• Title/Summary/Keyword: INTERVENTION

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Impacts of Diastolic Function on Clinical Outcomes in Young Patients with Acute Myocardial Infarction (젊은 급성 심근경색증 환자에서 좌심실 이완 기능 및 충만압이 관상동맥중재술 후 임상 경과에 미치는 영향)

  • Cho, Eun Young;Jeong, Myung Ho;Yoon, Hyun Ju;Kim, Yong Cheol;Sohn, Seok-Joon;Kim, Min Chul;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Ahn, Youngkeun;Cho, Jae Young;Kim, Kye Hun;Park, Jong Chun
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.538-547
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    • 2018
  • Background/Aims: The impact of left ventricular (LV) diastolic function and filling pressure on clinical outcomes in young patients with acute myocardial infarction (AMI) has been poorly studied. Therefore, the aim of this study was to investigate the impact of LV diastolic function and LV filling pressure on major adverse cardiac events (MACEs) in young patients with AMI. Methods: A total of 200 young patients (males < 45 year, females < 55 year) with AMI were divided into two groups according to the diastolic function; normal (n = 46, $39.5{\pm}5.3$ years) versus abnormal (n = 154, $43.5{\pm}5.1$ years). Results: Despite regional wall motion abnormalities, normal LV diastolic function was not uncommon in young AMI patients (23.0%). During the 40 months of clinical follow-up, MACEs developed in 26 patients (13.0%); 14 re-percutaneous coronary intervention (7.0%), 8 recurrent MI (4.0%), and 4 deaths (2.0%). MACEs did not differ between the normal and abnormal diastolic function group (13.6% vs. 10.9%, p = 0.810), but MACEs were significantly higher in the high LV filling pressure group than the normal LV filling pressure group (36.8% vs. 10.5%, p < 0.001). On multivariate analysis, high LV filling pressure was an independent predictor of MACEs (hazard ratio 3.022, 95% confidence interval 1.200-7.612, p = 0.019). Conclusions: This study suggested that measurement of the LV filling pressure (E/e' ratio) would be useful in the risk stratification of young patients with AMI. However, it would be necessary to monitor this category of patient more carefully.

The Definition of a Catastrophe as Trauma by Visual Media and the Resultant Problems: A Critical Analysis of the "Antimimetic Theory" (시각 미디어에 의한 대재앙적 사건의 트라우마 규정과 그에 따른 문제들 - "반모방 이론"에 대한 비평적인 분석을 통해서)

  • Seoh, Gil-Wan
    • Cross-Cultural Studies
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    • v.43
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    • pp.265-288
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    • 2016
  • This essay begins by discussing the issue of the definition of a catastrophe as a trauma by visual media and the problems that result. We assume a concrete approach towards these problems by examining the process through which 9/11 was defined as a "national trauma" in the exclusion of images of bodies falling from towers, which were some of the most shocking images in the media coverage of 9/11. The choice to exclude images of falling men from American visual media representations of 9/11 goes hand in hand with the tendencies of a contemporary trauma theory. This essay assumes that the representations in the U.S visual media depend on "antimimetic theory," one of the leading contemporary trauma theories, in order to validate its logic, and examines the limitations and problems of the theory. This work aims to examine the issue of the definition of a catastrophe as trauma by visual media on the basis on the "antimimetic theory" and the danger that results. Because the antimimetic theory, which the visual media in the United States uses to define 9/11 as trauma, emphasizes literal and unmediated representation of an external event, it lacks an understanding of the human aspects of the event. There is no way to intervene in the construction and interpretation of the trauma. As a result, the theory discourages active attempts to find a solution to the problems of the people directly connected with the event. Thus, it provides an opening for manipulative intervention of an external power. This essay attempts to provide a critical analysis of the "antimimetic theory" in order to help people who witness catastrophic events through various types of visual media, and to seek an alternative means of experiencing and responding to the trauma, that does not stem from the perspective of specific media outlets or external powers.

