• Title/Summary/Keyword: Geriatric disease

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Korean Aspect of the Medical Problems of the Aged (노인의료문제의 한국적 측면)

  • Kwun, Koing-Bo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.191-202
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    • 1985
  • As the result of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 20 years, the life expectancy of the Korean people has lengthened considerably and as a result the number of old aged people has markedly increased. Such an increase of the number of aged people brought about many problems. Authors would like to take a medical look at the "Problem of old aged people" presently facing us in Korea. Currently the number of people over 65 has increased rapidly and is 1,620,000, 4% of total population. But it is still much lower than 8.9% in Japan, 10.7% in U.S.A., and 14.9% in the United Kingdom. Over 25% of these aged people were found to have at least more than one disease which requires medical care. Diseases occur in the circulatory system, 30.9%, respiratory system, 17.1%, digestive system 8.6%, mental disorders, 8.4%, malignant neoplasms, 7.0%. About 51% of the aged over 65 are under medical security benefit, mostly with partial coverage plan. Their clinic visit rate was very low (2.0% in 1981), which might be due to financial reasons. Since diseases affecting the aged progress chronically, early detection and long term care are utter most important. However there is almost no special facility, long term care center or geriatric specialist. For proper management of medical problems in the growing population of the Korean eldery expansion of medical security coverage, greater number of specialized facilities, education of geriatric special manpower and efficient operating system should be established.

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Analysis of the educational status of gerontological nursing subjects - Focusing on the American gerontological nursing competency- (노인간호 교과목 교육현황 분석 - 미국노인간호역량 중심으로 -)

  • Park, Sung Ji;Kim, Eun Mi;Yu, Myeong Hwan;Kang, Ji Sook
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.4
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    • pp.583-590
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    • 2021
  • This study was attempted to identify the current status of education of gerontological nursing at nursing colleges across the country and to check whether 19 senior nursing competencies suggested by the American Association of Nursing Colleges are reflected in the courses. The subjects of this study were 198 nursing education institutions accredited by KABONE, and each university's website, department homepage, university handbook, admission-related information, curriculum table, and syllabus were collected and analyzed through an internet search engine. The collected syllabus and the most recent curriculum table of the elderly nursing course were checked and analyzed using SPSS 23.0. The current status of gerontological nursing management was presented by calculating the frequency and percentage, and the educational contents presented in the syllabus were analyzed based on 19 geriatric nursing competencies presented by AACN. 185 institutions (93.43%) operated the geriatric nursing subjects, 98 institutions (49.49%) offered theory subject, and 84 institutions (42.42%) offered both theory and practice. In the case of compulsory majors, 52.92% had the most, 27.84% for the first semester of the 4th year, and 53.54% for 2 credits. As a result of analyzing the lesson plan, communication-related educational competency was included in 40% of cases. As AACN gerontological nursing competency 'effective information provision ability for the elderly', 'ethical and non-coercive decision-making', 'care without restraint', 'safe and effective transition across levels of care' was not included in the education content. In conclusion, gerontological nursing education has been focused on disease, and effective information provision capabilities including communication with the elderly need to be reflected.

The Relationship Between High School Teachers Health Perception and Health Promotion Behavior (고등학교 교사의 건강지각과 건강증진행위의 관계)

