Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential diagnosis. Since most PNE have a benign progress, symptoms often improve with age and without special treatment. Therefore, it is important to reassure the caregivers after making an accurate diagnosis.
This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.
Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.
Purpose: This study aimed to determine health problems experienced by workers in special employment relationships (WSER) and identify coping strategies used when such problems occur. Methods: This qualitative study used the focus group interview method. Thirteen study participants included five home-visit tutors, five insurance salespersons, and three credit card recruiters. The interviews were conducted from November 2018 through January 2019, with each occupational group interview lasting about 2 hours. Analysis based on phenomenological research was independently performed by two researchers. Results: Most participants had common health problems involving vocal cord symptoms, and stress related to emotional labor and traffic accidents. The unique health problems included cystitis, musculoskeletal, and digestive symptoms in home-visit tutors; reduced vision and hearing in insurance salespersons; and mental distress in credit card recruiters. There was no protection system for their health coverage, and the company emphasized their self-employed status to avoid taking responsibility for them. Twelve participants did not purchase occupational accident insurance owing to both not having adequate information and economic burden concerning premium status. Conclusion: WSER experienced both physical and mental health problems. These problems were caused by their unstable employment status, and the social security system for their coverage being non-functioning.
Journal of Physiology & Pathology in Korean Medicine
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v.26
no.1
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pp.10-18
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2012
In this paper, to find out how different the treatment of special individuals named 'old people' is with that of ordinary cases, Dongeuibogam(東醫寶鑑) was chosen as the study material and some parts in it where the symptoms of old people in the same disease category were treated in different ways were excerpted to analyze the tendency of pathological symptoms and prescriptions in the physiological perspective. As the result of analysis on the parts in Dongeuibogam(東醫寶鑑) where the old people were treated in different ways, it turned out that 65 prescriptions were used in 24 pathological symptoms. The 24 symptoms are included mainly in chapters of 'inner view(內景)' and 'outer form(外形)'. They are including the pathological symptoms which had been presented as general geriatric symptoms and also seems to have added other symptoms which should be clinically reflected in the specialty of treatment for geriatric diseases. The 65 prescriptions are also recorded mainly in chapters of 'inner view(內景)' and 'outer form(外形)'. The herbs used for them were sweet and warm herbs such as Rehmannia glutinosa (Gaertner) Libosch(熟地黃), Angelica gigas Nakai(當歸), Panax ginseng C. A. Mey(人蔘) and Atractylodes macrocephala Koidz(白朮) that can support the essence blood of liver and kidney and the energy of spleen, lung and stomach. Those herbs could be added or subtracted according to the symptom. It seems to have resulted from the treatment method that old people was applied to old people in consideration of their physiological features. When the 24 symptoms and 65 prescriptions for geriatric diseases different from ordinary ones in Dongeuibogam(東醫寶鑑) were considered in the physiological view point, it could be seen that each pathological symptom was manifested as a exhaustion of kidney qi(腎氣枯渴) which was a characteristic physiologic state of old people. Through this, it could be seen that the use of prescriptions was also made to mitigate the body fluid deficiency(津液不足), the kidney yin inner heat(腎陰內熱), the heart spirit void and loss(心神虛損), the kidney yang deficiency(腎陽不足), the spleen failing in transportation(脾失健運), the spleen yang deficiency(脾陽不足), the liver fire inner movement(肝火內動) and the lung energy void and loss(肺氣虛寒).
Purpose: The purpose of this study was to investigate the levels of physical symptoms, anxiety, depression, and quality of life (QOL) during chemotherapy for colorectal cancer patients in South Korea and to identify factors influencing their QOL. Methods: Data were collected from 144 colorectal cancer patients receiving chemotherapy during 2012 at one general hospital located in Seoul. Physical symptoms were measured by the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, and anxiety and depression were measured by the Hospital Anxiety Depression Scale. QOL was measured by the Functional Assessment of Cancer Therapy-Colorectal. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, $Scheff{\acute{e}}$ post hoc test, Pearson correlation and stepwise multiple regression. Results: Mean age of the participants was 56.6 and most of them were not employed. In terms of cancer stage, 38.2% were in stage 3, followed by stage 4 (34.7%). The most frequent symptom was lack of appetite, followed by sleep disturbance and fatigue. The mean score for anxiety was 5.40 with a prevalence of 23% and that of depression 8.85 with a prevalence of 64.6%. The mean score for quality of life was 81.93 out of 136 and 75.3% of the variance in QOL was explained by depression, symptoms, anxiety, treatment place, and occupational status. Depression was the strongest predictive factor. Conclusion: Oncology professionals need to pay special attention to relieving depression as well as physical symptoms to improve QOL during chemotherapy for colorectal cancer patients.
