• 제목/요약/키워드: after-school care

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미세먼지 관련 건강행위 강화를 위한 정책의 탐색적 연구: 미디어 정보의 토픽 및 의미연결망 분석을 활용하여 (An Exploratory Study on the Policy for Facilitating of Health Behaviors Related to Particulate Matter: Using Topic and Semantic Network Analysis of Media Text)

  • 변혜민;박유진;윤은경
    • 대한간호학회지
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    • 제51권1호
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    • pp.68-79
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    • 2021
  • Purpose: This study aimed to analyze the mass and social media contents and structures related to particulate matter before and after the policy enforcement of the comprehensive countermeasures for particulate matter, derive nursing implications, and provide a basis for designing health policies. Methods: After crawling online news articles and posts on social networking sites before and after policy enforcement with particulate matter as keywords, we conducted topic and semantic network analysis using TEXTOM, R, and UCINET 6. Results: In topic analysis, behavior tips was the common main topic in both media before and after the policy enforcement. After the policy enforcement, influence on health disappeared from the main topics due to increased reports about reduction measures and government in mass media, whereas influence on health appeared as the main topic in social media. However semantic network analysis confirmed that social media had much number of nodes and links and lower centrality than mass media, leaving substantial information that was not organically connected and unstructured. Conclusion: Understanding of particulate matter policy and implications influence health, as well as gaps in the needs and use of health information, should be integrated with leadership and supports in the nurses' care of vulnerable patients and public health promotion.

Clinical assessment of various imaging systems for dental plaque scoring after the use of 3 different toothpastes

  • Simge Meseli;Sergen Ekenel;Bora Korkut;Burak Aksu;Dilek Tagtekin;Funda Yanikoglu
    • Imaging Science in Dentistry
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    • 제53권3호
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    • pp.209-216
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    • 2023
  • Purpose: This study was conducted to compare dental plaque scores obtained through clinical examinations and various imaging techniques, as well as to assess the effectiveness of herbal and conventional toothpastes for plaque removal. Materials and Methods: Thirty volunteers were divided into 3 groups. Each group was given a different toothpaste (from 2 herbal toothpastes and a conventional toothpaste) with which to brush their teeth for 21 days. Both initially and after brushing, dental plaque samples were collected, and plaque on the buccal surfaces of anterior teeth was scored using several imaging systems after staining with a disclosing agent. Specifically, digital dental photography, intraoral digital scanning, and FluoreCam imaging were employed to capture intraoral images. The Turesky Modified Quigley-Hein Plaque Index was used for clinical examination and image analysis. Quantitative polymerase chain reaction analyses and correlational assessments between clinical examination and imaging scores were conducted before and after toothpaste use. The Shapiro-Wilk test and Pearson correlations were utilized. Results: The lowest mean value was observed in the clinical examination without staining, while the highest was obtained using the FluoreCam method. No significant change was found in the level of any microorganism assessed following toothpaste use (P<0.05), with the exception of a decrease in S. mutans levels after using conventional toothpaste (P<0.05). Conclusion: Herbal toothpaste demonstrated plaque-removal effectiveness comparable to that of conventional toothpaste. The use of imaging methods for measuring plaque index has been suggested as a means to educate patients about plaque control and promote ongoing oral care.

폐렴환자에서 진동 공명 영상 검사(VRI)의 유용성 (Usefulness of Vibration Response Imaging (VRI) for Pneumonia Patients)

