• Title/Summary/Keyword: Primary Care Activity

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Effects of Altered Calcium Metabolism on Cardiac Parameters in Primary Aldosteronism

  • Lim, Jung Soo;Hong, Namki;Park, Sungha;Park, Sung Il;Oh, Young Taik;Yu, Min Heui;Lim, Pil Yong;Rhee, Yumie
    • Endocrinology and Metabolism
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    • v.33 no.4
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    • pp.485-492
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    • 2018
  • Background: Increasing evidence supports interplay between aldosterone and parathyroid hormone (PTH), which may aggravate cardiovascular complications in various heart diseases. Negative structural cardiovascular remodeling by primary aldosteronism (PA) is also suspected to be associated with changes in calcium levels. However, to date, few clinical studies have examined how changes in calcium and PTH levels influence cardiovascular outcomes in PA patients. Therefore, we investigated the impact of altered calcium homeostasis caused by excessive aldosterone on cardiovascular parameters in patients with PA. Methods: Forty-two patients (mean age $48.8{\pm}10.9$ years; 1:1, male:female) whose plasma aldosterone concentration/plasma renin activity ratio was more than 30 were selected among those who had visited Severance Hospital from 2010 to 2014. All patients underwent adrenal venous sampling with complete access to both adrenal veins. Results: The prevalence of unilateral adrenal adenoma (54.8%) was similar to that of bilateral adrenal hyperplasia. Mean serum corrected calcium level was $8.9{\pm}0.3mg/dL$ (range, 8.3 to 9.9). The corrected calcium level had a negative linear correlation with left ventricular end-diastolic diameter (LVEDD, ${\rho}=-0.424$, P=0.031). Moreover, multivariable regression analysis showed that the corrected calcium level was marginally associated with the LVEDD and corrected QT (QTc) interval (${\beta}=-0.366$, P=0.068 and ${\beta}=-0.252$, P=0.070, respectively). Conclusion: Aldosterone-mediated hypercalciuria and subsequent hypocalcemia may be partly involved in the development of cardiac remodeling as well as a prolonged QTc interval, in subjects with PA, thereby triggering deleterious effects on target organs additively.

Self-Help Education as Outreach Program for Osteoarthritis Patients in Rural Korea

  • Lee, Kyung-Sook;So, Ae-Young;De Gagne, Jennie C.;Choi, Jung-Sook;Lee, Eun-Hee;Suh, Gil-Hee;Choi, Sun-Ha;Heitkemper, Margaret M.
    • Journal of muscle and joint health
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    • v.18 no.2
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    • pp.270-281
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    • 2011
  • Purpose: This study was done to determine if osteoarthritis (OA) patients living in rural Korea would have a benefit from a structured group program focused on self-help strategies. Methods: A hundred and twenty-six patients with OA were recruited from nine Primary Health Care Posts. The experimental group received a 6-week self-help education program while the control group received usual care. T-tests and c2-tests were used to determine the homogeneity between the experimental and control groups. Independent sample t-tests were performed to determine the effect of the treatment program. To guard against such likelihood, the level of significance of t-test was determined by Bonferroni correction within the study constructs. When significant group differences were found in study variables at baseline, analysis of covariances (ANCOVAs) were used for group comparisons of outcome variables. Results: The experimental group reported more significant improvement in fatigue, difficulty with physical activity, depression, quality of life, self-efficacy, and health behaviors than did the control group. The experimental group also showed improvements in range of motion and muscle strength as compared to the control group. Conclusion: A self-help group education program was an effective and powerful strategy to promote physical and psychosocial health in OA patients

A Study on the Effect that Leisure Programs on Depression and Self-esteem in Elderly Women in Rural Areas (여가활동프로그램이 농촌여성노인의 우울과 자아존중감에 미치는 효과)

  • Lim, Jung-Soon
    • Journal of Korean Academy of Rural Health Nursing
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    • v.2 no.2
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    • pp.120-126
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    • 2007
  • Purpose: The objective of this study was to evaluate the effects of leisure programs over 8 weeks on elderly women 60 and over who lived in a rural area. Did the program affect feelings of depression and self-esteem? Method: The leisure programs in this study included rhythm gymnastics for elderly women, recreation, balloon art, paper folding, viewing movies, shuttle cock game, exhibition and evaluation activity. As a Quasi-Experimental study, the design of this study was a Nonequivalent Control Group Pretest-Posttest Design. Results: It was shown that leisure programs for elderly women for 8 weeks, consisting of rhythm gymnastics, self-introduction, hobby activities and recreation can reduce depression and enhance the feeling of self-esteem in elderly women in the rural area. Conclusion: It is concluded that public health centers in rural areas should conduct leisure programs during the farmers' slack season, and that the community halls for elders can contribute to improving the life quality of elderly women by being more affirmative and positive if they develop as healthy and active cultural centers where elderly women will want to come and participate.

