• Parasites, Hosts and Diseases
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• 제57권5호
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• pp.499-504
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• 2019

Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

• 성인간호학회지
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• 제15권1호
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• pp.116-125
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• 2003

Purpose: This study was to evaluate the importance of liver cancer patient's diet and to provide guideline materials for proper nursing intervention. Method: The hermeneutic phenomenological method of van Manen was applied for the in-depth interview of liver cancer patients and the cultural background studies including linguistic, literary and art works to enhance the insight and understanding, from which the meaning of the cognition and lesson of the experiences were extracted. The participants for this study were five male patients, who had been diagnosed with liver cancer, 5-15 years ago and had been treated with Transcatheter Arterial Embolization without chemotherapy. The repeated interview and close observation were carried out for nine months starting from January 2001 in Seoul, Korea. Result: Eight essential themes were emerged ; (1) confliction(frustration) with hospital treatment (2) trial of every possible remedies (3) liking unpolluted natural foods(4) faithful tolerance (5) experiencing diet effectiveness (6) discovering personal control methods (7) deepen their faith in God (8) searching for healthy new life. Conclusion: The alternative diet therapy influenced their life beyond the physical overcoming of cancer toward psychological and spiritual healing. The study evidenced the necessity for scientific research and education on the effectiveness and application of complementary and alternative diet therapy for the treatment of cancer in hospital practices.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• 대한간호학회지
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• 제31권1호
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• pp.7-19
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• 2001

In our country, patients with diabetes mellitus are searching for complementary treatments to recover from illness, while they received treatments from the doctor. However, have been evaluated or investigated systematically. This study was carried out to explore application of complementary treatments for patients with DM. For this survey, questionnaires were developed by researchers and the data was collected from July to October of 1999. Among the 223 subjects, there is one general hospital, one oriental hospital, 15 area C.H.P, ahd 2 area health centers. The results were as follows: 1. The total number of cases was 223 and the average age was 62.85 years old and average duration of DM was 8.1 years. The number of patients who had experience with alternative therapies was 145 (65%). The number of those who have not undergone treatments was 78 (35%). 2. The 43.5% of experienced CAM were advised family and relatives. Only 30.3% approved the effect of CAM and 52.5% said that If another a new CAM is introduced, they will try it. 4. Ninety three kinds of complementary treatments were used. Among the used items, 63.7% was various types of plants, 21.6% was animal material and 14.7% was the mixed group. As a single item, Bombyx Mori (Silkworm) was the most frequently used (10.5%) followed by the bean, mushroom, Morus bombycis (mulberry), Ginseng, Commelina Communis (Dalgaebi), Chinese medicine, root of Rosa rugosa (Haedangwha). 5. Among the used items, Trichosanthes kirilowii Max. Eucommia ulmoides Oliver, Commelina Communis, Aralia elata, pine needle, mulberry fruit, root of Rosa rugosa. Ginseng, Lycii Fructus, Dioscorea radix, Polygonatum odoratum, Cassia tora L, Bombyx Mori, loach, Crucian carp were based upon the pharmacological function of effect for control of diabetes mellitus symptom. 6. In the analysis of the relationships between the general characters of the patients with new complementary alternative medicine try and hospital treatment; 1) The shorter group suffered from DM (p=.038), poor Self-MBG (p=.037) and wanted to try new complementary alternative medicine. 2) The group of DM education experience were carried out hospital treatment well (p=.045). In conclusion, further study will be required for the patients experience using alternative therapies as the D-M in terms of holistic view of patients.

• 음성과학
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• 제7권2호
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• pp.19-35
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• 2000

Speech evaluation and treatment planning for the patients with articulation disorders have traditionally been based on perceptual judgement by speech pathologists. Recently, various computerized speech analysis systems have been developed and commonly used in clinical settings to obtain the objective and quantitative data and specific treatment strategies. 10 dysarthric children (6 neurogenic and 4 functional dysarthria) participated in this experiment. Speech evaluation of dysarthria was performed in two ways; first, the acoustic analysis by Visi-Pitch and a Computerized Speech Lab and second, the perceptual scoring of phonetic errors rates in 100 word test. The results of the initial evaluation served as primary guidlines for the indivisualized treatment planning of each patient's speech problems. After mean treatment period of 5 months, the follow-up data of both dysarthric groups showed increased maximum phonation time, increased alternative motion rate and decreased occurrence of articulatory deviation. The changes of acoustic data and therapeutic effects were more prominent in children with dysarthria due to neurologic causes than with functional dysarthria. Three cases including their pre- and post treatment data were illustrated in detail.

• 상하수도학회지
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• 제26권4호
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• pp.579-589
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• 2012

To reduce extensive energy costs of the internal recycling for the purpose of denitrification in the advanced wastewater treatment, a post-treatment process using an electro-coagulation to treat nitrate in the secondary effluents is evaluated in this study. Removals of phosphorus and organics in the secondary effluents by the electro-coagulation were also evaluated to propose an alternative advanced wastewatert treatment process. A series of experiments of the electro-coagulation were carried out with the following 4 different samples: synthetic solution containing nitrate only, synthetic solution containing nitrate as well as phosphorus, secondary effluents from activated sludge cultivated in laboratory, and secondary effluents from real wastewater treatment plants. Removals of nitrate and phosphorus in the synthetic solution were 30 and 97 % respectively, which verified the feasibility of the process. Removals of nitrate, phosphorus and COD in the secondary effluents from the cultivated sludge in laboratory were 49, 90 and 19 % respectively. Removal efficiency of the total nitrogen, nitrrate, phosphorus and COD in the secondary effluent from real wastewater treatment plant were 50, 61, 98 and 80 % respectively. The removal of the total nitrogen was less than the nitrate as expected, which is due to the formation of ammonia nitrogen in the cathode. But the proposed scheme could be an energy saving and alternative process for the advanced wastewater treatment if further studies for the process optimization are carried out.