Purpose: An osteoma is one of the common benign tumors that penetrate the nasal portion, paranasal and frontal sinus. This tumor is mostly found by radiation test accidentally, however in rare cases; it can be found to be touched or with its symptoms as the tumor grows. We report this case since we found and healed the benign tumor which was affecting orbit and the both sides of fronal sinus. Methods: A 19 year old female patient visited to our hospital due to the mass on her forehead. The symptoms began 3 years ago but no special symptom was found except for touchable mass. She was diagnosed as the osteoma of superior orbital parts and both sides of frontal sinus using X-ray and CT scanning. The size of osteoma was $5{\times}2.5{\times}3.5\;cm$ and indicated the patterns penetrated to the right side of orbital region. The osteoma excision was conducted with coronal incision and wide area of defect part in frontal sinus and superior orbital part were reconstructed by cranial bone graft and resorbable fixation plates. Results: The patient recovered without any postoperative infections or complications and symptoms. Dysaesthesia was found on her frontal area but improved in 1 month after the surgery. Conclusion: The occurrences of osteoma in frontal sinus are rare and can be treated with conservative methods if there are no infections and symptoms. We report this case since we found the benign tumor, which was affecting orbit and the both sides of fronal sinus and healed it with coronal resectomy without any complications.
Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.
Sun-Ju Ahn;Jong Duck Kim;Jong Hyun Yoon;Jung Ha Park
Health Policy and Management
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v.33
no.1
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pp.29-39
/
2023
Background: Breaking the chain of disease transmission from overseas is necessary to control new infectious diseases such as coronavirus disease 2019 effectively. In this study, we developed a mobile app called Self-Symptom Checker (SSC) to monitor the health of inbound travelers. Methods: SSC was developed for general users and administrators. The functions of SSC include non-repudiation using QR (quick response) codes, monitoring fever and respiratory symptoms, and requiring persons showing symptoms to undergo polymerase chain reaction tests at nearby screening stations following a review of reported symptoms by the Korea Disease Control and Prevention Agency, as well as making phone calls, via artificial intelligence or public health personnel, to individuals who have not entered symptoms to provide the necessary information. Results: From February 12 to March 27, 2020, 165,000 people who were subjected to the special entry procedure installed SSC. The expected number of public health officers and related resources needed per day would be 800 if only the phone was used to perform symptom monitoring during the above period. Conclusion: By applying SSC, more effective symptom monitoring was possible. The daily average number of health officers decreased to 100, or 13% of the initial estimate. SSC reduces the work burden on public healthcare personnel. SSC is an electronic solution conceived in response to health questionnaires completed by inbound travelers specified in the World Health Organization International Health Regulations as a requirement in the event of a pandemic.
The purposes of this study were to investigate the oral health status of the disabled children attending special schools in Seoul and Gyeonggi area, which were to collect baseline data for set up a oral health center in special schools. The study group comprised 915 disabled children aged 12~15 year. They were examined clinically and surveyed on 4 oral health related characteristics according to the type and level of disabilities The results may be summarized as follows: 1. DMFT index was the highest in children with crippled disorder. The plaque control was more required to the children with mental retardation or developmental disorder other than another types of disabilities. 2. About one third of the children with mental retardation or developmental disorder had their teeth brushed at least 3 times daily without any help. Over the half of the children with crippled disorder had their teeth brushed 2 times daily, 33.3% were independent and 38.9% totally dependent on help from others. 3. The more level of disabilities was higher, the more frequency of tooth brushing was lower and degree of dependance of the tooth brushing was higher. 4. There was tendency to visit to dental office more frequently for relief of dental symptoms in children with crippled disorder 5. The inability to call for help from others was the major barrier to dental care for the disabled.
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