Recently, our society has been changing its population structure due to low birth rate along with the extension of life span due to the development of medical environment and improvement of living environment. It was not long before the population became older, and the problem of the elderly was amplified by generational conflict. The current generation of senior citizens could not afford to prepare for their own retirement income due to their children's education, marriage and housing problems, and is a generation alienated from the benefits of public income security. In addition, not only are they in poverty with rapid industrialization, informatization and economic instability, but they are also threatened with livelihood. The increase in elderly crimes arising from the elderly, who are less adaptable to our society dominated by materialism, is being highlighted as a new social issue. In this study, we are going to analyze the causes of violent and violent senior citizens' crimes in quality along with quantitative growth, and present criminal situations and preventive measures using 10 years of data, judging that this is a time when a national response is needed through a social discussion on crimes committed by senior citizens in our society, where the pace of aging is unprecedentedly fast in the world In order to achieve this research objective, various opinions and statistical data of our society where the standards of senior citizens are changing were reviewed, and analysis of crimes was conducted on literature utilizing data of the Supreme Public Prosecutor's Office, the National Police Agency, and the National Statistical Office, recent press releases, and existing research materials. In this study, we will diagnose crimes committed by senior citizens in various aspects, including the characteristics of the elderly and the view of the elderly in the present society, and explore the direction of development for the prevention of future crimes as well.
Purpose: Although infants with bronchopulmonary dysplasia (BPD) are at risk of developing secondary pulmonary hypertension (PH), which is associated with significant morbidity and mortality, little has been reported about the incidence, clinical course and prognosis of PH secondary to BPD in premature infants. This study was done to investigate the incidence, risk factors, clinical course, and the ultimate prognosis of PH developed secondary to BPD in very low birth weight infants (<1,500 g). Methods: Medical records of very low birth weight infant (VLBWI) admitted to Samsung Medical Center NICU from January 2000 to July 2007 were reviewed retrospectively. BPD was defined by Jobe's classification. The diagnosis of pulmonary hypertension was established as velocity of tricuspid valve regurgitation (TR) ${\geq}$3 m/s and a flattening of the intraventricular septum by conducting Doppler echocardiography. Results: The incidence of pulmonary hypertension was 6% in VLBWI with BPD and it developed in moderate to severe BPD. The diagnosis of pulmonary hypertension was made on postnatal 133 days (range 40-224 days) and the risk factors related to developing pulmonary hypertension were severe BPD, small for gestational age and outborn infants. The mortality rate was 57% and especially higher in severe BPD (70%). The time to recovery spent 3 months (range 1-10 months) in survived patients. Conclusion: Based on the results of this research, pulmonary hypertension secondary to BPD in VLBWI related to severity of BPD and had a poor prognosis. We expect that regular long-term echocardiography may be helpful in treating reversible in VLBWI with moderate to severe BPD.
Choi, Hwa Young;Kim, Seul Ki;Kim, Seok Hyun;Choi, Young Min;Jee, Byung Chul
Clinical and Experimental Reproductive Medicine
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v.44
no.4
/
pp.224-231
/
2017
Objective: We studied the association between sperm DNA fragmentation (SDF) and several clinical in vitro fertilization outcomes. Methods: We retrospectively analyzed 169 consecutive fresh IVF cycles. Semen was collected on the day of oocyte retrieval, and we assessed standard semen parameters and the SDF level (by terminal deoxynucleotidyl transferase dUTP nick-end labeling). Poor ovarian response (POR) was defined as the collection of three or fewer mature oocytes. Oocytes were inseminated by the conventional method or intracytoplasmic sperm injection. Results: SDF did not affect the fertilization or pregnancy rate, but did have a significant effect on the miscarriage rate. In the miscarriage group (n = 10), the SDF level was significantly higher (23.9% vs. 14.1%) and number of mature oocytes was significantly lower (4.3 vs. 7.6) than in the live birth group (n = 45). Multiple regression analysis showed that SDF was an independent predictor of miscarriage (odds ratio, 1.051; 95% confidence interval, 1.001-1.104). The cutoffs for the SDF level and number of mature oocytes that could predict miscarriage were > 13% and ${\leq}3$, respectively. In the low-SDF group (${\leq}13%$), the miscarriage rate was similar in POR patients and those with a normal ovarian response (NOR; 14.2% vs. 4.3%). In the high-SDF group ( > 13%), the miscarriage rate was significantly higher in the POR group than in the NOR group (60.0% vs. 13.3%, p= 0.045). Conclusion: Our study demonstrated that a high SDF level ( > 13%) was associated with a high miscarriage rate, and that it mainly contributed to miscarriage in the POR group. The results suggest that SDF measurements should be considered in couples with POR in order to predict the prognosis of the pregnancy.