  • 박유진;박중희;홍미진;김원동;이계영;김순종;김희정;하경원;전규락;김현애;유광하
    • Tuberculosis and Respiratory Diseases
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    • 제71권1호
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    • pp.30-36
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    • 2011
  • Background: Pneumonia is commonly seen in outpatient clinics. it is widely known as the most common cause of death from infectious disease. Pneumonia has been diagnosed by its typical symptoms, chest X-ray and blood tests. However, both chest X-rays and blood tests have limitations in diagnosis. Thus primary care clinicians usually have been constrained due to a lack of adequate diagnostic tools. Vibration response imaging (VRI) is a newly emerging diagnostic modality, and its procedure is non-invasive, radiation-free, and easy to handle. This study was designed to evaluate the diagnostic usefulness of the VRI test among pneumonia patients and to consider its correlation with other conventional tests such as Chest X-ray, laboratory tests and clinical symptoms. Methods: VRI was performed in 46 patients diagnosed with pneumonia in Konkuk University Medical Center. VRI was assessed in a private and quiet room twice: before and after the treatment. Sensors for VRI were placed on a patient's back at regular intervals; they detected pulmonary vibration energy produced when respiration occurred and presented as specific images. Any modifications either in chest X-ray, C-reactive protein (CRP), white blood cell count (WBC) or body temperature were compared with changes in VRI image during a given time course. Results: VRI, chest X-ray and CRP scores were significantly improved after treatment. Correlation between VRI and other tests was not clearly indicated among all patients. But relatively severe pneumonia patients showed correlations between VRI and chest X-ray, as well as between VRI and CRP. Conclusion: This study demonstrates that VRI can be safely applied to patients with pneumonia.

효과적인 산전관리를 위한 고객관계관리(CRM)의 도입 (The Application of Customer Relationship Management for the Effective Prenatal Care)

  • 신숙;백수경;강성홍;김유미
    • 한국병원경영학회지
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    • 제10권1호
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    • pp.93-114
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    • 2005
  • The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

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급성기 뇌경색환자의 치료시기에 따른 단기 예후 평가 : NIHSS를 이용한 후향적 연구 (Short-term Prognosis according to Time of Treatment of Patients with Acute Cerebral Infarction : Measurement by NIHSS)

  • 박승찬;조승모;김도경;임지연;이재욱;홍진우;이인;이인선;김영균;권정남
    • 동의생리병리학회지
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    • 제26권6호
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    • pp.929-933
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    • 2012
  • This study was done to examine the prognosis according to onset and duration of treatment in acute ischemic cerebral infarction patients. We analysed NIHSS(National Institutes of Health Stroke Scale) score of acute ischemic cerebral infarction patients who visited department of Internal Korean Medicine, one medical center in Busan from January to December 2009. We divided patients into two groups by the initial time of treatment. Group A is admitted within 7 days, Group B is admitted from 7 to 14 days. We used NIHSS for functional recovery after 3 weeks later from admission day, and analyzed prognostic factor by analysis of covariance. All patients showed statistically significant improvement after 1week, 2weeks, 3weeks from admission, and between 1st week and 2nd week. However, there was no significant difference between 2nd week and 3rd week. NIHSS recovery score after 3weeks were analysed according to the timing of treatment. There was a statistically significant difference between two groups. The percentage of aggravated patients showed no statistically significant difference between the two groups. This study suggests that earlier admission care has an effect on functional recovery of patients with acute ischemic cerebral infarction. Further research on the large scale and long-term follow up is required.

신생아에서 비경구적 칼슘 글루코네이트 요법 이후의 의인성 피부 석회침착증 후 자연관해 (Spontaneous Resolution of Iatrogenic Calcinosis Cutis after Parenteral Calcium Gluconate Therapy in Neonates)

  • 송광순;이시욱;김두한;민경근;연창진
    • 대한정형외과학회지
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    • 제54권2호
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    • pp.192-196
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    • 2019
  • 저칼슘혈증은 신생아에서 흔하게 발견되며 대개 정맥 내 칼슘 투여를 통해 교정할 수 있다. 이 과정에서 발생할 수 있는 의인성 피부 석회화증은 칼슘 제제의 정맥 투여에 기인하는 것으로 알려져 있다. 저자들은 칼슘 글루코네이트의 혈관 외 유출로 인하여 신생아의 상지나 하지를 침범한 피부 석회화증 3예를 보고하고자 한다. 신생아 집중치료실에서 칼슘 글루코네이트의 정맥 내 투여와 관련하여 발생한 경화성 피부 결절을 보이는 생후 2주 여아, 생후 4주 남아 및 여아, 총 3명의 신생아가 협진 의뢰되었다. 초기 발견 후 각각 3주, 4주, 6개월에 방사선 사진 및 신체 검진상 만져지는 결절과 석회화의 완전한 관해가 이루어졌다. 또한 3명 모두에게서 점진적인 치유양상을 보였으며 기능적, 미용적 합병증은 발생하지 않았다. 환자들의 일반 양성 질환에 대한 인식이 높아짐에 따라 의인성 피부 석회침착증의 조기 진단을 내리고, 질환에 대한 충분한 설명과 이해를 바탕으로 불필요한 치료를 피함으로써 의료 과실 분쟁을 줄일 수 있을 것으로 생각된다.