  • Kim, Dong-Hwan;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • v.4
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    • pp.21-41
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    • 2003
  • The purposes of this study were to ; first, investigate High School Teachers health promotion behavior types; second, explore the effects High School Teachers perceived benefits and perceived barriers have on their health promotion behavior ; third, suggest a desirable course that will increase teachers health. To this end, this researcher conducted a survey on health promotion behavior, perceived benefits, and perceived barriers to 329 High School teachers working in Goyang-si, Gyonggi-do. The results of the survey are as follows: Health Promotion Behavior A closer look at high school teachers health promotion behavior shows that male teachers, compared with female teachers, more actively promote their health. However, female teachers are more aware of their personal hygiene and disease risks. Older teachers, rather than younger teachers, are more willing to promote their health through better eating habits and more frequent exercise. A comparison between married and single teachers revealed that married teachers promote their health through better eating habits, and single teachers receive less stress and are better at managing their stress. Teachers working in technical high schools are better at managing their stress and personal hygiene than academic high schools teachers. Teachers working after 8 o'clock show better health promotion behavior through proper eating habits, stress management, regular exercise, disease prevention: however, teachers working before 7:30 are poor at managing their stress. Teachers not teaching supplementary lessons and not supervising night self-study are better at managing their stress, exercise schedule, and disease prevention than teachers who are. Perceived Benefits, Perceived Barriers, and Health Promotion Behavior A Comparison between male and female teachers shows that female teachers firmly believe improved eating habits and regular exercises would greatly enhance their health. However, female teachers felt more discomfort in their working environment and in utilizing medical institutes. Teachers in the 20s and 40s perceived health benefits through regular lifestyle and exercise. Teachers with less experience feel more pressure from their work environment. Teachers below their 30s feel more dissatisfaction towards using medical facilities. Teachers working in Technical High Schools are more aware of promoting their health through regular health checkups, exercise, and lifestyle ; however, teachers from Academic High Schools feel more pressure from their work environment. Teachers not performing supplementary lessons and supervising night self-study sessions are more willing to go through regular health checkups than those performing them. Also, teachers with supplementary lessons and night self-study supervisions claimed lack of leisure time, pressure from work environment, and inconvenience in using medical facilities a deterrent to promoting their health behavior. The Relationship between Health Promotion Behavior, Perceived Benefits, and Perceived Barriers The correlation ratio between Health Promotion Behavior and Perceived Benefits shows a positive relationship. The results show that High School teachers believed regular health checkups are necessary in maintaining their health. This research shows that teachers consider the following factors important in the order shown ; regular lifestyle and exercise, prevention of geriatric diseases, improving ones eating habits. In short, teachers who are more aware of the importance of regular health checkups are also more aware of the importance of promoting their health. The correlation ratio between Health Promotion Behavior and Perceived Barriers shows negative relationship. High School Teachers believe that lack of leisure activity, pressure from work environment, familys financial burden, fear of diseases, inconvenience in using medical facilities are a deterrent in promoting their health behavior. In other words, teachers with less leisure time and negative pressures from their work environment were less active in promoting their health behavior. This study shows that High School teachers will be able to promote their health behavior by maintaining regular health checkups, lifestyle, exercise, and preventing geriatric diseases. However, teachers believed that insufficient leisure time and negative pressure from their work environment acted as a deterrent to maintaining their health behavior. Most High School teachers believe they are at present healthy, and they were actively engaged in Preventative Health Promotion. The result of this study demonstrates that External factors have a large impact on teachers, which in turn acts negatively on their Health Promotion Behavior. In order to guarantee teachers health promotion behavior, systematic health checkups and increased leisure time, improvement in their work environment are necessary. Teachers also need to take a more active interest in their health.

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Beyond Clot Dissolution; Role of Tissue Plasminogen Activator in Central Nervous System

  • Kim, Ji-Woon;Lee, Soon-Young;Joo, So-Hyun;Song, Mi-Ryoung;Shin, Chan-Young
    • Biomolecules & Therapeutics
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    • v.15 no.1
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    • pp.16-26
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    • 2007
  • Tissue plasminogen activator (tPA) is a serine protease catalyzing the proteolytic conversion of plasminogen into plasmin, which is involved in thrombolysis. During last two decades, the role of tPA in brain physiology and pathology has been extensively investigated. tPA is expressed in brain regions such as cortex, hippocampus, amygdala and cerebellum, and major neural cell types such as neuron, astrocyte, microglia and endothelial cells express tPA in basal status. After strong neural stimulation such as seizure, tPA behaves as an immediate early gene increasing the expression level within an hour. Neural activity and/or postsynaptic stimulation increased the release of tPA from axonal terminal and presumably from dendritic compartment. Neuronal tPA regulates plastic changes in neuronal function and structure mediating key neurologic processes such as visual cortex plasticity, seizure spreading, cerebellar motor learning, long term potentiation and addictive or withdrawal behavior after morphine discontinuance. In addition to these physiological roles, tPA mediates excitotoxicity leading to the neurodegeneration in several pathological conditions including ischemic stroke. Increasing amount of evidence also suggest the role of tPA in neurodegenerative diseases such as Alzheimer's disease and multiple sclerosis even though beneficial effects was also reported in case of Alzheimer's disease based on the observation of tPA-induced degradation of $A{\beta}$ aggregates. Target proteins of tPA action include extracellular matrix protein laminin, proteoglycans and NMDA receptor. In addition, several receptors (or binding partners) for tPA has been reported such as low-density lipoprotein receptor-related protein (LRP) and annexin II, even though intracellular signaling mechanism underlying tPA action is not clear yet. Interestingly, the action of tPA comprises both proteolytic and non-proteolytic mechanism. In case of microglial activation, tPA showed non-proteolytic cytokine-like function. The search for exact target proteins and receptor molecules for tPA along with the identification of the mechanism regulating tPA expression and release in the nervous system will enable us to better understand several key neurological processes like teaming and memory as well as to obtain therapeutic tools against neurodegenerative diseases.