Should Workers Avoid Consumption of Chilled Fluids in a Hot and Humid Climate?

  • Brearley, Matt B.
    • Safety and Health at Work
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    • v.8 no.4
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    • pp.327-328
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    • 2017
  • Despite provision of drinking water as the most common method of occupational heat stress prevention, there remains confusion in hydration messaging to workers. During work site interactions in a hot and humid climate, workers commonly report being informed to consume tepid fluids to accelerate rehydration. When questioned on the evidence supporting such advice, workers typically cite that fluid absorption is delayed by ingestion of chilled beverages. Presumably, delayed absorption would be a product of fluid delivery from the gut to the intestines, otherwise known as gastric emptying. Regulation of gastric emptying is multifactorial, with gastric volume and beverage energy density the primary factors. If gastric emptying is temperature dependent, the impact of cooling is modest in both magnitude and duration (${\leq}5$ minutes) due to the warming of fluids upon ingestion, particularly where workers have elevated core temperature. Given that chilled beverages are most preferred by workers, and result in greater consumption than warm fluids during and following physical activity, the resultant increased consumption of chilled fluids would promote gastric emptying through superior gastric volume. Hence, advising workers to avoid cool/cold fluids during rehydration appears to be a misinterpretation of the research. More appropriate messaging to workers would include the thermal benefits of cool/cold fluid consumption in hot and humid conditions, thereby promoting autonomy to trial chilled beverages and determine personal preference. In doing so, temperature-based palatability would be maximized and increase the likelihood of workers maintaining or restoring hydration status during and after their work shift.

Overview of Noncommunicable Diseases in Korean Children and Adolescents: Focus on Obesity and Its Effect on Metabolic Syndrome

  • Lee, Hye Ah;Park, Hyesook
    • Journal of Preventive Medicine and Public Health
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    • v.46 no.4
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    • pp.173-182
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    • 2013
  • Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

Physical Activity and Cancer Prevention: Awareness and Meeting the Recommendations among Adult Saudis

  • Amin, Tarek Tawfik;Al-Hammam, Abudllah Mohammed;AlMulhim, Nasser Abdullah;Al-Hayan, Mohammed Ibrahim;Al-Mulhim, Mona Mohammed;Al-Mosabeh, Modhahir Jawad;Al-Subaie, Mohammed Ali;Al-Hmmad, Qassem Ahmed;Al-Omran, Ahmed Adi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2597-2606
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    • 2014
  • Background: There is a scarcity of information about the proportion of the adult Saudi population that meet the recommended guidelines of physical activity (PA) to reduce cancer risk. Moreover, their awareness about the role of PA in cancer prevention is unclear. Objectives: This cross-sectional study aimed at estimating the proportion of adult Saudis meeting the PA guidelines, specifically those recommended by American Cancer Society (ACS) for cancer prevention, and to assess the public awareness about the role of PA in cancer prevention. Materials and Methods: Using a multistage sampling method, 2,127 adult Saudis of both genders were recruited from 6 urban and 4 rural primary health care centers in Al Hassa, Saudi Arabia. Participants were personally interviewed to gather information about their sociodemographic characteristics, searching activity about PA and cancer, and the time spent in leisure time PA (moderate and vigorous)/week using the Global Physical Activity Questionnaire with show cards. Finally, items about the role of PA in cancer risk reduction were inquired. Results: Of the included participants, 11.6% met the recommendations for cancer prevention (${\geq}45$ minutes of moderate-vigorous PA activity/${\geq}5$ days/week or 225 minutes/week). Multivariate regression showed that being male (AOR=1.49, CI=1.09-2.06), <20 years of age (AOR=3.11, CI=2.03-4.76), and unemployed (AOR=2.22, CI=1.57-3.18) were significant predictors for meeting PA recommendations for cancer prevention. Only 11.4% of the sample indicated correctly the frequency and duration of PA required for an average adult to be physically active and while >70% of them indicated the role of PA in prevention of hypertension, coronary heart disease and lowering elevated blood cholesterol, only 18.6% and 21.7% correctly mentioned the role of PA in reducing colon and breast cancer risk, respectively. Poor knowledge was found among those with less than college education and aged ${\geq}50$ years. The level of knowledge was significantly positively correlated with total leisure time PA of the participants. Conclusions: A minority of adult Saudis in Al Hassa was aware about the role of PA in cancer prevention and engaged in sufficient LTPA for cancer risk reduction benefits, highlighting the need for public health actions to include policies and programs that address factors deterring their participation in LTPA and increasing their awareness with remedies to manage the prevalent misconceptions.

