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Effects of non-pharmacological intervention on depressive symptoms in the older adults with mild cognitive impairment : A systematic review and meta-analysis (비약물 중재프로그램이 경도인지장애 노인의 우울 증상에 미치는 효과: 체계적 문헌고찰과 메타분석)

  • Pang, Yanghee;Cho, Mijung
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.5
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    • pp.71-80
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    • 2022
  • The purpose of this study was to evaluate the effects of the non-pharmacological intervention on depressive symptoms in the older adults with mild cognitive impairment. A total of 1,147 studies were retrieved from PubMed, CINAHL, PsycINFO, Science direct, KISS, RISS, and DBPia. Twenty-one studies which met the criteria were selected and the quality assessment was conducted independently by two investigators. The effect size of non-pharmacological intervention was estimated using Comprehensive Meta-Analysis 3.0. The overall effect size turned out to be the medium effect size (Hedges' g=-0.68, 95% CI=-1.01~-0.36). As a result of the subgroup analysis, the intervention type was statistically significant. The effect size of cognitive intervention (Hedges' g=-1.03, 95% CI=-1.43~-0.61) and multi component intervention (Hedges' g=-0.97, 95% CI=-1.63~-0.33) was greater than excise intervention (Hedges' g=-0.53, 95% CI=-1.16~0.03). This study shows that non-pharmacological intervention was also effective in reducing depressive symptoms in the older adults with mild cognitive impairment. Based on the research results, it is expected that various non-pharmacological intervention studies will be attempted to improve cognitive function and depressive symptoms of the older adults with mild cognitive impairment.

Development of Mental Health Self-Care App for University Student (대학생을 위한 정신건강 자가관리 어플리케이션 개발)

  • Kang, Gwang-Soon;Roh, Sun-Sik
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.1
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    • pp.25-34
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    • 2019
  • The purpose of this study is to develop a mobile app for mental health self care of university student. User centered design is a research design that applies the subject's needs assessment, analysis, design, development, evaluation, modification and supplement to suit the subjects. In order to manage the mental health of university students, they consisted of four main areas of mental health problems: drinking, sleeping, depression, and stress. It is designed to enable self test content, analysis and notification of inspection results, and management plan for current status of each area. Based on this, I developed an Android based mental health self-care Application. The subject can enter his or her mental health status data to explain the normal or risk level for each result, and the subject can then select the appropriate intervention method that he or she can perform. In addition, we developed a mental health self care calendar that can display the present status of each of the four areas on a day by day basis, and the current status can be expressed in an integrated manner through animations and status bars. The purpose of this study was to develop a mental health self-care app that can be improved by continuous and improved programs.

Does the Health Supplement HemoHIM Cause Liver Injury? (건강기능식품 헤모힘이 간손상을 일으키는가?)

  • Seok Jeong Yang;Jeong-Sook Park;Byung-Sun Kim;Kwang-Jae Lee
    • Journal of Industrial Convergence
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    • v.21 no.6
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    • pp.37-42
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    • 2023
  • This study aimed to examine the safety of HemoHIM, a dietary supplement containing methoxsalen. HemoHIM is a dietary supplement marketed globally, and a competitor to ginseng. It has been reported to contain methoxsalen, a plant extract for treating psoriasis and vitiligo. Methoxsalen is known to cause hepatotoxicity, but most of the cases has been reported from ingestion as a drug, not a food. There are no reports of hepatotoxicity from the consumption derived from natural products such as Angelica gigas, Cnidium officinale, and Paeonia lactiflora, which are the main ingredients in the HemoHIM. However, a recent case of acute hepatitis was reported in Hong-Kong after ingestion of HemoHIM. It is difficult to conclude that hepatitis was caused by HemoHIM, because there was no check of co-occurring medications with a higher risk of hepatotoxicity, no description of the progress, no quantitative comparison of methoxsalen in HemoHIM to it in common foods such as carrots and celery, and no description of the patient's underlying diseases. On the other hand, there was a study that suggest hemoHIM is safe, and that study had adequate number of subjects even though more studies are needed to ensure safety.

Development of community-based intensive health care program for the community dwelling elderly (재가노인을 위한 지역사회 중심의 집중건강관리프로그램의 개발과 적용)

  • Song, Mi-Sook;Song, Hyun Jong
    • 한국노년학
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    • v.29 no.1
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    • pp.37-50
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    • 2009
  • The purpose of the present study was to develop a community-based intensive health care program for the community dwelling elderly to strength their functional status and to verify the effect on their geriatric syndrome. A one-group pretest-posttest design was used for the study. A total of 69 frail elderly, who lived in the area within 20 minutes by car, were committed themselves to the day care center(Sangikjae), and had the ability of verbal communication were selected from G city in Kyunggi province. The participants completed a set of questionnaires to measure the sub-score of frailty, fall, urinary incontinence, malnutrition, and mild cognitive disorder domain, using the Otasha-Kensin through the physical examinations and interviews. After 4 weeks of intervention, the outcome was measured to evaluate the effects of the program, and the data obtained were analyzed using descriptive statistics, paired t-test and McNemar test. The results showed that the sub-score of frailty, fall, urinary incontinence, and malnutrition domain were statistically significantly decreased after intervention except those of urinary incontinence and mild cognitive disorder domain, implying that the risk of frailty, fall, and malnutrition was decreased. These findings indicated that community-based the intensive health care program is effective for relieving geriatric syndrome of the community dwelling elderly.