Objectives: The purpose of this study is to examine the factors affecting the rate and duration of breastfeeding. Methods: We analyzed the data from the year 2000 Korea National Fertility Survey that was collected through direct interviews. In particular, the mothers who delivered their last child and the child was under 1 year of age from January 1998 to June 2000 (N=1,066) were analyzed via a logistic model to assess the factors affecting the breastfeeding rate. Among the study subjects, those who had initiated breastfeeding (N=740) were analyzed through Cox's proportional hazard model to evaluate the factors affecting the duration of breastfeeding. Results: The multivariate logistic model showed that the delivery type and the baby's birth-weight have a statistically significant influence on the breastfeeding rate. Women who delivered their babies through Cesarean section were less likely than others to breastfeed. In contrast, the women whose babies weighed 2.5Kg or more were more likely than others to breastfeed. The results obtained from the survival analysis are as follows: the higher the mother's education level, the shorter is the breastfeeding duration. The mother's work status played a significant role in the early termination of breastfeeding. Women aged 35 or older showed a longer breastfeeding duration than the younger age groups, whereas the maternal age was not a significant factor in affecting whether or not a mother would breastfeed. Conclusions: Reducing the cases of operative delivery (Cesarean section) and low weight births, enlightening young and highly educated women on breastfeeding and improving the environment for breastfeeding on the job are important strategies to encourage women to breastfeed.
The present research was designed to evaluate the effects of pre and post-partum energy level and feeding pattern on the performance of crossbred dairy cows and their calves under farm conditions. A total of 16 crossbred dairy cows were divided into two equal groups on the basis of their body weight and milk production. One group was given 30% less and the another was given 30% more energy than MAFF's (1984) recommendation. After calving all cows were given same ad.libitum diet to assess the effects of feeding during pregnancy on their performance. It was observed that just before calving cows on low energy group gained less (p<0.05) weight than that of the cows on high energy group (12.9$\pm$11.71 vs. 42.25$\pm$12.74 kg/cow. Birth weight of calves of low energy group was lower (p<0.05) than that of the calves of high energy group (17.87$\pm$1.78 vs. 20.73$\pm$2.24 kg/calf). Cows that were on low pre-calving dietary energy level produced less milk during lactation than the cows of high energy pre-calving group (3.45$\pm$0.75 vs. 4.27$\pm$0.79 lit./cow). No significant difference was noticed on calf growth rate and reproductive parameters of cow. Energy level that was 30 % less than MAFF's (1984) recommendation was found to be very low and not suitable for our crossbred cows during their last three months of pregnancy.
Endocrine disruptors have been concerned in toxicology but now challenged as physiological point especially concerned with exposing dose and period. In this study the low-dose chronic administration of di(2-ethylhexyl) phthaltae (DEHP) during reproductive period was examined to evaluate the possible roles. Adult male and female CD-1 mice were exposed to DEHP with drinking water containing $133{\mu}g/L$ and $1,330{\mu}g/L$ DEHP in water according to OECD 433 guide line and sacrificed just after weaning. The weights of uterus and ovary were decreased by drinking of $1,330{\mu}g/L$ DEHP water. There was not adverse effects on either accumulated mating rate and mating rate depend on estrus stage, pregnancy duration, and sex ration at birth. However, the accumulated rate of successful delivery and litter size were significantly high at $1,330{\mu}g/L$ DEHP water. The number of epididymal sperm was significantly increased by drinking of $1,330{\mu}g/L$ DEHP water. In addition, the number of follicles (primary, secondary, tertiary) were more many than control at $1,330{\mu}g/L$ DEHP water drunk mother. Though further studies are needed to identify what are the mechanism of DEHP in folliculogenesis and spermatogenesis. From this study we firstly report the effect of low-dose chronic administration of DEHP with drinking could change the ovarian follicle population size and spermatogenesis rate. Put together, those finding is different from previous high-dose effects and suggest the physiological role of DEHP in gonads and uterus.
