• Title/Summary/Keyword: High risk group

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Effectiveness of Medical Aid Case Management in Excessive Healthcare User by Interventions based on the Number of Accesss (의료급여 과다이용자의 중재방법별 접근횟수에 따른 사례관리 효과)

  • Song, Myeong-Kyeong;Cho, Jeong-Hyun;Kim, Soon-Ok
    • Journal of Digital Convergence
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    • v.15 no.7
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    • pp.259-269
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    • 2017
  • This study analyzed medical aid case management effects based on the number of access by visits, phone calls, letters, internal investigation, resource links, and requests, in medical aid case management business that is carried out to improve the quality of life of medical care beneficiaries and reduce financial cost. Secondary analysis study using data of 564 high-risk group in the medical aid case management and their healthcare utilization data. Letters had positive correlations with the scores of all case management domains. The higher visits was, the lower the score of self-health care ability was, and the higher the number of phone calls was, the higher the score for reasonable medical use was. While there was no significant difference in medical cost according to aid management by interventions, the higher visits and resource links were, the lower the subjects' total number of payment days was. There is a difference in the various areas of the quality of health -related life and medical use depending on case management by intervention method and its number. It is necessary to carry out the efficient number of access to case management by intervention method.

Cranberry Juice to Reduce Bladder Biofilms and Infection in Geriatric and Spinal Cord Injured Patients with Dysfunctional Bladders

  • Reid, Gregor;Potter, Patrick;Lam, Dominique;Warren, Diny;Borrie, Michael;Hayes, Keith
    • Preventive Nutrition and Food Science
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    • v.8 no.1
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    • pp.24-28
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    • 2003
  • There is evidence to suggest that cranberry juice supplements improve the health of the urinary tract by inhibiting the binding of fimbriated uropathogenic E. coli to the bladder mucosa. In patients with neurogenic bladders, urinary tract infections (UTI) are particularly common and often poorly managed by antibiotic treatment. A double-blind, randomized, placebo-controlled trial was undertaken on 29 geriatric and spinal cord injured patients with dysfunctional bladders. They received three times daily at mealtimes a 4 oz bottle of cranberry juice (Ocean Spray Cranberries, USA) or a specially prepared synthetic placebo drink. Two episodes of UTI arose in week one of cranberry intake and none thereafter, compared to four episodes of UTI in 4 placebo patients in weeks four, six and 10. Mean bacterial adhesion counts on bladder cells of the patients rose during the first month of treatment in 71 % of the placebo patients compared to only 31 % of cranberry patients (p < 0.001). The difference persisted to some extent for the second and third months. Bacterial adhesion levels correlated with culture findings (higher adhesion and higher viable counts in urine) (p < 0.001), positive leukocyte nitrite tests (136$\pm$131 bacteria per cell versus 52$\pm$86 in negative tests) (p < 0.001), and higher white blood cell counts (> 10) per high power field (126$\pm$125 versus 48$\pm$85 bacteria per cell) (p<0.001). E. coli was the most frequently isolated organism (40% samples) followed by K. pneumoniae (17%) and a number of other uropathogens. Group B Streptococci, and coagulase negative Staphylococcus were recovered from urine in 4 samples but were not associated with any red blood cell presence. The daily intake of cranberry juice, in amounts which are not detrimental to long term compliance, appeared to have a role in reducing the risk of bladder colonization and infection in a highly susceptible patient population.

