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Factors affecting the rehabilitation center exit and reentry among homeless persons with mental illness. (정신장애노숙인의 재활시설 퇴소 및 재입소 영향요인에 관한 연구)

  • Min, So-Young;Lee, Byung-Suk
    • Korean Journal of Social Welfare Studies
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    • v.42 no.1
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    • pp.219-242
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    • 2011
  • This study examined the factors associated with exit from and reentry into the rehabilitation center among homeless persons with mental illness. Shelter use of a total of 203 study population was monitored between 2004 and 2008. Cox's proportional hazard model was employed to analyze the factors influencing the rate of the first exit from and the first reentry into the rehabilitation center. Also, competing risk analysis was conducted to examine the factors differently associated with the type of the first exit from the rehabilitation center: a positive exit and a negative exit. This study found that homeless persons with mental illness were less likely to experience the negative exit while their resident registration status not being abolished on the first entry into the rehabilitation center, having more frequent hospitalizations during the rehabilitation center stay, being connected to the family members, having more participations into the basic rehabilitation, mental rehabilitation, and vocational rehabilitation programs during the rehabilitation center stay. Age, the number of hospitalization and of the participations into the mental rehabilitation programs during the rehabilitation center stay were associated with the rate of the first reentry into the rehabilitation center.

The Effects of Medical Service Quality for the Main Caretaker of Patients at the Convalescent Hospital for Seniors on Customer Loyalty (주보호자가 지각하는 요양병원 서비스품질이 고객충성도에 미치는 영향)

  • Choi, Dong-choon
    • Journal of Venture Innovation
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    • v.6 no.4
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    • pp.133-151
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    • 2023
  • The purpose of this study is to examine the correlation between medical service quality, customer trust, customer satisfaction and customer loyalty in domestic convalescent hospitals. Participants in this research were individualis who assumed responsibility for being the main caretaker of patients that were in hospitalization The following main results were derived. First, among the quality of medical services, tangibles, realiability, responsiveness, empathy were found to have a significant positive effect on customer trust. Second, among the quality of medical services, tangibles, realiability, responsiveness, assuracne, empathy were found to have a significant positive effect on customer satisfaction. Third, among the quality of medical services, only realiability variable were found to have a significant positive effect on customer loyalty. This result means that customer satisfaction and customer trust plays a mediating role between the medical service quality and loyalty. Fourth, customer trust was found to have a significant positive effect on customer loyalty. Fifth, customer satisfaction was found to have a significant positive effect on customer loyalty.

A Case Report of Korean Medicine Treatment for a Patient with Left Facial Paraesthesia, Temporomandibular Joint Pain, and Post-traumatic Neck Pain induced by Cerebral Infarction (뇌경색으로 유발된 좌측 안면부 이상감각, 턱관절 및 후경부 통증 환자에 대한 한의학 치료 1례)

  • Tae-ha Kwon;Min-joo Kim;Dong-soo Seol;Min-seok Go;Min-ji Lim;Seong-hyun Lee;Sae-young Bong;Da-woon Song;Yeon-hoo Yi;Yoo-jin Lee;Cha-young Lee;Joo-hee Oh
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.904-910
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    • 2023
  • Objectives: The aim of this case report is to present the effects of Korean medicine treatment in a patient with left facial paraesthesia, temporomandibular joint (TMJ) pain, and post-traumatic neck pain induced by cerebral infarction. Methods: A 26-year-old male patient was treated with Cheongpa-Jeon H, acupuncture, pharmacopuncture (Shinbaro2), and Chuna Therapy for 24 days of hospitalization. Left facial paraesthesia, TMJ pain, and post-traumatic neck pain were assessed with a Numeric Rating Scale (NRS) and EuroQoL-5 Dimension (EQ-5D). Post-traumatic neck pain was assessed using the Neck Disability Index (NDI). Results: After 24 days of treatment, the patient's left facial paraesthesia and left arm tingling sensation were relieved from NRS 6 to NRS 2. Left TMJ pain was reduced from NRS 5 to NRS 2. The EQ-5D score increased from 0.138 to 0.73. The NDI score decreased from 71.11 to 37.78. Conclusion: These results show that left facial paraesthesia, TMJ pain, and post-traumatic neck pain can be relieved with Korean medicine treatment. However, further well-designed studies are required to confirm these findings.