Seventy neonates with congenital intestinal atresia and stenosis who were treated at pediatric surgical service. Hanyang University Hospital from September 1979 to December 1996 were analyzed retrospectively. The lesion occurred in 27 cases at the duodenum, in 26 cases at the jeiunum, in 13 cases at the ileum and in 2 cases at the pylorus and colon each. There were 10 multiple atresias and 7 apple-peel anomaly cases. The atresia predominated over the stenosis by the ratio of 4 : 1. Male to female ratio was 1.3 : 1. The average gestational age was 38 weeks, and the average birth weight was 2,754 grams. Though 22.9 % were borne prematurely and 34.3 % had low birth weight, 92.3 % of them had a weight appropriate for gestational age. Polyhydramnios(40 %) was more frequently observed in duodenal and jeiunal atresia while microcolon in ileal atresia(58.3 %). Weight loss and electrolyte imbalance occurred more frequently in the duodenal stenosis cases because of delayed diagnosis. Twenty(55.6 %) of 37 jeiunoileal atresia cases had evidence of intrauterine vascular accident : 4 intrauterine intussusception, 3 intrauterine volvulus and 3 strangulated intestine in gastroschisis, and 10 cases of intrauterine peritonitis. There were one or more associated anomalies in 45 patients (64.3 %). Preoperatively proximal loop volvulus developed in 3 cases and proximal loop perforation in 5 cases and one case each of distal loop perforation, duodenal perforation and midgut volvulus occurred in the jeiunoileal atresia. Overall mortality rate was 20 %.
Pratomo, Hadi;Amelia, Tiara;Nurlin, Fatmawati;Adisasmita, Asri C.
Clinical and Experimental Pediatrics
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v.63
no.11
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pp.433-437
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2020
Background: Indonesia is one of the countries with the highest preterm birth rate. Preterm infants are more likely than term and normal weight infants to experience neonatal mortality and morbidity due to acute respiratory, gastrointestinal, immunologic, central nervous system, hearing, and vision problems. Kangaroo mother care (KMC) is a proven cost-effective intervention to help reduce mortality rates among preterm infants; however, it has not been fully implemented in hospitals. Purpose: Assess KMC knowledge and perceptions among health providers. Methods: This qualitative study was conducted from December 2015 to April 2016 and consisted of 21 in-depth interviews and 3 focus group discussions (FGDs). The 3 categories of health personnel in the study were clinical providers, hospital management representatives, and Indonesian Midwife Association members. Results: Most health providers know about the benefits of KMC including stabilizing temperatures, weight gain, and maternal-infant bonding and reducing human resources and labor costs. They were also aware of which newborns were eligible for KMC treatment. Their knowledge was mostly gained from observation or obtained from pediatricians and personal experience. They believed that a low birth weight infant in an incubator could not be treated with KMC and that it could only be practiced if a special gown was used when holding the baby. This perception could be caused by a lack of formal KMC training, leading to misunderstanding of its aspects. Conclusion: In conclusion, KMC knowledge of clinical providers in the 2 hospitals was sufficient, primarily due to their health-related educational background. Some perceptions could be potential barriers to or facilitate the implementation of KMC practice. These perceptions should be considered in future KMC training designs.
Purpose: There has not been decisional consensus in the concepts and the ways of postpartum cares between Western and non-Western cultures though the importance of postpartum period has been emphasized by the multitude of health professionals. In this study, we investigated the differences in recognition concerning postpartum care among Koreans, Korean residents in America, and Americans (hereafter, K, KA, A). Methods: We used questionnaire of women who had given birth from last 6 weeks to less than 13 years. The women consisted of three groups;104 K, 44 KA, and 44 A. Results: In the perception survey concerning postpartum care, every three group thought that postpartum care was important. However, there were differences in understanding how it would affect women's health, and what they did in the period. K significantly agreed with the content and the importance of postpartum care. The investigation concerning seven categories of postpartum care showed that K group performed the 6 categories except consuming medication beneficial for the postpartum care. KA group performed in a low rate and A group performed two categories in a significantly low rate two categories; avoiding cold stimulation and keeping the body warm. Conclusion: Based on this study, it should be suggested that there were common points and differences among the recognition concerning postnatal care in three groups. Therefore, health professionals make efforts in understanding diversities on postnatal care and providing the adequate services reflecting each mother's needs and recognition.
Eli D. Medvescek;Sorana Raiciulescu;Andrew S. Thagard;Katerina Shvartsman
Journal of Preventive Medicine and Public Health
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v.56
no.2
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pp.190-195
/
2023
Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.
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