Synthesis of Nanoscale Sn-Pb Alloy Powders by Electrical Explosion of Wire (전기선폭발법을 이용한 Sn-Pb 나노분말의 합성)

  • ;;;;A. P. Ilyin;D. V. Tichonov
    • Proceedings of the Korean Powder Metallurgy Institute Conference
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    • 2003.04a
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    • pp.35-35
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    • 2003
  • )를 금속와이어에 인가하면 저항발열에 의해 와이어가 미세한 입자나 금속증기상태로 폭발하는 현상을 이용한 것으로 기상합성법에 속한다고 할 수 있다. 선폭법은 다른 제조법에 비해 공정이 간단하여 생산비용이 저렴하며, 원재료의 조성을 갖는 분말의 합성과 금속간화합물, 융점차이가 나는 재료의 합금화 등이 가능하다. 인가에너지의 크기와 폭발 시 분위기를 제어함으로써 분말의 평균크기와 분포 제어 또한 가능하다. 본 연구는 러시아의 우수한 기초기술을 바탕으로 Pb-Sn계 합금은 전기폭발법으로 극미세분말을 제조하였으며, 분말의 형상, 상 화학조성의 변화를 조사하였다. 본 실험에 사용된 Sn-Pb계(All-Union State Standard 1499-70, 0.53mm)합금와이어는 자동시스템(1-0.6Hz)에 의해 챔버안으로 공급되었다. 이 때 임계폭발 와이어 길이는 50-80nm으로 실험을 행하였다. 챔버 압력은 1.4~2.0atm으로 유지하였다. 제조된 분말의 특성은 XRD, XRPES, SEM등을 이용하여 분말의 형상과 상, 화학조성, 표면분석을 행하였으며 DSC, TGA, BET분석을 통하여 온도변화에 따른 금속분말의 열량변화, 질량변화, 비표면적을 측정하였다. 제조된 Sn-Pb계 분말은 모두 평균 입도 117nm~220nm의 구형형상이었다. 이때 합금분말의 조성은 51.17~63.21 at%Sn, 35.47~46.37 at%Pb로 나타났다. 와이어에 인가되는 비에너지(W/Wc)가 감소된에 EK라 표면층의 Pb함량이 증가함을 보였다. 이는 와이어 내부 저항의 감소로 인한 공정시간의 지연과 Sn, Pb의 확산계수 차이에 의한 것으로 사료된다. 열분석 결과, Sn~Pb계 화합물의 융점은 167~$169^{\circ}C$로 관찰되었으며, $10^{\circ}C$/min로 $920^{\circ}C$까지 승은 하였을 때 17.1~18 wt%의 질량증가를 보였다.TEX>계 나노복합분말이 얻어짐을 알 수 있었다. 이 때 X션 회절피크의 line broadening으로부터 복합분말의 Fe 명균 결정립 크기는 24nm로 초미세 결정럽의 분말합금이었다. 포화자화값은 볼밀처리에 따라 점점 증가하여 MA 30시간에는 20.3emu/g로 포화됨을 알 수 있었다. 또한 보자력 Hc는 MA초기단계에 350e로 매우 낮으나 30시간 후에는 Hc값이 2600e로 매우 큰 값을 나타내었다. 이것은 환원반응결과 초기에 생성된 Fe의 결정립이 비교적 크고 결정결함이 적으나 볼밀처리를 30시간까지 행하면 Fe 결정렵의 미세화 빛 strain 증가로 magnetic hardening이 일어나기 때문인 것으로 사료된다.길이가 50, 30cm인 압출재를 제조하였다. 열간압출한 후의 미세조직을 광학현미경으로 압출방향에 평행한 방향과 수직방향으로 관찰하였고, 열간 압출재 이방성을 검토하기 위하여 X선 회절분석을 실실하여 결정방위를 확인하였다. 전기 비저항 및 Seebeck 계수 측정을 위하여 각각 2$\times$2$\times$10$mm^3$ 그리고 5$\times$5$\times$10TEX>$mm^3$ 크기의 시편을 준비하였다.준비하였다.전류를 구성하는 주요 입자의 에너지 영역(75~l13keV)에서 가장 높은(0.80) 상관계수를 기록했다. 넷째, 회복기 중에 일어나는 입자들의 유입은 자기폭풍의 지속시간을 연장시키는 경향을 보이며 큰 자기폭풍일수록 현저했다. 주상에서 관측된 이러한 특성은 서브스톰 확장기 활동이 자기폭풍의 발달과 밀접한 관계가 있음을 시사한다.se that were all low in two aspects, named "the Nonsignificant group". And the issues were high risk perception in general setting and lo