Effects of Health Perceptions and Social Support on Health Promotion Behaviors among College Students: the Mediating Effect of Self-efficacy (대학생의 건강지각, 사회적 지지가 건강증진행위에 미치는 영향: 자기효능감의 매개효과)

  • Su Jeong Park;A Reum Lee;Byoung Gil Yoon;Jung Hee Park
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.6
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    • pp.461-469
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    • 2023
  • We attempted to identify the mediating effect of self-efficacy on the relationship between health perception, social support, and health promotion behaviors among university students and to provide basic data to improve health promotion behaviors. Data were collected using a structured questionnaire from a sample of 173 university students in City C. Health promotion behaviors according to general characteristics were found to have statistically significant differences in gender(t=3.892, p<.001) and major satisfaction(F=5.867, p=.003) .There was no statistically significant difference in age, grade, major field, hospitalization or surgery experience in the last three years, and economic activity. Health promotion behavior was positively correlated with health perception (r=.439, p<.001), social support (r=.532, p<.001), and self-efficacy (r=.533, p<.001) and was statistically significant. It was found that self-efficacy had a partial mediating effect (Z=3.964, p<.001) on the effect of health perception on health promotion behavior, and self-efficacy had a partial mediating effect (Z=4.24, p<.001) on the effect of social support on health promotion behavior. Therefore, it is necessary to identify the factors affecting health support, social support, and self-efficacy among college students and prepare intervention measures to improve health promotion behavior.

Development of a Prediction Model for Fall Patients in the Main Diagnostic S Code Using Artificial Intelligence (인공지능을 이용한 주진단 S코드의 낙상환자 예측모델 개발)

  • Ye-Ji Park;Eun-Mee Choi;So-Hyeon Bang;Jin-Hyoung Jeong
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.16 no.6
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    • pp.526-532
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    • 2023
  • Falls are fatal accidents that occur more than 420,000 times a year worldwide. Therefore, to study patients with falls, we found the association between extrinsic injury codes and principal diagnosis S-codes of patients with falls, and developed a prediction model to predict extrinsic injury codes based on the data of principal diagnosis S-codes of patients with falls. In this study, we received two years of data from 2020 and 2021 from Institution A, located in Gangneung City, Gangwon Special Self-Governing Province, and extracted only the data from W00 to W19 of the extrinsic injury codes related to falls, and developed a prediction model using W01, W10, W13, and W18 of the extrinsic injury codes of falls, which had enough principal diagnosis S-codes to develop a prediction model. 80% of the data were categorized as training data and 20% as testing data. The model was developed using MLP (Multi-Layer Perceptron) with 6 variables (gender, age, principal diagnosis S-code, surgery, hospitalization, and alcohol consumption) in the input layer, 2 hidden layers with 64 nodes, and an output layer with 4 nodes for W01, W10, W13, and W18 exogenous damage codes using the softmax activation function. As a result of the training, the first training had an accuracy of 31.2%, but the 30th training had an accuracy of 87.5%, which confirmed the association between the fall extrinsic code and the main diagnosis S code of the fall patient.

The Extent of Late Gadolinium Enhancement Can Predict Adverse Cardiac Outcomes in Patients with Non-Ischemic Cardiomyopathy with Reduced Left Ventricular Ejection Fraction: A Prospective Observational Study

