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The Effects of Discharge Planning for the Elderly with Pulmonary Disease in the Emergency Room (퇴원계획중재가 응급실 내원 호흡기 질환 노인의 퇴원준비도, 간호서비스 만족도, 재입원율에 미치는 효과)

  • Kim, Hyeon-Ju;Park, Yeon-Hwan
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.24-32
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    • 2014
  • Purpose: The purpose of this study was to examine the effects of discharge planning on patient satisfaction, the readmission rate and preparedness for discharge in the elderly admitted to the emergency room (ER) for pulmonary disease. Methods: A quasi-experimental intervention study design was used. Older adults with pulmonary health problems in the ER in one general hospital were randomly allocated to either an experimental (n=21, 74.2 years) or control group (n=19, 70.7 years). The experimental group participated in a discharge planning program by a geriatric nurse practitioner. Data were collected from medical records, physical measurements and structured questionnaires including information on demographics, patient satisfaction, readmission, and preparedness for discharge. Results: Participants in the experimental group had significantly better outcomes with regard to patient satisfaction with nursing services (p=.003) and preparedness for discharge (p=.034). However, there was no significant effect on the readmission rate (p=.392) Conclusion: The results suggested that a discharge planning program could bolster nursing service satisfaction and preparedness for discharge in older patients admitted to the ER for pulmonary health problems. To clarify the effects of discharge planning on older patients admitted to the ER, a larger sample population, better instruments for various measures, a new manual on discharge planning and frequent follow-up will be necessary.

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Epidemiology of Esophageal Cancer in Ardabil Province During 2003-2011

  • Amani, Firouz;Ahari, Saeid Sadeghieh;Akhghari, Lyla
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4177-4180
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    • 2013
  • Background: The aim of this research was to perform an epidemiologic survey of esophageal cancer in Ardabil province. Materials and Methods: In this cross-sectional descriptive study, 661 patients diagnosed with EC were studied from March 2002 to May 2011 e. The necessary data were collected with a checklist from the documents in Ardabil Cancer Registry (ACR) and analyzed by statistical methods with SPSS.18 software. Results: Of the total new cases of EC registered in ARC during study period, 430 (65.1%) of patients were male with the male to female standard ratio was 1.18, with a statistically significant gender bias. The most common morphology of EC was squamous cell carcinoma (SCC, 68.8%) followed by adenocarcinoma (28.5%). It was observed that in most of patients, EC lesions were in the middle third of esophagus. In addition, most patients were rural and about 40% had smoking habits. The age-standardized incidence rate of cancers was 48.4 per 100,000 among females and males. The annual incidence rates in males and females was 7.1 and 6.7 per 100,000; respectively. Conclusions: Results showed that the prevalence and annual incidence rate of cancer in Ardabil province is lower than other areas of the country with a male predominance and a relatively high proprortion of adenocarcinomas.

Prescription Characteristics of Medication for Acute Respiratory Diseases before and after Pay-for-Performance -using National Health Insurance Big data- (의원 가감지급사업 실시 전후에 따른 급성호흡기계질환의 의약품 처방특성 -국민건강보험 빅데이터를 활용하여-)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.14 no.1
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    • pp.93-102
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    • 2020
  • Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.

The Infant and Child Growth Assistance System Based on a Smartphone

  • Byun, Ki-Won;Kang, Joon-Gyu
    • Journal of the Korea Society of Computer and Information
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    • v.21 no.8
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    • pp.95-103
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    • 2016
  • Food habit forming the basis for a lifetime of food and nutrient intake is established in early childhood and has an effect to the child's growth, sociality, and obesity. A variety of nutrition screening tools exists for assessing the health and nutrition status of children such as the Growth Curve, for determining if growth is appropriate. Body mass index(BMI) as a more reliable index of overweight to prevent childhood obesity, and Nutrition Quotient(NQ) and eating behaviors questionnaire for young children and parents to estimate their nutrient intake adequate or not. Such tools are mainly used by health practitioners, such as doctor and dietitian to provide nutrition intervention services to children at risk, especially and are not easy to use for general parents, who need assessment at any time and at any place. We propose Growth Assistance System for infants and children, which is possible to assess their physical condition, nutritional status, and eating behavior integrated. To be convenient and portable, it is implemented over the smartphone as an application. The system offers the growth charts, the BMI curves, NQ and eating behavior questionnaire to take a monitoring and the functionalities operate well. We hereby expect this system support the normal growth and development of infants and young children. And also support for the health practitioner (dietitians and nutritionists) to take a role in providing nutrition counseling and education to children needing nutrition services.