준 만삭 이상아에서 폐표면 활성제 보충요법의 성적 (The outcome of surfactant replacement therapy in above nearterm neonates with severe pulmonary disease)

  • 손수민;이보영;김천수;이상락;권태찬
    • Clinical and Experimental Pediatrics
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    • 제50권12호
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    • pp.1200-1205
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    • 2007
  • 목 적 : SRT는 주로 RDS이 있는 미숙아에서 시행되어 왔다. 저자들은 폐질환을 주소로 인공 환기 요법이 필요했던 재태 주령 36주 이상의 신생아에서 폐표면 활성제를 이용한 보충요법의 투여 성적를 알아보고자 본 연구를 시행하였다. 방 법 : 1999년 7월부터 2004년 6월까지 계명대학교 동산의료원 신생아 집중치료실에 입원한 후 폐질환을 주소로 인공 환기 요법을 받았던 재태 주령 36주 이상의 환아 중 SRT를 시행 받았던 48명의 환아를 대상으로 원인 질환에 따라 MAP군과 RDS군 그리고 PN군으로 나누어서 후향적으로 의무기록을 분석하였다. 모든 대상 환아들에서 SRT를 시행하였으며 폐표면 활성제(Newfacten: 유한양행, Seoul, Korea)는 120 mg을 생리식염수 2-4 mL에 용해하여 평균 120 mg/kg 용량으로 투여하였는데, RDS 군에서는 투여 6시간 후에도 임상적 호전이 미약할 때는 1회 더 투여하였다. 각 군에서 폐표면 활성제 사용 전 후의 임상지표(흡입 산소 농도 및 산소화 지수)와 폐표면 활성제 투여 시점으로부터의 총 인공 환기기 사용 및 산소 투여 기간을 알아보았으며 성적(합병증 및 생존율)를 분석하였다. 결 과 : 총 48례의 환아 중 MAP 군: 15명, RDS 군: 27명, PN 군: 6명 이었다. 폐표면 활성제 투여 전의 산소화 지수는 MAP 군이 $21.8{\pm}3.2$, RDS 군에서 $18.3{\pm}4.5$, PD 군에서 $18.6{\pm}6.0$였고, SRT 후 12시간째의 산소화 지수는 MAP 군이 $8.61{\pm}6.75$, RDS 군에서 $4.98{\pm}0.69$, PD 군에서 $5.8{\pm}1.19$로 통계적으로 유의하게 개선되었다(P<0.05). 총 인공 환기기 사용기간은 MAP 군이 $4.9{\pm}1.2$일, RDS 군이 $5.5{\pm}2.8$일, PN 군이 $7.2{\pm}4.8$일 이었고 산소 투여기간은 MAP 군이$9.4{\pm}1.7$일, RDS 군이 $8.8{\pm}3.5$일, PN 군이 $10.3{\pm}5.6$일 이었다. 기흉, 신생아 폐 고혈압 지속증 등의 합병증 발생은 MAP 군에서 20%, RDS 군에서 25.9%, PD 군에서 50%로 나타났으며, 이중 RDS 군에서 SRT를 처음 시행한 시간에 따른 합병증의 발생 정도는 생후 12시간 전에 시행한 경우의 발생률이 15례 중 2례(13.3%)로 12시간 이후에 시행한 경우의 12례 중 7례(58.3%) 보다 유의하게 낮았다(P<0.05). 생존율은 MAP 군이 86.7%, RDS군과 PN 군이 모두 100%로 모든 군에서 양호한 예후를 보였다. 결 론 : 중증 폐 질환을 주소로 인공 환기 요법이 필요한 임신기간 36주 이상의 준 만삭 이상아에서의 폐표면 활성제 보충요법은 좋은 임상경과를 가지며 특히 RDS인 경우 생후 12시간 내 투여가 합병증을 줄여서 치료성적의 향상에 도움이 될 것으로 사료된다.