  • Eun Kyoung Kim;Ga Yeon Lee;Shin Yi Jang;Sung-A Chang;Sung Mok Kim;Sung-Ji Park;Jin-Oh Choi;Seung Woo Park;Yeon Hyeon Choe;Sang-Chol Lee;Jae K. Oh
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.324-333
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    • 2021
  • Objective: The clinical course of an individual patient with heart failure is unpredictable with left ventricle ejection fraction (LVEF) only. We aimed to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived myocardial fibrosis extent and to determine the cutoff value for event-free survival in patients with non-ischemic cardiomyopathy (NICM) who had severely reduced LVEF. Materials and Methods: Our prospective cohort study included 78 NICM patients with significantly reduced LV systolic function (LVEF < 35%). CMR images were analyzed for the presence and extent of late gadolinium enhancement (LGE). The primary outcome was major adverse cardiac events (MACEs), defined as a composite of cardiac death, heart transplantation, implantable cardioverter-defibrillator discharge for major arrhythmia, and hospitalization for congestive heart failure within 5 years after enrollment. Results: A total of 80.8% (n = 63) of enrolled patients had LGE, with the median LVEF of 25.4% (19.8-32.4%). The extent of myocardial scarring was significantly higher in patients who experienced MACE than in those without any cardiac events (22.0 [5.5-46.1] %LV vs. 6.7 [0-17.1] %LV, respectively, p = 0.008). During follow-up, 51.4% of patients with LGE ≥ 12.0 %LV experienced MACE, along with 20.9% of those with LGE ≤ 12.0 %LV (log-rank p = 0.001). According to multivariate analysis, LGE extent more than 12.0 %LV was independently associated with MACE (adjusted hazard ratio, 6.71; 95% confidence interval, 2.54-17.74; p < 0.001). Conclusion: In NICM patients with significantly reduced LV systolic function, the extent of LGE is a strong predictor for long-term adverse cardiac outcomes. Event-free survival was well discriminated with an LGE cutoff value of 12.0 %LV in these patients.

SARS-CoV-2 mRNA Vaccine Elicits Sustained T Cell Responses Against the Omicron Variant in Adolescents

  • Sujin Choi;Sang-Hoon Kim;Mi Seon Han;Yoonsun Yoon;Yun-Kyung Kim;Hye-Kyung Cho;Ki Wook Yun;Seung Ha Song;Bin Ahn;Ye Kyung Kim;Sung Hwan Choi;Young June Choe;Heeji Lim;Eun Bee Choi;Kwangwook Kim;Seokhwan Hyeon;Hye Jung Lim;Byung-chul Kim;Yoo-kyoung Lee;Eun Hwa Choi;Eui-Cheol Shin;Hyunju Lee
    • IMMUNE NETWORK
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    • v.23 no.4
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    • pp.33.1-33.13
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    • 2023
  • Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been acknowledged as an effective mean of preventing infection and hospitalization. However, the emergence of highly transmissible SARS-CoV-2 variants of concern (VOCs) has led to substantial increase in infections among children and adolescents. Vaccine-induced immunity and longevity have not been well defined in this population. Therefore, we aimed to analyze humoral and cellular immune responses against ancestral and SARS-CoV-2 variants after two shots of the BNT162b2 vaccine in healthy adolescents. Although vaccination induced a robust increase of spike-specific binding Abs and neutralizing Abs against the ancestral and SARS-CoV-2 variants, the neutralizing activity against the Omicron variant was significantly low. On the contrary, vaccine-induced memory CD4+ T cells exhibited substantial responses against both ancestral and Omicron spike proteins. Notably, CD4+ T cell responses against both ancestral and Omicron strains were preserved at 3 months after two shots of the BNT162b2 vaccine without waning. Polyfunctionality of vaccine-induced memory T cells was also preserved in response to Omicron spike protein. The present findings characterize the protective immunity of vaccination for adolescents in the era of continuous emergence of variants/subvariants.

Acute Insomnia in Post-Traffic Accident Patients Treated with M&L Psychotherapy Combined with Traditional Korean Medicine: Three Case Reports (교통사고 후 발생한 급성 수면장애 환자에 대한 M&L 심리치료와 한방 복합치료 치험 3례)