A Study on the Factors Affecting Self-Regulation Program for the Hypertensives in Rural Area (농촌지역 고혈압 환자를 위한 자기조절 프로그램 관련 요인 연구)

  • Park, Young-Im;Jun, Myung-Hee
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.202-213
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    • 2001
  • This study was conducted to identify the changes of the relationship among general characteristics, self-efficacy. and self-care of the hypertensives in rural area. For this purpose, self-regulation program was carried at two Community Health Practitioner Post located in the suburbs of Daejeon City from September to November. 1999. Data were analyzed with non-parametric statistics, t-test, pearson correlation. The results were as follows; 1. The level of self-care was significantly different according to sex, status of smoking, and the level of self-efficacy of non-smoker was significantly higher than smoker. 2. After self-regulation program, there were significant positive relationship among self-efficacy, self-care, internal locus control, and negative relationship between perceived barrier and self-care. From these results, it can be concluded that the self-regulation program is an effective nursing strategy to promote self-care performance of hypertensives in rural area, and this program can be recommended for the management of hypertensives.

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Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

  • Rodrigues, Evaldo;Braitt, Antonio Henrique;Galvao, Bruno Ferraz;da Silva, Emmanuel Joao Nogueira Leal
    • Restorative Dentistry and Endodontics
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    • v.42 no.1
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    • pp.60-64
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    • 2017
  • Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

Prescription Characteristics of Antibiotics for Clinical Subjects of Acute Respiratory Infection Outpatients -Using National Health Insurance Big Data- (급성호흡기감염 환자의 표시과목별 항생제 처방특성 -국민건강보험 빅데이터를 활용하여-)

  • Gong, Mi-Jin;Hwang, Byung-Deog
    • The Korean Journal of Health Service Management
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    • v.13 no.4
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    • pp.121-132
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    • 2019
  • Objectives: This study analyzed the prescription antibiotics characteristics of Acute respiratory infection outpatients. It provides a basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods: The research data were collected from the National Health Insurance Corporation's 2014 sample cohort for Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics classification of diseases codes J00-J06, J20-J22, J40 outpatients. Results: The antibiotic prescription rate on the evaluation project for appropriate prescribing indicators of Health Insurance Review & Assessment Service was 43.54%, whereas in this study it was about 10% higher because the analysis targeted the entire acute respiratory infection diagnosis. Conclusions: There is a need to identify the correct antibiotic prescription by expanding the current assessment standard. Such standard must include acute lower respiratory infections and minor diagnosis because current evaluation projects on appropriate prescribing indicators targets only the major diagnosis of acute upper respiratory infection.

Endocrown restorations for extensively damaged posterior teeth: clinical performance of three cases

  • Tzimas, Konstantinos;Tsiafitsa, Maria;Gerasimou, Paris;Tsitrou, Effrosyni
    • Restorative Dentistry and Endodontics
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    • v.43 no.4
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    • pp.38.1-38.9
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    • 2018
  • The restoration of endodontically treated teeth (ETT) with more than one cusp missing and thin remaining walls is challenging for the general practitioner. The use of posts combined with full coverage restorations is a well-established approach, yet not following the minimal invasive principles of adhesive dentistry. Endocrowns are indirect monoblock restorations that use the pulp chamber of the ETT for retention. In this study the fabrication of 4 endocrowns and their clinical performance will be discussed. Two clinical cases include computer-aided design/computer-aided manufacturing manufactured molar endocrowns (one feldspathic ceramic and one hybrid composite-ceramic restoration) and the other two are dental laboratory manufactured resin composite premolar endocrown restorations. The modified United States Public Health Service criteria were used to assess the clinical behavior of the restorations at different follow up periods. Endocrown restorations present a satisfactory clinical alternative, either by the use of resin composite or glass ceramic and hybrid materials. Specific guidelines with minimal alterations should be followed for an endocrown restoration to be successful. Due to limited evidence regarding the long term evaluation of this restorative technique, a careful selection of cases should be applied.