Literature Review on Spirit and Qi Regimen (정.기(精.氣) 양생법(養生法)에 관한 문헌연구)

  • Baek, Suk-Hee;Sok, So-Hyun;Oh, Hae-Kyung;Moon, Hee-Ja
    • Journal of East-West Nursing Research
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    • v.2 no.1
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    • pp.96-106
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    • 1997
  • In Chinese medicine, the activities of removing and solving the inner cause are called the regimen in preventing the disease and the good condition of mind emphasizes us to practice ourselves the doctrine of regimen of the mind to promote the health and long life of the living body, in other words, it means we should have clean mind, less desire, less thought, less agony and widely open our emotion and will, and it also means the raising of good nature, the moral cultivation, and we can be healthy when we live by good virtus as the root of regiem. The meaning of the Qi has been expanded more and more since its origination throught the process of practice and perception of man. 1) Matter is changed to the smoke when burned, the energy of water becomes the rain in the sky and the rain raises all living creatures by making them wet. Throught these changes of circulation, men could realize the energy to be the common and original matter of forming all the creatures. 2) The direction of showing the breathing of men in and out has been expended. 3) It was widely understood as the meaning of showing vitality of men, and it was the original root of chinese medicine. 4) It was expended to be showing spirit of nature such as the sun, moon, star, sky, land, mountain and the moral spirit of men as peacefullness. By the original meaning of the word of energy expanded to the wider side of sky, land, men and things, nature, society, man and the moral spirit could get the unified basis of the matter. As the above, the word of Qi has been used in wider meaning at this time from the past. In other words, all things in the universe come into being and extinct by the chang of motion of the Qi and it is recognized to be the living activity in human body. The Qi-kong based on this energy and the motion applied to our daily life are very extensive (Lee, Hye - lung, 1997). Here are the summaries of the effect of the Qi-kong ; 1) The physical constitution is strenthened, physiological function is prosperous and we are free from various geriatric disease and psychosomatic disease not to mention the cold and indigestion. 2) It maintains the clear spirit, elevates intelligence, strengthens the spiritual power and demonstrates the potentiality at the amximum. 3) It maintain beautiful figure and clean skin never losing the charm but full of energy and vitality. 4) It keeps the balanced body never suffering from the unbalance of the bones, various and neuralgia. 5) It maintain the spiritual comfort, the natural posture in everything and real happiness (Lee, Hye-Jung, 1997 : Suh, Yong Kyu, 1989). Chinese medicine mentions the motion by Qi with Qi - kong. But the motion does not require special method in Western medicine. I t is the only way of living of our ancestor indaily life. It is maintaining the healthy lifr by training the Qi, and it is the motion of being with the nature with the open mind in breathing rather than artificially restricting our daily life, it is the motion of the body.