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.97-100
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• 2015

Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.

• 정신신체의학
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• 제6권1호
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• pp.70-78
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• 1998

Alternative medicine is defined as the practices used for the prevention and the treatment of diseases that are not taught widely in medical schools, nor generally available inside hospitals. Alternative medicine or therapy is of growing interest to the general public. We conducted a survey to determine the prevalence and patterns of using alternative medicine such as herbal medicine acupuncture, folk medicine, health food and diet, yoga, qi therapy, shiatsu, chiropractics, homeopathy etc.. Based on 794 completed questionnaires, 484 respondents(61%) reported using at least one form of alternative medicine for their medical problems. The major medical conditions for which they used alternative medicine were back pain(85.6%), arthritis(85.4%), hypertension(85.2%), cerebrovascular disorders(86.4%), and insomnia(84.6%). The types of alternative medicine frequently used were herbal medicine, acupuncture, folk medicine, and health food. The reasons why the vast majority of people sought after alternative medicine was that: less side-effect, it is not harmful, it is more effective, there is a shorter waiting time, and a better explanation fur the conditions and a kinder therapist. We found that the frequency of using alternative medicine in the health care system was high. Physicians need to be more aware that many patients may be using alternative medicine. Further survey of the nation-wide prevalence of alternative medicine, and scientific study into the efficacy of this medicine should be followed. In the meantime, we suggest paying attention to possible harmful effects caused by some sorts of alternative medicine.

• 대한수학교육학회지:학교수학
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• 제10권3호
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• pp.357-374
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• 2008

본 연구는 현재 고등학교 1학년에서 처음 소개되는 복소수 단원의 복소수의 정의와 연산, 그 연산에 대한 성질 등 교과서의 서술 방식이 학생들의 '수준'과 교육과정의 흐름에 맞게 논리적으로 서술되어 있는지 알아보고자 하였다. 여기서 학생들의 '수준'이란 실수에서 복소수로의 새로운 수 체계의 확장에 따른 대수적 구조를 파악하고 이해할 수 있는 수준으로 가정한다. 즉, 고등학교 1학년 교과서 전반의 전체적인 흐름을 볼 때 복소수 단원의 목표는 새로운 수의 확장에 따른 대수적 구조의 보존을 이해하고 파악하는 것이므로 이러한 목표에 맞게 복소수의 정의와 연산, 그 연산에 대한 성질이 교과서에서 서술되는 방식이 수학적인 입장에서 보았을 때 논리적인 비약(gap)이나 순환논증의 오류를 가지지 않고 적절하게 서술하고 있는지를 살펴보고자 한 것이다. 본 연구는 이런 관점에서 16종 교과서를 분석하여 크게 다섯까지의 분석 대상을 찾아내었다. 첫째는 허수 단위 i의 도입과 음수의 제곱근, 둘째는 복소수의 정서방식에서 실수와 순허수의 정의 방식, 셋째는 복소수의 사칙 연산, 넷째는 복소소의 연산에 관한 성질에서의 대소 관계와 역원의 표현 방법, 마지막으로 대수적 구조의 보존에 관한 것이다. 본 연구에서 주요 관점에서 살펴본 위의 5가지 대상에 관한 교과서의 서술방식은 논리적 정확성의 문제와 순환논리의 오류가 생길 수 있는 가능성이 있다고 판단되었고, 연구자가 일부 논리적 비약(gap)으로 판단한 것이 있는데, 이는 오류가 아닐 수 있으나 학생들이 이해하는 데에 있어 논리적으로 전후가 맞지 않는 전개과정 이라고 판단되었기 때문이다.

• 근관절건강학회지
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• 제4권2호
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• pp.177-196
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• 1997

This study was undertaken to explore the antecedent factors and process of the treatment-seeking behaviors of medical and alternative treatments in patients with arthritis using methodological triangulation. The data were collected from 995 arthritic patients who were registered either in a center of rheumatology for medical treatment or residents of community having no treatment to classify different treatment patterns. Sixteen patients with various types of treatment only, alternative treatment only, and no treatment were selected among the total samples to identify the antecedent factors through in-depth interview. The quantitative data were analyzed by percentile, t-test, chi-square test and discrimant analysis using SAS PC program, while the qualitative data were analyzed by means of grounded theory methodology. Treatment-seeking behaviors of patients change from the early stage to the sick-role stage. At the early stage, initial characteristics of pain and acculturation of medical professionalism affect the choice of treatment patterns. The acculturation of medical professionalism is affected by health care accessibility, level of education, duration of sickness and lay referral system. At the sick-role stage, lay referral system and acculturation of medical professionalism affect the choice of treatment patterns. The acculturation of medical professionalism is affected by characteristics of symtoms, perceived treatment effects, perceived causes of diseases and socio-economic status as well as health care accessibility, level of education and lay referral system. In conclusion, different factors as well as common factors are influencing the treatment-seeking behaviors depending on the disease and treatment stages. More detailed further studies are required to explore the value system or medical acculturation of patients which is one of the most important factors in decision-making about treatment modalities.