만성적인 신체질환이 있는 노인 환자의 우울증 조기발견을 위한 병원기반 모델 (A General Hospital-Based Model for Early Detection of Depression in the Geriatric Patients with Chronic Medical Diseases)

  • 박선철;이화영;이동우;한상우;박상호;김여주;최재성;정성원;이소영;나경세;권영준
    • 생물정신의학
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    • 제20권2호
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    • pp.31-39
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    • 2013
  • The geriatric patients with chronic physical diseases are frequently associated with the continuous clusters of depression including nonpathological sadness, subsyndromal depression, minor depressive disorder, and major depressive disorder. Because of the complex and reciprocal relationships among depression, elderly, and chronic physical diseases, screening approaches with specific nosological methods should be needed in the realm of early detection of depression. Cognitive decline is frequently manifested in geriatric depression with medical or neurological diseases. Also, somatic symptoms of depression or emotional symptoms of physical diseases can play a role as a hampering factor in the early detection of depression. Furthermore, after-care has been regarded as an essential factor of depression screening in the geriatric patients with chronic physical diseases. We reviewed the most popular examples of integrated medicine for depression in primary care. Thus, we propose a general hospital-based model for early detection of depression which includes favorable response loop between screening and therapeutic intervention. Our model can be a basis for evidence-based detection and after-care for depression in the geriatric patients with chronic medical diseases.

손마사지가 허혈성 심질환 환자의 불안에 미치는 효과 (The Effect of Hand Massage Program on Anxiety in Patients with Ischemic Heart Diease)

  • 현경선;이향련;공송심;윤경자;김현섭;김효남;최지원;김운정
    • 성인간호학회지
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    • 제13권2호
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    • pp.340-349
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    • 2001
  • The purpose of this study was to investigate the effect of a hand massage program on anxiety, vital sign and pain in clients with ischemic heart disease. The design utilized for this study was quasi-experimental with a nonequivalent control group non-synchronized design The subjects were fifty-four patients, twenty-eight for the experimental and twenty-six for the control group, who were admitted with ischemic heart diease at a cardiac intensive care unit in K medical center of K university. This study was carried out from May, 1999 to March, 2000. The level of anxiety and pain measured by Visual Analogue Scale, systolic blood pressure, diastolic blood pressure and pulse rate were measured before and after hand massage, the state of Anxiety was measured by the Spielberger (1970) scale at admission and after hand massage for three days. The collected data were processed by using the SPSS PC program and analyzed using $\chi^2$-test and t-test. The result of this study are as follows : 1. The scores of VAS anxiety and State of anxiety of the experimental group were lower than those of the control group. 2. The degree of systolic blood pressure, diastolic blood pressure and pulse rate of the experimental group were lower than that of the control group. 3. The score of VAS pain of the experimental group was lower than that of the control group. The results suggested that hand massage can decrease VAS anxiety, State of anxiety, vital signs and VAS pain of patients who were admitted with ischemic heart disease at cardiac intensive care unit Therefore, it is proposed that hand massage is an appropriate nursing intervention to relieve anxiety of the patients who were admitted with ischemic heart disease at a cardiac intensive care unit.

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의료전달체계 변경이 3차 의료기관 안과에 미친 영향 (The effect of change of mandatory referral system in an ophthalmology of tertiary care medical institution)

  • 김양수;유승흠;오현주;권오웅
    • 한국병원경영학회지
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    • 제7권1호
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    • pp.88-104
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    • 2002
  • According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

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