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Inferior Capsular Shift Procedure using Splitting Subscapularis and Capsule for Instability of the Shoulder (견관절 불안정성의 견갑하근 및 관절 낭 수평 분할을 이용한 하방 관절 낭 이동술)

  • Park Jin-Young;Lim Soo-Taek;Yoo Moon-Jib;Lyu Suk-Joo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.102-107
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    • 2002
  • Purpose: The aim of this retrospective study were to report the short-term results of inferior capsular shift procedure using splitting subscapularis and capsule for the patients who had shoulder instability and were apt to recur after arthroscopic stabilization procedure. Materials & Methods : Fifteen cases of instability of the shoulder were included with an average follow-up of 2 years (range: 1$\~$3 years). There were 13 men and 2 women with an average age of 27years. Multidirectional instability was found in 4 cases, voluntary instability in 3 cases, bony Bankarte lesion in 2 cases and 6 cases were contact sportmen. Thirteen shoulders underwent the inferior capsular shifts and Bankart repairs and 2 shoulders without Bankart lesion underwent the inferior capsular shift only. Average 19 mm of shift (range: 10$\~$25 mm) was done. Results : Fourteen patients showed good and excellent results with one subluxation and one positive apprehension test. Postoperative ranges of motions did not change in forward elevation, external rotation at side and external rotation at 90$^{\circ}$ abduction (p>0.05). Conclusion : Inferior capsular shift procedure using splitting subscapularis and capsule can be helpful in shoulder instability patients who were high-risk group of recurrence with arthroscopic procedure.

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Calcium current on cryopreservation in mouse oocytes (동결 생쥐 난자에서의 calcium 전류)

  • Kang, Da-Won;Kim, Eun-Sim;Choe, Chang-Yong;Park, Jae-Yong;Han, Jae-Hee;Hong, Seong-Geun
    • Korean Journal of Veterinary Research
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    • v.42 no.1
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    • pp.35-43
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    • 2002
  • Cryopreservation is commonly used for an efficient utilization of semen, oocytes and embryos but has disadvantage in the survival, development of the post-thawed eggs. The high risk in the survival, development of eggs after thawing is thought to be caused by inappropriate internal regulation of $Ca^{2+}$ and/or formation of intracellular ice crystals. In this experiment, we tested whether the $Ca^{2+}$ current (iCa), a decisive factor to $Ca^{2+}$ entry, was altered in post-thawed oocytes by using whole cell voltage clamp technique. The quality and survival rates of the oocytes derived from both fresh and frozen groups were examined by morphology and FDA-test. Vitrified oocytes (VOs) were incubated for 4 hr after thawing and then donated to this experiment. Ethyleneglycol-ficoll-galactose (EFG) was used as a cryoprotectant for vitrification. The membrane potential was held at -80 mV and step depolarizations of 250 ms were applied from -50 mV to 50 mV in 10 mV increments. The survival rates showed a higher in VOs vitrified with EFG containing $Ca^{2+}$ than in VOs vitrified with EFG under the $Ca^{2+}$-free condition (82.0% vs 14%). In group with/without $Ca^{2+}$, the survival rates were significantly (P<0.01) difference. In the fresh metaphase II oocytes (FOs), current-voltage (I-V) relationship showed that iCa began to activate at -40 mV and reached its maximum at -10 mV. With same voltage pulses, inward currents were elicited in VOs. I-V relationships observed in VOs were similar to those in FOs. Time constants of activation and inactivation of the inward current shown in VOs were not different to those in FOs. This accordance in I-V relations and time constants in FOs with those in VOs indicates that the inward currents in FOs are unaltered by vitrification and thawing. Therefore, vitrification with EFG does not play as a factor to deteriorate $Ca^{2+}$ entry across the membrane of the oocytes.

