• 제목/요약/키워드: after-school care

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Early Mobilization and Rehabilitation of Critically-Ill Patients

  • Hye Min Ji;Yu Hui Won
    • Tuberculosis and Respiratory Diseases
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    • 제87권2호
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    • pp.115-122
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    • 2024
  • Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.

계획되지 않은 재입원에 대한 위험요인분석 (A Study on the Identification of Risk Factors for unplanned Readmissions in a University Hospital)

  • 황정해;이선자
    • 한국보건간호학회지
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    • 제16권1호
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    • pp.201-212
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    • 2002
  • This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

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Clinical Features, Diagnosis, Management, and Outcomes of Idiopathic Pulmonary Fibrosis in Korea: Analysis of the Korea IPF Cohort (KICO) Registry

  • Jegal, Yangjin;Park, Jong Sun;Kim, Song Yee;Yoo, Hongseok;Jeong, Sung Hwan;Song, Jin Woo;Lee, Jae Ha;Lee, Hong Lyeol;Choi, Sun Mi;Kim, Young Whan;Kim, Yong Hyun;Choi, Hye Sook;Lee, Jongmin;Uh, Soo-Taek;Kim, Tae-Hyung;Kim, Sang-Heon;Lee, Won-Yeon;Kim, Yee Hyung;Lee, Hyun-kyung;Lee, Eun Joo;Heo, Eun Young;Yang, Sei Hoon;Kang, Hyung Koo;Chung, Man Pyo;Korea ILD Study Group,
    • Tuberculosis and Respiratory Diseases
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    • 제85권2호
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    • pp.185-194
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    • 2022
  • Background: The Korea Interstitial Lung Disease Study Group has made a new nationwide idiopathic pulmonary fibrosis (IPF) registry because the routine clinical practice has changed due to new guidelines and newly developed antifibrotic agents in the recent decade. The aim of this study was to describe recent clinical characteristics of Korean IPF patients. Methods: Both newly diagnosed and following IPF patients diagnosed after the previous registry in 2008 were enrolled. Survival analysis was only conducted for patients diagnosed with IPF after 2016 because antifibrotic agents started to be covered by medical insurance of Korea in October 2015. Results: A total of 2,139 patients were analyzed. Their mean age at diagnosis was 67.4±9.3 years. Of these patients, 76.1% were males, 71.0% were ever-smokers, 14.4% were asymptomatic at the time of diagnosis, and 56.9% were at gender-age-physiology stage I. Occupational toxic material exposure was reported in 534 patients. The mean forced vital capacity was 74.6% and the diffusing capacity for carbon monoxide was 63.6%. Treatment with pirfenidone was increased over time: 62.4% of IPF patients were treated with pirfenidone initially. And 79.2% of patients were treated with antifiboritics for more than three months during the course of the disease since 2016. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality. Conclusion: In the recent Korean IPF registry, the percentage of IPF patients treated with antifibrotics was increased compared to that in the previous IPF registry. Old age, acute exacerbation, treatment without antifibrotics, and exposure to wood and stone dust were associated with higher mortality.

방문구강건강관리사업에서 정신적 장애인의 구강건강관리시간에 영향을 미치는 요인 (A STUDY ON FACTORS AFFECTING DENTAL TREATMENT TIME OF PATIENTS WITH MENTAL DISABILITY IN VISITING DENTAL SERVICES)

  • 임경철;이재영;진보형;이교린;김소연;백혜란;김영재
    • 대한장애인치과학회지
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    • 제14권2호
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    • pp.78-87
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    • 2018
  • Patients with mental disability who are classified as dental severely disabled, have poor oral health status and many difficulties in taking health services. The purpose of this study was to investigate factors of influencing in visiting oral health care services. After receiving approval from institutional review board in Seoul National University, 39 participants were recruited and the oral health examination and questionnaire were taken. Data were analyzed using one-way ANOVA, independent t-test, hierarchical linear regression for predicting influence of each participants' characteristics on oral examination time and care time. In regression model, the higher the disability grade and the lower the degree of cooperation, the more oral examination time increased. However possibility of communication was not significantly influenced. Also, the higher the disability grade and the lower the degree of cooperation, the more oral care time increased. However possibility of communication was not significantly influenced. These results are expected to provide objective data for introduction and establishment of visiting dental care.