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Acute postoperative myelopathy caused by spontaneous developed cervical disc herniation: Case report & literature review (수술후 자연발생 경추간판탈출에 의한 척수병증: 증례보고 및 문헌고찰)

  • Lee, Jeong-Woo;Lee, Keun Hyeong;Lee, Ju-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.303-308
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    • 2019
  • Non-traumatic acute myelopathy caused by cervical disc herniation is rare. To date, no case has been reported to be caused by extrusion cervical disc herniation, unrelated to patient posture during surgery. Here, we report the case of a 65-year-old male patient with cervical myelopathy who underwent subsequent arthroscopic rotator cuff surgery under general anesthesia; non-cervical spine surgery. Ed. Notes: I am unable to understand the insertion of the highlighted phrase. Please delete if not required, or revise the sentence appropriately. Patient showed acute postoperative tetraplegia in spite of optimal anesthetic management. He showed no limitation of neck movement at pre-operative airway evaluation, and had no history of trauma to the cervical spine. During surgery, there had been no overextension or twisting of the neck, including at the time of anesthetic induction by tracheal intubation. However, cervical disc herniation causing spinal canal cord compression was detected in the postoperative magnetic resonance imaging, which probably resulted in tetraplegia of the patient. Motor and sensory functions were recovered after 21 days of conservative treatment, including steroid pulse intravenous therapy without any surgical intervention. In this report, the disease is described after reviewing other reported cases; furthermore, we also discuss the pathophysiology of the disease. Based on our report, we propose that under general anesthesia, clinicians should pay attention to the possibility of pre-existing cervical disease, even in non-cervical spine surgeries of geriatric patients.

CT-Based Leiden Score Outperforms Confirm Score in Predicting Major Adverse Cardiovascular Events for Diabetic Patients with Suspected Coronary Artery Disease

  • Zinuan Liu;Yipu Ding;Guanhua Dou;Xi Wang;Dongkai Shan;Bai He;Jing Jing;Yundai Chen;Junjie Yang
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.939-948
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    • 2022
  • Objective: Evidence supports the efficacy of coronary computed tomography angiography (CCTA)-based risk scores in cardiovascular risk stratification of patients with suspected coronary artery disease (CAD). We aimed to compare two CCTA-based risk score algorithms, Leiden and Confirm scores, in patients with diabetes mellitus (DM) and suspected CAD. Materials and Methods: This single-center prospective cohort study consecutively included 1241 DM patients (54.1% male, 60.2 ± 10.4 years) referred for CCTA for suspected CAD in 2015-2017. Leiden and Confirm scores were calculated and stratified as < 5 (reference), 5-20, and > 20 for Leiden and < 14.3 (reference), 14.3-19.5, and > 19.5 for Confirm. Major adverse cardiovascular events (MACE) were defined as the composite outcomes of cardiovascular death, nonfatal myocardial infarction (MI), stroke, and unstable angina requiring hospitalization. The Cox model and Kaplan-Meier method were used to evaluate the effect size of the risk scores on MACE. The area under the curve (AUC) at the median follow-up time was also compared between score algorithms. Results: During a median follow-up of 31 months (interquartile range, 27.6-37.3 months), 131 of MACE were recorded, including 17 cardiovascular deaths, 28 nonfatal MIs, 64 unstable anginas requiring hospitalization, and 22 strokes. An incremental incidence of MACE was observed in both Leiden and Confirm scores, with an increase in the scores (log-rank p < 0.001). In the multivariable analysis, compared with Leiden score < 5, the hazard ratios for Leiden scores of 5-20 and > 20 were 2.37 (95% confidence interval [CI]: 1.53-3.69; p < 0.001) and 4.39 (95% CI: 2.40-8.01; p < 0.001), respectively, while the Confirm score did not demonstrate a statistically significant association with the risk of MACE. The Leiden score showed a greater AUC of 0.840 compared to 0.777 for the Confirm score (p < 0.001). Conclusion: CCTA-based risk score algorithms could be used as reliable cardiovascular risk predictors in patients with DM and suspected CAD, among which the Leiden score outperformed the Confirm score in predicting MACE.

