• Title/Summary/Keyword: Long-term compliance

검색결과 118건 처리시간 0.031초

보건소조직을 통한 고혈압관리사업 (Community-based Hypertension Control Program in Hwachon : Problems and Possibilities)

  • 이인숙;배상숙
    • 보건행정학회지
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    • 제3권2호
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    • pp.25-56
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    • 1993
  • Hypertension has already become a serious health problem in many countries. Treatment is effective, however, and the detection and long-term management of those at risk pose sustained challenges. Community programs can be an important strategy for primary prevention of hypertention and for monitoring the progress and promoting compliance of hypertensive patients. Hwachon Health Demonstrain Project has designed community hypertention control program, especially emphasizing role of public health sector, and operate that model from 1990 at Hwachon county, Kwangwon province. This paper appraise the effectiveness of curent activities. Many paper appraise the effectiveness of curent activities. Many hypertensive persons who have not recognized his disease were identified and began hypertension treatment. However about two thirds of patients have not complied continuously with medical advice. Consequently, the project team redirects its efforts. Less emphasis is being placed screening and identification of patients, while more emphasis is being placed on increasing compliance with treatment recommendations. Some approches to improve hypertension control program are also discussed in the context of the field experience and literature on this suvjest.

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Effect of Dilation on the Mechanical Characterization of Vascular Prostheses

  • Ulcay Y.;Pourdeyhimi B.
    • Fibers and Polymers
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    • 제6권1호
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    • pp.49-54
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    • 2005
  • The purpose of this study has been to investigate the effect of dilation on the some mechanical properties of several types of warp-knitted vascular grafts. The structures of warp knit vascular grafts used in the experiments were reverse locknit, locknit, and Tricot. Various mechanical properties of these grafts were determined using devices developed for the purpose. Clinical data obtained were compared with experimental results of warp knit vascular grafts. The most important mechanical properties are found to be creep extension, bursting strengths, and compliance. Preliminary results indicate that vascular grafts are non-compliant and exhibit creep which is predictive of the long term dilation that has been noted in the clinical results. It is found that there is a positive correlation between experimental data and clinical results for at least the grafts tested.

홍삼의 온열 효과와 복약 순응도에 관한 연구 (A Study on Thermal Effect and Medication Compliance of Red Ginseng Extract)

  • 최민선;정재철;박장경;안홍엽;김동일
    • 대한한방체열의학회지
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    • 제7권1호
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    • pp.44-54
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    • 2009
  • Purpose: To evaluate thermal effect and medication compliance of red ginseng extract. Methods: Randomized, double-blind, placebo-controlled, cross-over clinical study was performed. Twenty four healthy, married women aged 30-45 years with FSFI score below 25 were randomly divided into two groups; red ginseng group(N=12) and placebo group(N=12). During the first 6-week period (Study1), each group was dosed with red ginseng or placebo twice a day. Before starting the second 6-week period(Study2), a crossover design was chosen with a 2-week break(Washout period). Interchanging two groups after Washout period, red ginseng and placebo were dosed to each group. The efficacy of thermal effect was measured with subjective warm sensation scale and lower abdomen temperature by Digital Infrared Thermographic imaging(DITI) before and after each 6-week period. A medication compliance was assessed after each 6-week period and the correlation medication compliance between Sasang Constitution and subjective warm sensation was analyzed. Results: Overall 23 participants completed the study. In subjective warm sensation scale, after taking placebo, all participants exhibited an improving trend, but there was no significant difference. In lower abdomen temperature by DITI, statistically significant objective thermal effect of red ginseng was also not shown. A medication compliance was higher in Yin constitution(Taeumin, Soeumin), and showed an upward trend with decreasing subjective warm sensation. But no statistically significant difference was exhibited. Conclusion: Statistically significant thermal effect of red ginseng was not shown in this study. We anticipate if a long-term clinical trial is practiced, significant thermal effect of red ginseng will be shown.

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홍삼의 온열 효과와 복약 순응도에 관한 연구 (A Study on Thermal Effect and Medication Compliance of Red Ginseng Extract)

