, Wanjei
    • Journal of the Korean GEO-environmental Society
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    • v.16 no.12
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    • pp.53-58
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    • 2015
  • Engineers should take great care of characterizing the engineering properties of mudrock, because the uncemented mudrock can be considered as a hard rock in appearance. Therefore, the mudrock samples obtained from the cut slope in Gyeongki-do were tested to evaluate the strength characteristics of uncemented mudrock in this study. The performed tests are index properties, slake durability, and swelling tests for the classification of the mudrock for engineering practice. To evaluate the effect of water on the engineering properties of the uncemented mudrock, resonant column, triaxial compression and direct shear tests with various water contents were performed. With the increasing water contents, stiffness at very small to small strain region and the cohesion value of the strength parameters decrease. Based on the test results, engineers should take great care of evaluating the engineering properties of uncemented mudrock.

Factors Affecting Heart Rate Variability in the Industrial Workers (사업장 근로자의 심박동 변이도에 영향을 미치는 요인)

  • Seo, Yunhui;Jeong, Chaibin;Seo, Myounghyo;Seo, Jonghun;Yu, Hodal;Pi, Chienmei;Lee, Kinam
    • Journal of Korean Medical Ki-Gong Academy
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    • v.10 no.1
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    • pp.130-157
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    • 2007
  • The purpose of this research is to seek for efficient health maintenance device and to suggest desirable daily habit, based on the inquiry on interrelationship between workers' daily lives and their heartbeat change level. The paper survey about general features, case history and daily habits was conducted on workers during medical examination in Jeollabukdo, and examined their change of heartbeat as well. The results of research deducted from data analysis are as follows; 1. There found very positive interrelations between time-domain analysis and frequency-domain analysis, and MHR and LF/HF ratio had negative connection with other analyses. 2. The recipient showed high time-domain analysis when they are younger, have worked shorter or have spouse, and it contributes to stable sympathetic nerve and parasympathetic nerve as it stimulates autonomic nervous system. 3. According to the result of frequency-domain analysis, recipients showed higher TP and LF when they are younger, and the highest HF when they are under 34.The level of VLF was higher for university graduates than the ones who finished high school. The recipients showed higher TP and HF when they don't have spouse, and lower TP, LF and HF when they have worked longer. 4. The level of RMSSD and TSRD was high for the people who don't have case history, and HF was high when they don't have any disease in progress. 5. According to the result concerning correlation of daily habits with time-domain analysis and frequency-domain analysis, cigarette, alcohol and sleeping hours don't affect heartbeat change, but the ones who regularly workout showed higher result in every analysis. It shows that the autonomic nervous system of recipients who regularly exercise response more actively. The result mentioned above suggests that the change of heartbeat is a direct index which shows the change of autonomic nervous system, and it depends on the exercise the most. Thus, workout is proved to be the best method in order for workers to take care of their health.

Living Conditions of the Rural Elderly: Clothing, Nutrition, Housing, and Psychological Adjustment (농촌지역 노인의 생활실태 조사연구 -의.식.주생활 및 심리적 적응을 중심으로-)

  • 윤복자
    • Journal of the Korean Home Economics Association
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    • v.28 no.4
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    • pp.65-86
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    • 1990
  • Living conditions of the rural elderly were assessed in terms of clothing behavior, health and nutritional status, housing and envioronmental condition, and psychological adjustment. The subjects were eighty individuals over sixty residing in the rural community of Iksan-kun, Chollabukdo. The interview method using questionnaires, direct measurement, and observation was used for this study. Data were compared with those obtained from a previous study of the elderly residing in an urban area. Clothing behavior showed that the elderly residing in the rural community were more concerned about plain and conservative design of clothes than their urban counterparts. Special protective clothes for cropdusting with agricultural chemicals had not been prepared. The following urgent needs were pointed out: development and supply of agricultural chemical protective clothing and development and education of appropriate washing and clothing care methods. The health status of the elderly was generally good, but poor eating habits were found more frequently in the rural elderly than among the urban dwellers. Several dietary nutrient intakes were insufficient. Contrasting the urban elderly with the rural group, it was found that the urban group lacked sufficient vitamin A and vitamin C and the urban women had insufficient calorie whereas the rural group was deficient in protein, vitamin A, calorie, and fat. A significant relationship was found between dietary nutrient intake and health index, food habit points, self recognized health status, meal satisfaction, and economic status. Urgent needs of the development of a nutrition education program for the elderly were pointed out. Most of elderly residing in the surveyed rural communities were living alone or with their spouse only, therefore only one room was used among the three or four available rooms. Most of the rural elderly were living either in a traditional Korean house built with differing floor levels or in a modified Korean style house. Minimal modernization had been made for kitchen facilities such as sink and gas range or for heating facilities with the briquette boiler. However, sanitary space such as lavatory and bathroom had not been remodeled. A housing welfare program for rural communities should be implemented at the national level. The comparison of psychological characteristics of the rural elderly with their city counterparts revealed that the rural elderly have a more stable psychological status and optimistic attitude than those living in a city. However, it was found that most of the elderly did not have any future plan. Community programs for the elderly including hobbies or leisure activities or education programs to generate close interpersonal relationships with their children should be developed and provided.

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Evaluation of Diet Quality according to Nutrient Intake between Highly Educated, Married, Unemployed and Employed Women (고학력 기혼여성의 취업여부별 영양소 섭취로 본 식사의 질 평가)

  • Choi Ji-Hyun;Chung Young-Jin
    • Journal of Nutrition and Health
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    • v.39 no.2
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    • pp.160-170
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    • 2006
  • This study was conducted to provide foundation data for making health care policy for married women by assessing the dietary intake between highly educated married, employed and unemployed women. It is a direct interview, cross-sectional study with 24-hour recall method for one day. In selecting the subjects for this study, married, unemployed women were selected from a certain area (Daedeok Science Town) in Daejeon where there are high rates of highly educated women, and the married, employed women were selected from the teaching profession in order to avoid confounding due to including a variety of jobs. According to the Korean Standard Classification of Occupations, teaching is the representational occupation of highly educated, married women. Then, to prevent confounding due to age, we selected the subjects out of each age group at the same rate through random sampling. Women who had not graduated college, worked only part-time, or had no current spouse were excluded. As a result, 486 highly-educated, married, unemployed (250) and employed (236) women were used for analyzing data. The unemployed women consumed a higher amount of fat, cholesterol, sodium, vitamin C and folic acid while the employed women consumed a higher amount of iron, vitamin $B_l$ and vitamin $B_2$. P/M/S ratio being 1/1.18/1.05 and 1/1.05/0.87, for the unemployed women and the employed women, respectively, unemployed respondents had a higher saturated fat intake than those of employed. It is in excess of the standard ratio (1/1/1) of the Korean RDA. At the same time, in unemployed respondents the percent of energy intake from fat (24.8%, 23.2%) and animal fat (12.4%, 11.4%) were higher than those of employed respondents. The mean daily nutrient intake of calcium, zinc, and iron for both groups of respondents were lower than the Korean RDA. Both groups had phosphorus as the highest nutrient and calcium as the lowest nutrient of INQ (Index of Nutritional Quality) while nutrients with the INQ being less than 1 were calcium and iron. To sum up, the following conclusions can be made: Nutrition education and guidance for reduction of the intake of fat, especially animal fat, are necessary for unemployed women. In addition, highly educated, married, unemployed and employed women should increase the consumption of foods rich in iron and calcium to prevent anemia and osteoporosis, while decreasing the intake of phosphorus to balance proportions of calcium and phosphorus.