Evaluation of the Nutrition Status and Metabolic Syndrome Prevalence of the Members according to the Number of Household Members based on the Korea National Health and Nutrition Examination Survey (2013-2014) (국민건강영양조사(2013-2014년) 자료에 근거한 가구원수별 구성원의 영양상태 및 대사증후군 유병율 평가)

  • Lee, Jin-Young;Choi, Soo-Kyong;Seo, Jung-Sook
    • Korean Journal of Community Nutrition
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    • v.24 no.3
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    • pp.232-244
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    • 2019
  • Objectives: This study evaluated the nutritional status and prevalence of metabolic syndrome of the people who participated in the KNHANES according to the number of household members. They were assessed by using information from the 2013~2014 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 6,088 persons aged 19 years and over participated in 2013~2014 KNHANES, and they were classified into three groups according to the number of household members (single-person, two-person, three-person & over). The dietary behavior, nutritional status, health-related factors and the prevalence of metabolic syndrome of the subjects were investigated with using information from the survey questionnaires of KNHANES. The nutrient intake data of the subjects were obtained by the 24-hour recall method and this was analyzed for evaluating the nutrition adequacy ratio and the index of nutritional quality. The prevalence of metabolic syndrome among the subjects, and according to the study groups, was estimated using the blood and physical measurement data of the subjects. Results: As for EQ-5D index available for all the health states generated by the EQ-5D descriptive system, the single-person household member was the lowest among all the household types. The index of nutrition quality for protein, crude fiber, calcium, phosphorus, potassium, riboflavin and vitamin C in the single-person household was lower than that of the two-person or the three-person and over households (p<0.001). The mean adequacy ratio of single-person households was significantly decreased compared with that of the other types of households (p<0.001). The prevalence of metabolic syndrome was higher in the single-person households than that in the multiple-person households (p<0.001). Conclusions: These results showed that dietary behaviors, nutrition status and health status might be influenced by the number of household members. The results from this study would be useful for improving Korean people's dietary life and health status by implementing evidence-based, specialized intervention for the members of diverse types of households.

The Effects of Job Stress of Nurses Working in the General Hospitals on Their Turnover Intention -Mediating Effects Organizational Commitment- (종합병원 간호사의 직무스트레스가 이직의도에 미치는 영향 -조직몰입의 매개효과-)

  • Kim, Gyeong-Suk;Cho, In-Sook
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.2
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    • pp.656-667
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    • 2019
  • This study is a descriptive research to grasp the effects of job stress on turnover intention and to confirm the mediating effect of organizational commitment according to the extent of job stress, organizational commitment and turnover intention in the relations between job stress and Turnover Intention of nurses working in general hospitals. Method: The subjects of this study were 199 nurses are working in general hospitals, that have more than 200 beds and less than 400 beds, located in Gwangju. I surveyed them using a structured questionnaire for collecting data from Sep. 01, 2017 to Sep. 20, 2017. The collected data were analyzed by the frequency, the percentage, t-test, ANOVA, Scheffe's Test, Pearson's Correlation Coefficient, Multiple Regression Analysis and Sobel Results: In the first step, job stress as an independent variable had a statistically significant effect on organizational commitment(${\beta}=-.321$, p<.001). In the second step, job stress, an independent variable, also had an important effect on turnover intention as a dependent variable(${\beta}=.389$, p<.001). Job stress and organizational commitment were meaningful predictor variables of turnover intention in the third step. The explanatory power of two variables was 45.5%. The value ${\beta}$ of job stress in the third step was .203(p<.001) which was smaller than its value ${\beta}$,.389(p<.001), in the second step. That meant organizational commitment had the mediating effect on turnover intention. The Sobel Test was conducted to verify the significance of the extent of the mediating effects of organizational commitment. The test result was that the value Z was -3.694 and the mediating effect of organizational commitment was significant on the relation between job stress and turnover intention(p<.002). Conclusion: this study is expected be useful to find ways to reduce subjects' turnover intention by decreasing their job stress, increasing their organizational commitment and developing intervention programs as basic data.