Development of Health Status Scale for Abdominal Obesity Elderly (복부비만 노인의 건강수준 측정도구 개발)

  • Kim, Jeong Soo
    • 한국노년학
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    • v.30 no.4
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    • pp.1095-1106
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    • 2010
  • The purpose of this study was to develop a Abdominal Obesity Elderly(AOE) Health Status Scale to assess self rated health level. The subjects of this study were total 255(pretest 56, test 199) elderly over 65year. The data were collected between June to August, 2009. The method of this study as follow: items generation, test of validity and reliability, 5 panels of experts reviewed the preliminary questionnaire and then data were collected from elderly. Factor analysis, Cronbach's alpha, mean, standard deviation were analyzed the data by SPSS-Win 12.0 program. Results of factor analysis, 5 factors with a total of 16 items extracted that were Social level(Social participation 6 items, Physical Activity 2 items), Physical level(Disease Perception 4 items, Physical Index 2 items), Psychological level(Emotional Support 2 items). The reliability of the AOE health status scale was .868(Conbach's α). In the factor analysis Conbach's α correlations for the 5 factors ranged from .806 to .577. Therefore, Content validity, construct validity, reliability of the AOE health status scale were established. The AOE health status scale is a reliable and valid instrument which abdominal obesity elderly health status can be assessed.

Evaluation of Malignancy Risk of Ampullary Tumors Detected by Endoscopy Using 2-[18F]FDG PET/CT

  • Pei-Ju Chuang;Hsiu-Po Wang;Yu-Wen Tien;Wei-Shan Chin;Min-Shu Hsieh;Chieh-Chang Chen;Tzu-Chan Hong;Chi-Lun Ko;Yen-Wen Wu;Mei-Fang Cheng
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.243-256
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    • 2024
  • Objective: We aimed to investigate whether 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[18F]FDG PET/CT for endoscopy-detected ampullary tumors 5-87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13-36.18; P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80-13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41-19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00-14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16-21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874-0.956] vs. 0.815 [0.732-0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816-0.967) in candidates for endoscopic papillectomy. Conclusion: Adding 2-[18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

Bereavement Care of Hospice Services in Korea (국내 호스피스 기관의 사별 관리 실태)

  • Ro, You-Ja;An, Young-Lan
    • Journal of Hospice and Palliative Care
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    • v.3 no.2
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    • pp.126-135
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    • 2000
  • Purpose : To evaluate the present status of bereavement care in Korean hospice service as a basic database for the effective bereavement care. Method : The data were collected two sets from September to October, 1999 and from November to December, 2000, 55 hospice institutions identified by the Hospice Education Institution, College of Nursing, Catholic University were contacted for a telephone survey. The researchers conducted telephone interviews with hospice administrators for 10 to 30 minutes. Result : 1) Among the 55 Korean Hospice institutions, 38 institutions(69.1%) provided bereavement services. 2) The contents of bereavement services consisted of telephone call 28 institutions(74.5%), bereaved family meeting 26 institutions(69.4%), home visiting 22 institutions(57.9%), mail 16 institutions(42.1%), personal counselling 7 institutions(18.4%). 3) The 26 hospice institutions(68.4%) which provided meetings for bereaved families met with the following frequency : Annually is 11 institutions(42.3%), biannually 6 institutions(23.1%), monthly 6 institutions(23.1%) and bimonthly 3 institutions(11.5%). 4) Only 4 hospice institutions(10.5%) used the assessment tool to screen for high risk of bereaved. 5) The major difficulties of current bereavement services were low attendance for the bereaved family meeting, shortage of professional managers and volunteers, limited accessibility to hospice institutions, little social awareness for the bereaved, and financial difficulties. 6) The hospice administrators expressed the need for the development of bereavement program, the education program for the bereavement services, trained professionals, the sufficient provision of human resource and financial support for more effective bereavement services. Conclusion : Although many hospice institutions(69.1%) provided bereavement services, they generally lacked capable bereavement professionals and various individualized bereavement services. In conclusion, it is required to develop the specified bereavement program and the training program for the staff and volunteers, so as to provide customized bereavement services based on individual needs. Further research will be necessary to evaluate the effects of customized bereavement services in Korea before applying to practice.