Factors Influencing Cognitive Function According to Degree of Cognition in Community Dwelling Elders (재가노인의 인지 정도와 인지 영향요인)

  • Bang, So-Youn;Park, Do-Soon;Yang, Kyoung-Mi;Kim, Og-Son;Kim, Chang-Hee;Kim, Myung-Ok
    • Journal of Korean Academy of Rural Health Nursing
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    • v.7 no.2
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    • pp.41-50
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    • 2012
  • Purpose: This study was done to identify differences in factors influencing cognitive function according to the cognition of community dwelling elders. Methods: A convenience sample of 565 community dwelling elders participated in this study and from May to June, 2010 trained research assistants collected data using structured questionnaires. Collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, correlation, and multiple regression with the SPSS Win 15.0 version. Results: The elders had a slightly low degree of cognitive function. Of the 565 elders, 41.1% were in the normal group for cognitive function and 58.9% in the mild impairment group. Although there were no significant differences in general characteristics between the groups, factors influencing cognitive function were different. Factors influencing elders in the normal group were leisure activity and moderately good health status. These variables accounted for 5.7% of the variance in cognitive function. Factors influencing elders in the mild impairment group were leisure activity, depression, and education level limited to elementary school graduation. These variables accounted for 19.9% of the variance cognitive function. Conclusion: This study provides comprehensive understanding of factors influencing cognitive function in elders. Differentiated nursing interventions according to degree of cognitive function are suggested.

Obesity in children and adolescents (소아청소년 비만)

  • Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.52 no.12
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    • pp.1311-1320
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    • 2009
  • Childhood obesity has rapidly increased in Korea during the past 20-30 years. Approximately 1 of 10 children and adolescents is obese. Appropriate prevention and intervention measures urgently need. Obesity prevention starts early in life, i.e., obesity prevention and education begins during the period of fetal development in utero. Behavioral changes are the most positively reflected during pregnancy. Infants should be fed breast milk, and inculcated with healthy eating and behavioral habits during infancy to ultimately establish a healthy lifestyle in children. For achieving a lifestyle and behavior that successfully allow children to overcome obesity, although individual motivation is important, active support of parents and family members is also imperative. Health care providers should also make an effort to actively prevent obesity and take necessary intervention actions. Although the efforts of individuals, family, and healthy care providers are important to prevent the rapid increase in obesity, primary prevention should be encouraged at a higher level. Schools should specifically aim at improving nutrition and physical activity by allocating times for healthy eating, playing, and physical education. Moreover, local communities should provide support by funding for safe recreational environments, such as playgrounds and walking tracks. Public health strategies in community and national policies, such as city planning, food marketing, and advertisements, are required for primary prevention of obesity.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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The Effect of Transcranial Direct Current Stimulation over the Primary Somatosensory Cortex in Patients with Chronic Stroke on Somatosensory and Upper Limb Function for Improving Life Care (만성 뇌졸중 환자를 대상으로 한 일차 체성 감각 피질을 자극한 경두개 직류 전류 자극이 라이프 케어 증진을 위한 체성감각과 상지기능에 미치는 영향)

  • Kim, Sun-Ho
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.6
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    • pp.269-277
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    • 2020
  • The purpose of this study is to investigate the recovery of sensation and the restoration of upper limb function according to transcranial direct current stimulation over the primary somatosensory cortex in patients with chronic stroke with sensory deficit. 20 patients with chronic stroke divided into 10 experimental groups and 10 control groups. Patients received transcranial direct current stimulations over the primary somatosensory cortex on the side of the stroke lesion, and The control group applied sham tDCS to the same location. Intervention was conducted 5 times a week, 20 minutes per session for a total of 2 weeks. Assessment was performed using the Erasmus MC modifications to the Nottingham Sensory Assessment(EmNSA), Semmes-Weinstein monofilament examination(SWME) for somatosensory, and Fugle-Meyer Assessment(FMA), Motor Activity Log(MAL), and accelerometer for upper extremity function. Assessment was conducted before and after the intervention. As a result of the study, the experimental group showed a significant improvement in the overall tactile sense, proprioception, cortical sense, and perception sensitivity than the control group, and showed a statistically significant difference in the usage amount of the upper limb. Based on the results of this study, it is thought that the possibility of effective clinical application of transcranial direct current stimulation for recovery of somatosensory and upper extremity function is thought to be increased.