Incidence and Procedure-Related Risk Factors of Delirium in Patients Admitted to an Intensive Care Unit (중환자실 입원 환자의 섬망 발생과 처치 관련 위험인자)

  • Ahn, Jee Seon;Oh, Jooyoung;Park, Jaesub;Kim, Jae-Jin;Park, Jin Young
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.35-41
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    • 2019
  • Objectives : Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. Methods : All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. Results : The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120-16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. Conclusions : There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.

The Necessity of Introducing Development Fee for Archaeology and Suggestions (매장문화재부담금제도의 도입 필요성과 방안)

  • Kim, Gwon Gu
    • Korean Journal of Heritage: History & Science
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    • v.49 no.3
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    • pp.224-239
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    • 2016
  • This article aims to review the major problems of the present Korean management system of archaeology and to seek desirable suggestions in order to pursue the sustainable harmony between the recovery of academic excavations and economic development. In order to continue the sustainable harmony between preserving the values of archaeological resources as limited pure public goods and economic development, the present system of developer's payment for archaeology must be replaced by the introduction of the development fee for archaeology. The excavation of archaeological resources have been done according to the market principle, that is, the lower price principle. But the principle has produced a lot of serious problems in the Korean management system of archaeology, which must result in the market failure. So the governmental intervention is urgently required. By introducing the development fee, the archaeological field units and the developers can avoid direct contact. Instead, the Heritage Management Office will operate the excavation fund raised by the development fee for archaeology in order to avoid low-price contracts, degrading excavation quality, and other related residents' complaints and social conflicts in advance. In addition, the budget for purchasing the preserved excavation sites, which are the source of the landowners' enormous complaints, must be allocated to the Heritage Management Office by the Ministry of Planning and Finance. More budget for small-sized excavations must be allocated as well in order to solve many residents' complaints. These budget increase will be the fundamentals to decrease the residents' big complaints and social conflicts in relation with the archaeological management, which will be a challenge of the Korean government. Along with the governmental efforts, the archaeological field units must do their all-out efforts to overcome many problems in excavation including low-price contracts. Finally, the wage system and working status system must be revised. Excellent young excavators must be recruited appropriately and continue to work in a safe psychological condition, which are the basis to guarantee high-quality excavation.

18-year Follow-up of Extended Newborn Screening for Metabolic and Endocrine Disorders (대사 및 내분비 질환에 대한 광범위 신생아 선별 검사의 18년 추적 관찰)

  • Song, Wung Joo;Lee, Sunho;Jeon, Young Mi;Kim, Sook Za;Jang, Mea Young
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.2
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    • pp.35-42
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    • 2018
  • Purpose: To follow up Korean patients with metabolic and endocrine disorders ascertained by Korea Genetics Research Center, and assess the long-term effectiveness of extended newborn screening program in Korea. Methods: From January 2000 to December 2017, tandem mass spectrometry and fluoroimmunoassay were employed in extended newborn screening (NBS). The NBS program obtained dried blood spots from 283,626 babies, 48 hours after birth, and screened for galactosemia, congenital hypothyroidism (CH), congenital adrenal hyperplasia (CAH), and 50 preventable inborn errors of amino acid, fatty acid, and organic acid metabolism. Results: 28 cases of amino acid disorders, 75 cases of organic acid disorders, 27 cases of fatty acid disorders, 51 cases of urea cycle disorders, 127 cases of CH, 14 cases of CAH, and 15 cases of galactosemia were ascertained through NBS and subsequent confirmatory laboratory tests. Patients with amino acid metabolic disorders, galactosemia, CH, or CAH were more likely to have a better long-term outcome if detected early. Early management of MSUD led to much better outcome in over 90%. Despite early intervention, 32% of other organic acidemia cases still resulted in developmental delay and neurological problems. Fatty acid disorders showed varied results; those with EMA and MCAD had a good outcome, but those with VLCAD had serious neurological problems and considerably higher mortality. 75% with UCD experienced serious neurological complications and higher mortality. Conclusion: The nation-wide NBS program must be accompanied by comprehensive long-term management and physician and family education of inborn errors of metabolism for a better outcome.