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A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System (모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구)

  • 이광옥
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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The Effects of Lifestyle Redesign Program on Time Usage and Quality of Life for Elderly with Stroke (라이프스타일 재설계 프로그램이 뇌졸중 노인의 시간 사용과 삶의 질에 미치는 효과)

  • Kim, Hyeong-Min;Jeon, Byoung-Jin
    • The Journal of Korean society of community based occupational therapy
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    • v.9 no.3
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    • pp.21-30
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    • 2019
  • Objective : This study was designed to identify the effects on the time usage and quality of life of seniors with stroke by applying lifestyle redesign programs on the theoretical basis of the Occupational Balance. Method : A pretest-posttest control group design was conducted for a total of 40 stroke elderly people living in nursing homes(20 experimental and 20 control groups). Prior assessment was conducted for two weeks before the application of the lifestyle redesign program. For the next 10 weeks, the lifestyle redesign program was applied seven times a week. After that, a week of post-evaluation was conducted. The time usage for the subjects was analyzed by Life Time Survey Table of the National Statistical Office(2009) and life quality for them was analyzed by World Health Organization Quality of Life-BRIEF (WHOQOL-BRIEF). Result : The comparison of time usage before and after application of the program demonstrated that for the experimental group, rest and sleep(t=-4.89, p<.001), and leisure(t=-4.67, p<.00b1) showed significant differences. In addition, intergroup comparison results showed that there were also significant differences in rest and sleep(t=-2.24, p<.01) and leisure(t=3.57, p<.01). The comparison of life quality showed a significant difference between two groups(t=6.80, p<.001). If you look at the sub-area of quality of life, a significant difference was identified in physical health(t=6.08, p<.001), psychological health(t=5.21, p<.001), living environment area(t=3.60, p<.01). Conclusion : Lifestyle redesign program actually reduced the time usage for rest and sleep for elderly with stroke living in nursing homes, and increased the time for participating in leisure life resulting in improved quality of life.

The Pain Behavior of Patients with Joint Pain (관절통환자의 통증정도와 통증연관 행위에 관한 연구)

  • 이은옥;한윤복;김순자;이선옥;김달숙;김조자;김광주;김주희;박점희
    • Journal of Korean Academy of Nursing
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    • v.18 no.2
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    • pp.197-210
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    • 1988
  • The purposes of this study were : 1) to assess the level of pain and to identity the varieties and the degree of pain-related behavior, 2) to measure the level of correlation between the level of pain and the degree of pain- related behavior, 3) to test the correlation between the Korean Pain Rating Scale (KPRS) and Graphic Rating Scale(GRS), and 4) to gather data relevant to the Socio-demographic status of the subjects. The level of pain was measured by KPRS and GRS developed by the researchers. The KPRS consists of three dimensions ; the sensory, the affective and the miscellaneous and the GRS of two separate scales ; the intensity scale and the unpleasantness scale. Of the 2, 025 who had visited orthopedic and neurosurgical out-patients department of 11 university hospitals in various districts of Korea with the episode of Joint pain, 405 subjects were self-selected by responding to the data gathering tools and questionaires mailed. The results are summaried as follows : 1. Maale(217, 53.6%) exceeded female patients(188, 46.4%) in number and the onset of joint pain was more prevalent in the age groups of the 20s and the 30s. 160(39.5%) had been hospitalized for the treatment of, and 87(21.5%) had retired because of the joint pain. 2. Mean pain score measured by KPRS was 128.31 (range; 0-1.344.8) ; mean sensory score was 43.23(range ; 0-645.88%), mean affective score was 46.09(range ; 0- 356.72), and mean miscellaneous score was 39.99(range ; 0-341.68). Mean pain scores measured by GRS were ; sensory intensity score ; 109.1(range ; 0-200) and distress score ; 99.1 (range ; 0-200). 3. The prevalent sites of joint pain revealed to be the right knee joint(203; 50.1%), left knee joint(181(44.7%), left ilium(147, 36.3%), lumbar region (106; 26.2%), hip joint(92; 22.7%) and the ankle(84; 20.7%). 4. The average sleep hour was 6.8hours per day and the average rest hour during the day hours was 3.3hours (range 0-20). 5. The average duration of suffering from joint pain was 49.1 months. 6. Most of the subjects(298; 73.6%) used some sorts of pain relieving practices ; the most prevalent pain relieving practice was the compliance with the physician prescribed treatments(34.4%). 7. The level of discomfort in carrying out the ADL(activities of daily living was 101.16(38.83) and the level of needs for aid in carrying out the ADL was 76.62(31.79). 8. The interrelation between KPRS total score and GRS sensory intensity score(.4438), as well as that of GRS distress score(r=.4446) were not highly correlated, however, sensory and affective dimension within KPRS (.7547) and pain intensity and distress score of GRS(.6975) revealed moderate intercorrelation. 9. Pain-related behaviors such as discomfort in carrying out ADL, the need for aids in carrying out ADL, frequency of pain relieving practices, varieties of pain sites and length of rest hours during the day hours revealed to be highly correlated with the level of pain measured by KPRS, GRS sensory intensity scale and GRS distress scale. The following are recommended ; 1. Test for the correlation of KPRS total score and the summated score of GRS ; sensory intensity and distress scores. 2. Possibilities of utilization of the pain-related behaviors which revealed high correlation as indirect assessment tool for measuring the level of pain.

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