Herbal Medicine for Functional Dyspepsia with Psychological Symptoms: A Systematic Review and Meta-Analysis (기능성소화불량 환자에서 나타나는 정신적 증상의 한약 치료 : 체계적 문헌고찰과 메타분석)

  • Cho, Yun-jae;Lee, Hanul;Jeong, Hae In;Lee, Hyun-Jin;Keum, Chang-Yul;Han, Aram;Ha, Na-Yeon;Kim, Jinsung
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.488-509
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    • 2021
  • Purpose: Functional dyspepsia (FD) is a chronic syndrome accompanied by repetitive digestive symptoms that appear in the upper gastrointestinal tract and are not caused by specific diseases. Psychological symptoms like anxiety, depression, insomnia, and somatization are frequently observed in FD. The purpose of this study was to review the effect of herbal medicine on the psychological symptoms that accompany FD. Methods: Database search (PubMed, EMBASE, KISS, Kmbase, KoreanMed, NDSL, OASIS, CNKI) was performed on February 24, 2021; a total of 1825 studies were searched. After the screening, 22 studies were included. Results: The studies were assessed by Cochrane RoB 2 and sorted into a table according to psychological symptoms. Meta-analysis was performed to estimate the effect of herbal medicine. Twenty of the twenty-two studies reported that herbal medicine was significantly more effective than the control group. Only three of the studies did not have a high risk of bias. Conclusion: Herbal medicine was significantly effective with or without Western medicine and had fewer adverse effects. Severe adverse effect was not reported. Psychological symptoms in FD affect onset and duration of FD, and some FD patients want to be treated for their anxiety before other symptoms. Reliable information about treatment for the psychological symptoms of FD is lacking. We reviewed the effect of herbal medicine treatment in this study, the results of which could be selected for primary or secondary treatment for FD.

Relationship Between Social Support and Subjective Well-being of the Urban Elderly People (도시지역 거주 노인들의 사회적 지지와 주관적 행복감의 관련성)

  • Ham, Seok-Pil;Kim, Beom-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.367-377
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    • 2021
  • This study examined the relationship between social support and the subjective well-being of the elderly living in urban areas. The study subjects were 382 elderly people aged 65 or older living in D metropolitan city. The survey was conducted through a personal interview by investigators who visited the study subjects using a structured questionnaire from May 1 to June 30, 2019. As a result, the subjective well-being of the study subjects differed significantly depending on various variables in the sociodemographic, health condition and, health-related behavior characteristics. The subjective well-being according to social support was significantly lower for the groups with lower social support. The correlation of subjective well-being and social support showed a significant positive correlation. Logistic regression showed that the risk of lower subjective well-being increased significantly in the group (Q1), where the total score of social support was very high (Q4). The above results suggest that the subjective well-being of the elderly living in urban areas was not only related to various variables in sociodemographic, health condition, and health-related behavior characteristics but also has significant relationships for social support. Therefore, it is necessary to develop detailed social support practices to improve the subjective well-being.

Validation of the Measure of Health Literacy for the Elderly (고령자의 건강정보이해능력(Health Literacy) 측정도구 타당화)

  • Chun, Heeran;Cho, Sung-il;Kim, Il-Ho
    • Korean Public Health Research
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    • v.44 no.4
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    • pp.99-109
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    • 2018
  • Objective : Health literacy (HL) is, defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." Being old is one of the main risk factors with limited health literacy. This study aims to adapt Chew's health literacy scale into the Korean language and validate the scale for the use of the elderly. Methods : Data were drawn from the '2016 Seoul Survey on Elderly Health and Functional Assessment, which includes a total of 725 people aged 60 to 79. The sample was randomly divided into two groups for reliability and validity tests of the modified Chew's scale of 8 items. The Korean version of the questionnaire was developed by group translation, expert reviews, and forward-backward translation. Exploratory and confirmatory factor analyses were conducted to assess and validate the factor structure of the scale. Results : Results suggest the two-factor structure ("Understanding" and "Applying" of HL) with 8 items. Exploratory factor analyses of the first sample (n=400) revealed that the internal reliability of the scale was high (Cronbach's ${\alpha}=.904$). Principal axis factoring extracted two factors ("Understanding" and "Applying" of HL) and explained 78.3% of total variance (KMO=.872, Bartlett's ${\chi}^2=2431.3$, df=28, p<.001). Confirmatory factor analysis of the second sample (n=325) was performed and the two-factor model was supported (GFI=.960, CFI=.979, TLI=.969, RMSEA=0.075). Conclusions : This study provides evidence for adequate criterion and validity of the health literacy scale for the community dwelling elderly in Korea.