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Comparison of Level of Participation and Quality of Life in Stroke Patients and the Healthy Elderly (뇌졸중 노인과 정상 노인의 참여수준 및 삶의 질 비교)

  • Lee, Juyeon;Lee, Chun-Yeop;Yoon, Tae-Hyung;Kim, Tae-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.9 no.1
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    • pp.47-56
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    • 2019
  • Objectives : This study was to compare the level of activity participation(instrumental activities, leisure activities, and social activities of living) and quality of life for elderly people with and without stroke, and to analyze the correlation between the level of activity participation and quality of life in their scores on measures. Methods : The Korean Activity Card Sort(K-ACS) was conducted among 25 elderly people with stroke and 25 elderly people without stroke living in Busan, and their level of activity participation and quality of life were evaluated using the The Medical Outcome Study 36-item Short Form Health Survey(SF-36). Results : Elderly people with and without stroke both showed a significant difference in the retained level of activity participation, instrumental activities of daily living, leisure activities, social activities, and the SF-36 score. The scores of the elderly people with stroke for the retained level of activity participation and instrumental activities of daily living in the Korean Activity Card Sort had a significant correlation with the SF-36 score, whereas leisure activities and social activities did not show a significant correlation with the SF-36 score. Among the elderly people without stroke, there was a significant correlation between scores for the retained level of activity participation, leisure activities, and social activities of living in the Korean Activity Card Sort and the SF-36 score, but there was no significant correlation between instrumental activities of daily living and the SF-36 score. Conclusion : The level of activity participation and quality of life could be considered to correlate with one another, and an intervention to improve the activity participation of elderly people with stroke would help to enhance their quality of life.

Influence of Academic Self-efficacy, Critical Thinking Disposition, and Learning Motivation on Problem Solving Ability in Nursing Students (간호대학생의 학업적 자기효능감, 비판적 사고성향, 학습동기가 문제해결능력에 미치는 영향)

  • Kim, Mi Young;Byun, Eun Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.376-383
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    • 2019
  • This study was conducted to investigate academic self-efficacy, critical thinking disposition, and learning motivation, which influence problem solving ability in nursing students. Data were collected from June 4, 2018 to June 29, 2018, and the final 213 data points were used for analysis. The SPSS/WIN 22.0 program was used to conduct descriptive statics, Pearson's correlation coefficient, t-tests, ANOVA, Scheffe's test and multiple regression analysis. The problem solving ability according to the general characteristics differed among residential type (F=3.930, p=0.021) and satisfaction with major (F=4.618, p=0.011). In the correlation between academic self-efficacy, critical thinking disposition, learning motivation, and problem solving ability of the subject, academic self-efficacy (r=0.573, p<0.001), critical thinking disposition (r=0.620, p<0.001), and learning motivation (r=0.563, p<0.001). The factors affecting the problem solving ability of the study subjects were major satisfaction (${\beta}=.117$, p=0.036), academic self-efficacy (${\beta}=0.314$, p<0.001), critical thinking disposition (${\beta}=0.318$, p<0.001), and learning motivation (${\beta}=0.217$, p=0.004), with an explanatory power of 45.2%. In this study, it is necessary to confirm the effects of the development of the intervention program and the application of the program, which can improve the problem solving ability of nursing students.

The Characteristics and Types of Psychiatric Consultation for Insomnia Symptom in Hospitalized Patients (불면증으로 의뢰된 입원환자의 임상적 특징 및 협진 유형 분석)

  • Jeon, Hansol;Ryu, Seung-Ho;Ha, Jee Hyun;Jeon, Hong Jun;Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.68-73
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    • 2018
  • Objectives: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. Methods: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into 'with reconsultation' and 'without reconsultation' groups. Results: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia 'with reconsultation group' and the insomnia 'without reconsultation group', but the 'with reconsultation' group had significantly more male patients and medical patients than the 'without re-consultation' group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. Conclusion: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.