Updates on the Immune Cell Basis of Hepatic Ischemia-Reperfusion Injury

  • Mi Jeong Heo;Ji Ho Suh;Kyle L. Poulsen;Cynthia Ju;Kang Ho Kim
    • Molecules and Cells
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    • 제46권9호
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    • pp.527-534
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    • 2023
  • Liver ischemia-reperfusion injury (IRI) is the main cause of organ dysfunction and failure after liver surgeries including organ transplantation. The mechanism of liver IRI is complex and numerous signals are involved but cellular metabolic disturbances, oxidative stress, and inflammation are considered the major contributors to liver IRI. In addition, the activation of inflammatory signals exacerbates liver IRI by recruiting macrophages, dendritic cells, and neutrophils, and activating NK cells, NKT cells, and cytotoxic T cells. Technological advances enable us to understand the role of specific immune cells during liver IRI. Accordingly, therapeutic strategies to prevent or treat liver IRI have been proposed but no definitive and effective therapies exist yet. This review summarizes the current update on the immune cell functions and discusses therapeutic potentials in liver IRI. A better understanding of this complex and highly dynamic process may allow for the development of innovative therapeutic approaches and optimize patient outcomes.

출산 여성의 산후관리서비스 이용에 영향을 미치는 요인 (Factors Affecting the Use of Postpartum Care Services)

  • 정윤선;권영대
    • 보건의료산업학회지
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    • 제11권1호
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    • pp.143-158
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    • 2017
  • Objectives : This study aims to analyze differences in the use of postpartum care services and identify the factors affecting their use. Methods : Data were collected from the 2008-2014 Korean Health Panel. Chi-square tests were conducted to analyze differences in the characteristics of women after birth by the use of postpartum care services. Logistic regression analysis was used to identify factors affecting the use of each type of postpartum care service. Results : Participants with higher education and household income levels were more likely to use a postpartum care facility. Individuals with a lower number of household members, who gave birth in 2011-2013, and who used hospitals specializing in obstetrics and gynecology had a greater likelihood of using a postpartum care facility. The probability of using a postpartum caretaker was higher when participants did not perform any economic activities. Conclusions : It is meaningful to confirm that use patterns and determinants of postpartum care facilities and postpartum caretakers are completely different and that the socioeconomic status of women affects the utilization of postpartum care facilities.

체제통합국 건강지표 비교를 통한 통일 후 보건의료에 대한 시사점 (The Implications on Healthcare System of the Unified Korea: Lesson from System Integration Countries)

  • 주영준;허성은;이주은
    • 보건행정학회지
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    • 제30권3호
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    • pp.301-310
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    • 2020
  • Background: In this study, we aimed to investigate the recent trends for health care indicators including maternal mortality ratio, infant mortality rate, under-five mortality rate, life expectancy, years of life lost, and healthcare resources in South Korea, North Korea, Germany, Russian Federation, Mongolia, Vietnam, China, Czech Republic, Poland, and Hungary. Methods: We used data from five sources: World Health Organization, Federal Institute for Population Research, World Bank, Organization for Economic Cooperation and Development health statistics, and national statistics. Results: In the early 1990s, health indicators continued to improve in countries that switched to the health insurance system, but the gap widened in North Korea as health indicators worsened. Conclusion: The establishment of a sustainable health care system after unification of the Korean peninsula requires substantial changes in the health care system and efforts to improve the health of North Koreans.

장애 유형별 치과 검진 및 관리에 대한 비교연구 (PATTERN OF CHECK UP AND DENTAL MANAGEMENT OF SPECIAL CARE NEEDS PATIENTS ACCORDING TO TYPES OF DISABILITIES)

  • 김동현;신터전;현홍근;김영재;김정욱;이상훈;김종철;장기택
    • 대한장애인치과학회지
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    • 제12권2호
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    • pp.50-54
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    • 2016
  • Regular dental visit of disabled patients is an important strategy for maintenance of oral health because of the lack of awareness of oral care. But there is limited information about follow up period in disabled patients after dental treatment. The aim of this study was to investigate the pattern of dental visit and dental management of special care needs patients according to the types of disabilities. A total of 140 patients who received dental treatment at Seoul National University Dental Hospital from 2010 to 2012 were reviewed. Patients were divided 3 groups according to the types of disabilities (disorder of external physical function, disorder of internal organ, psychic disability). Patient's characteristic, dental treatment performed, follow up period and frequency were investigated. The mean follow up period was 28.2 months and average frequency of visit was 3.69 times per year. There was no difference in period and annual visit between 3 groups, but significantly difference in cooperation with medical hospital in affiliation. Regular check-up was the most common dental treatment in all groups. In psychic disorder group, the proportion of sedative treatment was significantly higher than other groups. The results of this study provide information necessary for treatment planning and dental management of disabled patients.

Implementation of Enhanced Recovery after Surgery (ERAS) Program in Perioperative Management of Gastric Cancer Surgery: a Nationwide Survey in Korea

  • Jeong, Oh;Kim, Ho Goon
    • Journal of Gastric Cancer
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    • 제19권1호
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    • pp.72-82
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    • 2019
  • Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.