  • KANGMOO GOO;Ji-Won Park;Jeong-Hyo Ji;Na-young Kim;Dong-Hwan Lee;Hyo-Rim Kim;Yu-Ra Im;Ja-Yean Son;Seok Gyu Yang
    • Journal of Oriental Neuropsychiatry
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    • v.35 no.2
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    • pp.205-216
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    • 2024
  • Objectives: To evaluate the effectiveness of Mindfulness & Loving Beingness (M&L) psychotherapy combined with traditional Korean medicine in treating acute sleep disorders in patients hospitalized following traffic accidents. Methods: We applied traditional Korean medicine treatments in conjunction with various mindfulness meditation techniques from M&L therapy, including Resource Mindfulness and Nourishment Brief Therapy. This study was conducted on three patients who reported acute sleep disorder symptoms on the first day of hospitalization following a traffic accident. The effectiveness of these interventions was assessed using the PTSD Checklist for DSM-5 (PCL-5-K), Insomnia Severity Index (ISI), EuroQol 5-Dimension (EQ-5D), Numerical Rating Scale (NRS), and Patient Global Impression of Change (PGIC). Results: ISI and PCL-5-K scores showed significant improvements after treatment, indicating reduced sleep disturbances and stress symptoms. Additionally, EQ-5D and PGIC scores were enhanced, reflecting an overall improvement in quality of life. Conclusions: This study suggests that integrating M&L therapy with traditional Korean medicine could significantly improve symptoms in patients with acute sleep disorders following traffic accidents.

Clinical Implications of Device-Detected Atrial Fibrillation in Cardiac Resynchronization Therapy

  • Minjae Yoon;Jaewon Oh;Kyeong-Hyeon Chun;Hee Tae Yu;Chan Joo Lee;Tae-Hoon Kim;Hui-Nam Pak;Moon-Hyoung Lee;Boyoung Joung;Seok-Min Kang
    • Korean Circulation Journal
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    • v.53 no.7
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    • pp.483-496
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    • 2023
  • Background and Objectives: Atrial fibrillation (AF) is associated with decreased cardiac resynchronization therapy (CRT) benefits compared to sinus rhythm (SR). Effective biventricular (BiV) pacing is a determinant of CRT success, but AF can interfere with adequate BiV pacing and affect clinical outcomes. We investigated the effect of device-detected AF on clinical outcomes and optimal BiV pacing in patients with heart failure (HF) treated with CRT. Methods: We retrospectively analyzed 174 patients who underwent CRT implantation between 2012 and 2019 at a tertiary center. The optimal BiV pacing percentage was defined as ≥98%. Device-detected AF was defined as an atrial high-rate episode ≥180 beats per minute lasting more than 6 minutes during the follow-up period. We stratified the patients without preexisting AF at pre-implantation into device-detected AF and no-AF groups. Results: A total of 120 patients did not show preexisting AF at pre-implantation, and 54 had AF. Among these 120 patients, 19 (15.8%) showed device-detected AF during a median follow-up of 25.1 months. The proportion of optimal BiV pacing was significantly lower in the device-detected AF group than in the no-AF group (42.1% vs. 75.2%, p=0.009). The devicedetected AF group had a higher incidence of HF hospitalization, cardiovascular death, and all-cause death than the no-AF group. The device-detected AF and previous AF groups showed no significant differences regarding the percentage of BiV pacing and clinical outcomes. Conclusions: For HF patients implanted with CRT, device-detected AF was associated with lower optimal BiV pacing and worse clinical outcomes than no-AF.

Evaluation and Management of Frailty, and Its Association With Pain (노쇠의 평가와 관리, 그리고 통증과의 연관성)

  • Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.32 no.1
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    • pp.1-9
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    • 2024
  • Frailty is a clinical syndrome as an increased vulnerability to stressors, leading to a decrease in physiologic reserves and a decline in the ability to maintain a good homeostasis. This condition leads to an increased risk of hospitalization, disability and mortality. Frailty occurs due to various causes and requires a multidimensional approach. It is also important to detect and manage it early. Frailty is also deeply related to neuropsychiatric problems such as pain and depression. In evaluating frailty, it is desirable to comprehensively consider not only physical areas such as disease, nutrition, movement, and sensory functions, but also psychosocial areas, and representative scales include Fried's physical frailty phenotype and Rockwood's frailty index. Physical activity and appropriate protein intake are important for frailty management, and inappropriate drug use should be reduced and oral care, cognitive function, and falls should also be noted. Frailty and pain can affect each other, and pain can promote frailty. Evidence has been published that hormone and protein abnormalities, immune system activity and inflammatory response, and epigenetic mechanisms work in common in the field of frailty and pain. More extensive and high-quality research should be conducted in the future, and the quality of life will be improved if the results are applied to the suppression and treatment of old age and pain.