Fall Risk Analysis of Elderly Living in the City (도시 거주 노인의 낙상 위험요인 분석)

  • Kim, Sang-hee;Kim, Seok-kyu;Kang, Chae-young;Kim, Su-jeong;Lee, Hyun-ju
    • Journal of Digital Convergence
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    • v.14 no.5
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    • pp.485-491
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    • 2016
  • The purpose of this study was to compare of the fall risk factors for elderly in the city. 62 people aged 65 years or older were classified as fallers and nonfallers based on experience of their falls in the previous year. By comparing the difference between the groups via evaluations of general characteristics, health related behavior and chronic disease, balance-related psychological (K-ABC) and physical measurement (BBS), depression (SGDS), and the correlations between the significant differences in variables were identified. According to the results, K-ABC, BBS, and SGDS are statistically significant differences between fallers and nonfallers (P<0.05). Also it has positive correlations between BBS and K-ABC (r=0.499) whereas negative correlation between K-ABC and SGDS(r=-0.472).

Analysis of Western-Korean cooperative treatment in hospital-care of patients with dementia

  • Lee, Jung Hee;Choi, Hong Sik;Kim, Jae Soo;Kim, Sang-Ho
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.49-58
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    • 2017
  • Objectives : The purpose of this study is to provide data to guide dementia health-care policy in Korea and to establish the position of Korean medical specialists in long-term care hospitals by analyzing the data of dementia inpatients. We analyzed the actual condition of dementia patients in care hospital and the effect of Western-Korean cooperative medicine on the progress of dementia. Methods : From January 1, 2016 to December 31, 2016, inpatients who were diagnosed with dementia at Mungyeong municipal long-term care hospital and admitted for more than 3 months were enrolled. Their medical records and simple tests were analyzed retrospectively. Results : We examined the detailed diagnosis, including both main and sub diagnosis, and Alzheimer disease dementia, at 97%, was the most common. At the time of admission, Korean Version of the Mini-Mental State Exam (K-MMSE) analysis showed that severe dementia affected 52%, and most were rated as Geriatric Depression Scale (GDS) 6. Based on the admission date, the results of a simplified test applied to the dementia patients every 6 months showed an maintain in the K-MMSE and GDS scores in 83%. Conclusion : The results of this study show that the rate of progression of dementia is somewhat lower in inpatients with moderate to severe Alzheimer's who have received Western-Korean cooperative treatment. However, due to institutional limitations, long-term inpatients such as those with dementia do not receive active traditional Korean medical treatment; hence, it is necessary to improve the national institution of traditional Korean medicine in long-term care hospitals.

A Study on the Nutrient Intakes of Hospitalized Elderly Dementia Patients Receiving a Regular Diet

  • Lee, Jin;Na, Mi-Hee;Kim, Woo-Kyoung
    • Food Quality and Culture
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    • v.1 no.1
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    • pp.46-57
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    • 2007
  • The purpose of the present study was to examine the nutrient intake status of elderly dementia patients. We surveyed the dietary intake of 50 demented elderly patients receiving a regular diet, who were hospitalized in a geriatric hospital in Yongin, Gyeonggi-do. The average age of the subjects was $79.6{\pm}6.5$ for the males and $80.5{\pm}6.3$ for the females. The average heights were $169.5{\pm}6.0\;cm$ (males) and $154.6{\pm}5.2\;cm$ (females), and the average weights were $58.5{\pm}7.4$ (males) and $51.7{\pm}8.9\;kg$ (females). Depending on the type of dementia, the male patients showed significant differences in their intakes of vegetable protein, fiber, total iron, and non-heme iron between the Alzheimer's disease (AD) and the vascular dementia (VD) groups, and the female patients showed significant differences in their intakes of total protein, phosphorus, zinc, and vitamin $B_6$ between the two groups. The male patients showed significant differences in their intakes of animal-source calcium and carotene according to ability to self-feed. According to physical activity, the male patients showed significant differences in vegetable fat and vitamin A intake, and the females showed significant differences in their intakes of total protein, animal protein, fiber, ash, total calcium, vegetable-source calcium, animal-source calcium, phosphorous, total iron, non-heme iron, heme iron, sodium, vitamins $B_1$, $B_2$, $B_6$, niacin, vitamin C, folate, and potassium. We found that the patients consumed excessive protein, but low amounts of calcium, vitamin $B_2$, and folate. Also, the patients' physical activity abilities appeared to affect their nutrient intakes.

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