Native 1st Metatarso-Phalangeal Joint Infection: A Rare Case Report

  • Iliopoulos, Efthymios;Hossain, Natasha;Bendall, Stephen
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.2
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    • pp.67-70
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    • 2019
  • Septic arthritis is a serious medical condition that can lead to significant complications if misdiagnosed or mismanaged. A rare case of a 1st metatarso-phalangeal joint septic arthritis in a native joint is presented in a patient with no significant risk factors. A 41-year-old patient was referred by his general practitioner owing to ongoing pain and swelling over his native 1st metatarso-phalangeal joint with difficulty on weightbearing for three months. After a series of investigations, including blood tests and a foot magnetic resonance imaging, which were inconclusive, the patient was led to the operating theatre for sampling and washout of his joint. The samples taken in the theatres revealed septic arthritis with Streptococcus mitis as the causative microorganism. The patient was treated with six weeks of oral antibiotics with a good functional outcome. This case report illuminates this rare condition and makes foot and ankle surgeons aware of its existence. A high suspicion for this condition can prevent misdiagnosis and mismanagement.

Effects of the Nuegra from Male Silkworm Extract on Enhancement of the Masculine Function and Activation of Overall Physical Function

  • Kim, D. C.;Kim, Y. W.;Park, M. S.;J. K. Suh;Lee, D. S.;Lee, S. H.;B. H. Chun;Y. K. Jun
    • International Journal of Industrial Entomology and Biomaterials
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    • v.5 no.1
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    • pp.109-122
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    • 2002
  • The purpose of this investigation is to evaluate the effects of the Nuegra on enhancement of the masculine and physical activities in general through measuring changes of the testosterone, FSH and subjective symptoms like fatigue, insomnia, urinary stream, muscular weakness, libido and erectile dysfunction. Total 168 male subjects were enrolled from 12 urology, internal medicine clinics and general practitioner, During the 6-week investigational period, 2 capsules of Nuegra were given to the subjects right after meal for 4 weeks, and 1 capsule of Nuegra was added each time in subjects with no or minimal effect. Testoster-one and FSH levels were measured at first visit and last visit, for evaluating masculine activities. To avoid bias and standardize the test results, only one clinic was assigned as a central lab, and all blood samples were transferred. General information and subjective symptoms were evaluated at first visit and at 2 weeks interval, week 2, 4 and 6 using VAS (Visual Analogue Scale). The mean age of the subjects were 51.8${\pm}$8.2 years old (range: 36.1-82.1). Based on the subjects who were tested on testosterone and FSH levels at day l and week 6, the means were 4.4${\pm}$1.4 nmol/L (range: 2.6-7.7), 8.6${\pm}$9.6 mIU/mL (range: 0.3-40.4), respectively at day 1. At week 6, the results were 4.9 ${\pm}$1.6 (2.6-8.9 range), 9.4${\pm}$13.1 (1.0-53.9 range), respectively. Marginally significant difference between pre-dose and post-dose was present. Statistically significant differences were revealed in general assessment for subjective symptoms, fatigue, insomnia, erectile dysfunction, etc. In fatigue, response rates were 39.6, 65.4 and 76.4% at week 2, 4 and 6, respectively (P < 0.0001). Response vates for erectile dysfunction were 13.4, 41.2 and 72.7% at week 2, 4, and 6 (P < 0.0001), respectively, Response rates for libido were 13.6, 51.6 and 73.5% at week 2, 4, and 6 (P < 0.0001), respectively. For urinary stream response rates were 26.9, 44.7 and 66.8% at week 2, 4, and 6 (P < 0.0001), respectively. VAS for muscular weakness did not show significant results that response rates were 40, 60 and 80% at week 2, 4, and 6 from 8.2 (P = 0.24), respectively. Response rates for insomnia were 50, 60, 100% at week 2, 4, and 6 (P < 0.0001), respectively. The results shows that Nuegra tends to enhance masculine activities including libido, erectile dysfunction and urinary stream and also effective for improving general conditions especially insomnia, muscular weakness and fatigue. In conclusion, this investigation has demonstrated that Nuegra does not only have tendency to increase masculine activities through increased secretion of the testosterone and FSH but also improve general conditions such as erectile dysfunction, libido, fatigue and muscular power.