  • 최민선;정재철;박장경;안홍엽;김동일
    • 대한한방부인과학회지
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    • 제22권3호
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    • pp.223-235
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    • 2009
  • Purpose: To evaluate thermal effect and medication compliance of red ginseng extract. Methods: Randomized, double-blind, placebo-controlled, cross-over clinical study was performed. Twenty four healthy, married women aged 30-45 years with FSFI score below 25 were randomly divided into two groups; red ginseng group(N=12) and placebo group(N=12). During the first 6-week period (Study1), each group was dosed with red ginseng or placebo twice a day. Before starting the second 6-week period(Study2), a crossover design was chosen with a 2-week break(Washout period). Interchanging two groups after Washout period, red ginseng and placebo were dosed to each group. The efficacy of thermal effect was measured with subjective warm sensation scale and lower abdomen temperature by Digital Infrared Thermographic imaging(DITI) before and after each 6-week period. A medication compliance was assessed after each 6-week period and the correlation medication compliance between Sasang Constitution and subjective warm sensation was analyzed. Results: Overall 23 participants completed the study. In subjective warm sensation scale, after taking placebo, all participants exhibited an improving trend, but there was no significant difference. In lower abdomen temperature by DITI, statistically significant objective thermal effect of red ginseng was also not shown. A medication compliance was higher in Yin constitution(Taeumin, Soeumin), and showed an upward trend with decreasing subjective warm sensation. But no statistically significant difference was exhibited. Conclusion: Statistically significant thermal effect of red ginseng was not shown in this study. We anticipate if a long-term clinical trial is practiced, significant thermal effect of red ginseng will be shown.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center

  • Mehmood, Shahbaz;Alhazmi, Hamdan;Al-Shayie, Mohammed;Althobity, Ahmed;Alshammari, Ahmed;Altaweel, Waleed Mohamed;Almathami, Ahmed;Vallasciani, Santiago
    • International Neurourology Journal
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    • 제22권4호
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    • pp.287-294
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    • 2018
  • Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

컴플라이언스법에 의한 다층 맞대기 이음의 잔류응력 추정 (Residual Stress Prediction in Multi-layer Butt Weld Using Crack Compliance Method)

  • 김유일;이장현
    • Journal of Welding and Joining
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    • 제30권6호
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    • pp.74-79
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    • 2012
  • It depends on the joint configuration, dimensions and constraints of the joint whether the residual stress at the root of single-sided butt weld is tensile or not. Therefore, recommendation is generally made that high R ratio should be used in the fatigue test of welded joint in order to prevent excessively long life caused by compressive residual stress. In this research, the residual stress profile in butt weld joint was obtained through compliance method, using successive extension of a slot and measurement of the variation of strain during the slot extension. The residual stress profile was firstly assumed to be the linear summation of Legendre polynomials up to 9th order excluding 0th and 1st order. Strain variation on the surface was measured while the slot was being extended by cutting to find out the 8 unknown coefficients of each polynomial term. The cut was made by the electric discharge machine. It was concluded that the residual stress near the surface is positive valued, however, it turned into the negative value as soon as it passed through 2 or 3 mm of the depth.

폐쇄성 수면무호흡증 환자의 지속적 상기도 양압술 순응도 (Compliance of Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome)

  • 최종배;이승희;정도언
    • 수면정신생리
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    • 제13권1호
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    • pp.27-32
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    • 2006
  • 목 적:이 연구는 폐쇄성 수면무호흡증의 치료에 사용되는 지속적 상기도 양압술(nCPAP)의 순응도를 조사하고, 순응도를 좌우하는 요인을 파악하여 치료에 도움이 되게 하고자 시행되었다. 방 법:1995년 1월부터 1999년 4월까지 서울대학교병원 신경정신과 수면다원검사실에서 nCPAP 처방압력 측정 검사를 받은 모든 환자 120명을 대상으로 하였다. 환자들의 의무기록을 열람하여 연령, 성별, 학력, 체중, 신장, 호흡장애지수, 평균 산소포화도, nCPAP 처방 압력, 이비인후과 수술여부, 주간 졸림 여부, 고혈압의 병력 등을 조사하였고, 환자들을 외래에서 직접 면담하거나 주소지로 전화하여 nCPAP의 구입여부, 현재 nCPAP 치료 여부, 사용기간, nCPAP 중단 이유 등을 조사하였다. 결 과:대상 환자 120명 중 83명에서 정보를 얻을 수 있었다. 83명 중 60명은 nCPAP 기기를 구입하였고 23명은 nCPAP을 구입하지 않았는데, nCPAP 기기를 구입한 환자들은 주간 졸림증이 있었고 학력이 높았다. nCPAP 기기를 구입한 60명 중에 지금까지 사용하고 있는 환자들은 26명(43.3%)이었고 나머지 34명(56.7%)은 사용을 중단하였는데, 가장 큰 중단 사유는 마스크의 불편(26.5%)이었고, 그밖에 소리가 시끄러움(17.6%), 다른 방법으로 해결(17.6%), 코가 막히고 입이 마름(11.8%) 등의 순이었다. 치료를 중단한 환자들 중 25명(73.5%)이 치료를 시작한 후 3개월을 넘기지 못하고 중단하였으며, 31명(91.2%)이 1년 내에 그만 두었다. nCPAP을 6개월 미만으로 사용한 25명(41.7%)과 6개월 이상 사용한 35명(58.3%)간에 성별, 연령, 호흡장애지수, 평균산소포화도, 처방압력, 이비인후과 수술 여부, 체질량지수, 고혈압의 병력, 주간졸림 여부, 학력 등을 비교하였는데, 주간 졸림 여부에서만 의미 있는 차이가 있었고, 나머지 변수에서는 차이가 없었다. 결 론:이 연구를 통해서 우리는 nCPAP 순응도가 외국의 연구에 비해 다소 낮고, 초기 주간 졸림의 여부가 nCPAP의 장기 사용에 의미있는 영향을 미친다는 것을 알게 되었다. 또한 초기 3개월 이상 지속적으로 사용하는 환자들이 장기적으로 사용할 가능성이 높았다. 이 결과를 바탕으로 우리는 폐쇄성 수면무호흡증에 nCPAP 치료를 할 때 환자를 적절히 선택하고 교육을 지속적으로 해야 nCPAP 순응도를 높일 수 있다고 제안한다.