The Heterogeneous Trajectories of Functional Disability in Older Adults and Their Predictors (노년기 기능장애의 이질적 발달궤적과 예측요인)

  • Lee, Hyunjoo
    • 한국노년학
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    • v.37 no.1
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    • pp.15-32
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    • 2017
  • The current study aims to identify the heterogeneous changes of functional disabilities in old age rather than to identify an average longitudinal pattern and to explore the effect of health status and social status as risk factors in functional disability trajectories. The sample consisted of a representative sample of community dwellers aged 65 and older from the Korean Longitudinal Study of Ageing (2006 - 2012) was the focus of the study. Latent Class Growth Analysis was used to identify the functional disability trajectory groups. Variables regarding health status and social status changes by class were identified using multinomial logistic regression. The results showed various change patterns in functional disability, which include independent (78%), stable high (4.4%), steeply increasing (7.1%), slightly increasing (5.5%), and moderate to low (4.7%). Aggravation in depressive symptoms and cognitive functions as well as decline in social participations and social engagements were significant predictors of membership in increasing group of functional disability. The findings provide important initial empirical information to target clinical practice and have implications in the importance of conducting research on groups with different characteristics.

Effects of Lonicera caerulea extract on adipocyte differentiation and adipogenesis in 3T3-L1 cells and mouse adipose-derived stem cells (MADSCs) (댕댕이나무 열매 추출물이 지방전구세포와 마우스 지방유래줄기세포의 분화 및 지방 생성 억제에 미치는 영향)

  • Park, Miey;Lee, Changho;Lee, Hae-Jeung
    • Journal of Nutrition and Health
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    • v.52 no.1
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    • pp.17-25
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    • 2019
  • Purpose: Obesity is a major health problem of global significance because it is clearly associated with an increased risk of health problems, such as nonalcoholic fatty liver disease (NAFLD), diabetes, cardiovascular diseases, and cancer. Lonicera caerulea (LC) originates from high mountains or wet areas and has been used as a traditional medicine in northern Russia, China, and Japan. LC contains a range of bioactive constituents, such as vitamins, minerals, and polyphenols. This study examined the anti-obesity effects of LC during differentiation in preadipocytes. Methods: The cell viability assay was performed after the differentiation of 3T3-L1 cells for 7 days. Oil Red O staining was used to visualize the changes in lipid droplets in 3T3-L1 cells and mouse adipose-derived stem cells (MADSCs). The mRNA expression of obesity-related genes was determined by quantitative real-time PCR. Results: According to the results of Oil Red O staining, the lipid levels and size of lipid droplets in the adipocytes were reduced and the LC extract (LCE, 0.25-1 mg/mL) markedly inhibited adipogenesis in a dose-dependent manner. The treatment of LCE also decreased the mRNA expression of peroxisome proliferator-activated receptor ${\gamma}$ ($PPAR{\gamma}$), CCAAT/enhancer binding protein-${\alpha}$ ($C/EBP{\alpha}$), and sterol regulatory element binding protein 1 (SREBP1) in 3T3-L1 cells. Western blot analysis showed that the $PPAR{\gamma}$, $C/EBP{\alpha}$, and SREBP1 protein levels in both 3T3-L1 and MADSC were reduced in a dose-dependent manner. Conclusion: These results suggest that LCE can inhibit adipogenic differentiation through the regulation of adipogenesis-related markers.