• Title/Summary/Keyword: Older patients

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Longitudinal Evaluation of Lung Function Associated with Emphysema in Healthy Smokers (건강한 흡연자에서 폐기종의 유무에 따른 폐기능 변화)

  • Sim, Yun-Su;Ham, Eun-Jae;Choi, Kyu-Yong;Lee, Suk-Young;Kim, Seok-Chan;Kim, Young-Kyoon;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.3
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    • pp.177-183
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    • 2010
  • Background: Smoking reduces pulmonary function and induces various lung diseases. Recently, the rate of emphysema detection has increased due to lung cancer screening with low-dose chest computed tomography (CT). The purpose of this study was to evaluate changes in lung function associated with emphysema in healthy smokers. Methods: One hundred and ninety one healthy smokers, who had undergone a low-dose chest CT (LDCT) scan as part of lung cancer screening and had revisited the health center after a median 23.9 months' time, were recruited into this study. The severity of emphysema was calculated by the direct observation of a radiologist and a pulmonologist indipendently. Longitudinal changes in lung function according to emphysema based on LDCT and type of smoker was analyzed. Results: Of the participants in this study, 25% of healthy smokers had emphysema, which was mild in severity, in older patients (p=0.003) and in heavy smokers (p<0.001). $FEV_1/FVC$ and FEF25-75% were decreased in current smokers with emphysema (p=0.001 and p=0.009, respectively) and without emphysema (p=0.001 and p=0.042). Although lung function was not decreased in ex-smokers without emphysema, $FEV_1/FVC$ and FEF25-75% were decreased in ex-smoker with emphysema (p=0.020 and p=0.010). Conclusion: Upon examination with LDCT, the prevalence of emphysema was higher in healthy smokers was than in non-smokers. Lung function was diminished in smokers with emphysema, in spite of former smoker.

A Study on Actual Conditions of Leisure Time and Service Satisfaction of Community-dwelling Elderly -Focused on Buyeo (지역사회거주 노인의 여가시간활용과 바우처사업 서비스 만족도에 관한 연구-부여군을 중심으로)

  • Jeon, Byoung-Jin;Lee, Jae-Shin;Kwon, Mi-Hwa
    • The Journal of Korean society of community based occupational therapy
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    • v.2 no.1
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    • pp.25-35
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    • 2012
  • Objective : This study conducted in rural areas, elderly services voucher business and leisure satisfaction survey based on data from the use of community-dwelling older people considering service needs was to find ways to take advantage of leisure time. Methods : Buyeo county residents in this study 71 patients were elderly, the characteristics of elderly gender, the presence of spouse, health status, education level, monthly living expenses, number of children, occupation, and the variables were included. Subjects' self-esteem, life satisfaction, quality of life, program satisfaction questionnaire for the survey were used, t-test and correlation analysis using the correlation between each factor were analyzed. Results : In a survey of participants in leisure activities, TV watching, meeting friends, such as phone calls to static and time-consuming activities were surveyed about satisfaction of the voucher business, the elderly oral health care services, health screening services, sports massage such as health-related services is relatively high degree of satisfaction. Conclusion : The results of this study of elderly people in rural communities through meaningful leisure time were utilized to determine what is lacking, a strong desire for health-related services that could be confirmed. Therefore, further experience and knowledge about activities by providing opportunities for meaningful leisure time needs to improve, and it based on a variety of programs to meet the needs of the elderly should be provided.

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Effects of health promotion education experience on present health status of elderly (건강증진 보건교육 경험이 노인의 현재 건강상태에 미치는 영향)

  • Lee, Heung Hun;Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.106-114
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    • 2019
  • This study aims to identify the effects of experiencing health promotion education on the present health status of elderly people. The subjects of this study were a total 10,532 elderly people (aged 65 years or older), and who were selected from the data of the '2017 Community Health Survey'. The health promotion education experience consisted of handwashing education/campaign, a non-smoking campaign and non-smoking education. The chronic disease control education experience consisted of education on hypertension, diabetes mellitus and arthritis. Psychiatric counseling consisted of consultations on stress, depression and suicide. The present health status consisted of the patients' ability to exercise, their self-care ability, their activities of daily living, their pain/discomfort and their anxiety/depression. The data was analyzed utilizing the chi-square test, the Mann-Whitney test and multivariate logistic regression analysis. The general characteristics of the subjects were 4,075 males (38.69%) and 6,457 females (61.31%). The average age was 73.71(±6.18) years old. The significant factors influencing the elderly peoples' present health status were age (OR=0.909, 95% CI=0.886-0.933), handwashing education/campaign (OR=2.463, 95% CI=1.703-3.563), a stop smoking campaign (OR=1.624, 95% CI=1.146-2.301) and consultation for mental problems (OR=0.533, 95% CI=0.359-0.791). In conclusion, to modify the personal habits that the elderly have had for a long time and to show the effects of education, long-term continuous education that focuses on the characteristics of the people will be effective.