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정신병적 장애로 첫 내원한 환자들의 임상 특징과 투약 순응도 및 의료 이용 추이: 예비 연구 (Clinical Characteristics, Drug Adherence to Antipsychotics and Medical Use Trends in Patients First Diagnosed with Psychotic Disorder: A Preliminary Study)

  • 허정운;김동욱;오승택;최원정;박재섭
    • 대한조현병학회지
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    • 제22권2호
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    • pp.42-50
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    • 2019
  • Objectives: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. Methods: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). Results: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40-60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). Conclusion: These findings suggest that patients in the 20s and 30s with the 40-60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

요양병원 감염관리 현황 및 감염관리 담당자의 중요도 인식 조사 (Survey on Infection Control Status and Perceived Importance of ICP (infection control practitioner) in Long Term Care Hospital)

  • 김유정;박정숙
    • 한국산학기술학회논문지
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    • 제18권7호
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    • pp.466-475
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    • 2017
  • 본 논문은 요양병원의 감염관리 현황을 파악하기 위하여 2016년 5월 1일부터 7월 31일까지 영남지역의 인증평가를 받은 156개 요양병원을 대상으로 자료 수집을 하였다. 현황 파악에서 있으면 '예', 없으면 '아니오', 중요도 인식은 5점 척도의 총 85문항으로 구성된 설문지를 이용하였다. 자료 분석에 사용된 설문지는 107부이며 자료 분석은 SPSS/WIN 22.0 Program을 이용하였다. 감염관리위원회는 80.4%에서 있다고 하였으며 중요도는 3.79로 나타났고, 감염관리 담당자는 86.0%에서 있으며 대부분 겸임이다. 감염관리규정은 손위생을 포함한 7개 문항에서 100% 구비하고 있으며 규정에 대한 중요도는 손위생이 4.47로 가장 높게 인식하고 있다. 감염관리 활동은 직원교육이 시행 빈도와 중요도 인식에서 가장 높게 나타났으며, 감염관리 수행률은 멸균물품 유효기간 준수율이 96.3%이고 중요도가 4.64로 가장 높게 나타났다. 요양병원의 감염관리 규정은 어느 정도 갖추어져 있으나 감염관리 전담인력 부족과 요양병원에서 적용 가능한 감염관리 규정 미비로 감염관리 활동이 제대로 이루어지지 못하고 있는 것으로 나타났다. 그러므로 요양병원에 적용 가능한 감염감시기준 및 감염관리 가이드라인 개발과 이를 적용할 감염관리 전담인력이 필요하다.

Determinants of Vietnam Government Bond Yield Volatility: A GARCH Approach

  • TRINH, Quoc Trung;NGUYEN, Anh Phong;NGUYEN, Hoang Anh;NGO, Phu Thanh
    • The Journal of Asian Finance, Economics and Business
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    • 제7권7호
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    • pp.15-25
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    • 2020
  • This empirical research aims to identify the relationship between fiscal and financial macroeconomic fundamentals and the volatility of government bonds' borrowing cost in an emerging country - Vietnam. The study covers the period from July 2006 to December 2019 and it is based on a sample of 1-year, 3-year, and 5-year government bonds, which represent short-term, medium-term and long-term sovereign bonds in Vietnam, respectively. The Generalized AutoRegressive Conditional Heteroskedasticity (GARCH) model and its derivatives such as EGARCH and TGARCH are applied on monthly dataset to examine and suggest a significant effect of fiscal and financial determinants of bond yield volatility. The findings of this study indicate that the variation of Vietnam government bond yields is in compliance with the theories of term structure of interest rate. The results also show that a proportion of the variation in the yields on Vietnam government bonds is attributed to the interest rate itself in the previous period, base rate, foreign interest rate, return of the stock market, fiscal deficit, public debt, and current account balance. Our results could be helpful in the macroeconomic policy formulation for policy-makers and in the investment practice for investors regarding the prediction of bond yield volatility.