Prevalence Rates of Risk Factors of Metabolic Syndrome, and Its Related with Obesity Indices Among the Health Checkup Examinees (건강검진 수검자들의 대사증후군 위험인자별 유병률 및 비만지표와의 관련성)

  • Park, Kyu-Ri;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.153-162
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    • 2016
  • The aim of this study was to estimate the prevalence of the metabolic syndrome risk factors for adults in the general population, understand the relationship of each factor with the obesity indicators, and examine the relevance and validity for predicting the metabolic syndrome in obese indicators. The study subjects were 1,051 adults aged 20 years and over, who underwent a health package check-up at the Korea Association of Health Promotion, D-branch from Feb. to Nov. 2014. As a result, the prevalence rates of metabolic syndrome of the study subjects were 21.5%, and the prevalence rates of the metabolic risk factors were as follows: 31.8% of men and 41.6% of women for abdominal obesity; 35.6% of men and 17.3% of women for TG; 17.6% of men and 34.2% of women for HDL-C; 53.5% of men and 35.9% of women for blood pressure; and 14.9% of men and 6.8% of women for FBS. The prevalence rates of metabolic syndrome were significantly higher in the older age group, in the group with the higher BMI, and in the group of higher level of drinking frequency. In the predictive indicators of obesity on metabolic syndrome risk factors, the waist / height ratio was higher than other indicators. Conclusively, WHtR appeared to be a useful indicator to show abdominal obesity and is better in selecting metabolic syndrome patients compared to other obesity indicators.

Attitudes toward Complementary and Alternative Medicine in Suwon City (수원시 주민의 대체의학 수용실태 조사)

  • Chun, Ki-Hong;Song, Hyun-Joug;Park, In-Whee;Yoo, Seung-Chul;Song, Mi-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.162-169
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    • 1999
  • Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

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A Case of Membranoproliferative Glomerulonephritis Type II (Dense Deposit Disease, DDD) (막성증식성 사구체신염 제 II형 (Dense Deposit Disease, DDD) 1례)

  • Kwon Hae Sik;Oh Seung-Jin;Lee Young-Mock;Kim Ji Hong;Kim Pyung-Kil;Kang Hae Youn;Jeong Hyeon Joo;Choi In Joon
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.188-195
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    • 2001
  • Type II membranoproliferative glomerulonephritis (Dense deposit disease) is an acquired primary glomerular disease characterized by electron microscopic evidence of a continuous dense membrane deposition replacing the lamina densa. It is a subtype of idiopathic membra- noproliferative glomerulonephritis, and was described as a separate entity by Berger and Galle in 1963. It frequently occurs in older chilren and young adults and the clinical course is variable, but is generally progressive. The presenting feature is nephrotic syndrome in many patients, and proteinuria and hematuria are also seen frequently. The purpose of this paper is to present a case of DDD (Dense deposit disease) from a 10 year old boy who was diagnosed as a acute poststreptococcal glomurulonephritis with protenuria, hematuria, and facial edema by renal biopsy 4 years ago. (J, Korean Soc Pediatr Nephrol 2001 ; 5 : 188-95)

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Consumption Values on the Intention to Re-use on Geriatric Hospitals (노인요양병원 재이용 의사에 영향을 미치는 소비가치 요인)

  • Kwon, Jin
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.921-930
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    • 2013
  • Objective: After introduction of the Elderly Long Term Care Insurance, number of geriatric hospitals increased greatly. However, few studies were conducted on the satisfaction of the patients of the geriatric hospitals especially on the intention to reuse geriatric hospitals. Methods: The current study modified Sheth's consumption value model, useful for the development of an effective marketing strategy for geriatric hospitals, and tested it in Korean circumstances. The survey was conducted at two municipal hospitals and three private hospitals in Seoul and Gyeonggi Province between August 1 and September 30 of 2012. Data were collected from 472 inpatients who are 60 years or older. The structured research tool was developed and distributed. Factor analysis and hierarchical logistic regression analysis were conducted using SPSS(version 14.0) Results: The result of the research suggested that the satisfaction on rehabilitation services, which is a functional value, among the consumption values was the strongest factor on the intention to reuse geriatric hospitals. Impression of high-end luxury, reliability of care, and outside locus of control on health followed. Conclusion: It is recommended that geriatric hospitals ought to improve rehabilitation programs, facilities, and equipments and enhance kindness of staff to encourage intention to reuse geriatric hospitals.

Evaluating Economic Value of Heat Wave Watch/Warning Information in Seoul and Busan in 2016: Focused on a Cost of Heat Wave Action Plan and Sample of Patients (2016년 서울과 부산지역 폭염특보 정보의 경제적 가치 평가 -폭염대책 비용과 환자 자료를 중심으로-)

  • Kim, In-Gyum;Lee, Seung-Wook;Kim, Hye-min;Lee, Dae-Geun
    • The Journal of the Korea Contents Association
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    • v.20 no.5
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    • pp.525-535
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    • 2020
  • This study aims to evaluate the economic value of the heat wave watch/warning (HW/W) forecast provided by the KMA (Korea Meteorological Administration) for the public sector. Local govermenments of Korea currently use the HW/W forecasts as a major input variable to determine the preparative requisite level for reducing potential damage by extreme heat events. To assess the value of the HW/W, which is not a marketable commodity, a decision-making model taking into account the cost and loss was established. The 'cost' variable was defined as the heat wave countermeasures budget for Seoul and Busan in 2016, and the 'loss' variable was set as the amount of health insurance claims for those 65 and older obtained from the Health Insurance Review and Assessment Service. Using this model, the value of the HW/W in 2016 was calculated as KRW 4,133M and KRW1,090M for Seoul and Busan, respectively. In addition, if the KMA reduces the False Alarm of the HW/W by a single instance, the value will be increased by KRW 76.6M and KRW 16.8M for the two cities. The results of this study are useful in quantitatively estimation of the value of the HW/W forthe public sector.

Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

Selective Contralateral Exploration in Pediatric Inguinal Hernia (소아서혜부탈장의 선택적 편대측 시험절개)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.18-26
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    • 1995
  • For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

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