• 재활복지
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• v.22 no.2
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• pp.31-51
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• 2018

This study performed to provide the basic information about the effects of the health management importance awareness on the occupational performance and basic fitness for the people with intellectual disabilities. 16 people with intellectual disabilities participated in muscle strengthening exercise. To assess health management importance awareness, the Canadian Occupational Performance Measure was used to identify the importance of the health management. According to the results of the importance, they were divided into two groups: Extreme and Neutral Importance Group in order to analyze the changes of the occupational performance and basic fitness. In-group analysis of the performance, satisfaction level, strength, and flexibility found that all measures improved in both groups following completion of the program. Between-group analysis following completion of the program indicated group differences in the performance and satisfaction level, but no group differences were found in the muscle strength and flexibility. Thus, this study showed the positive effects from the results of the program participation targeting the people with intellectual disabilities, and highlighted the importance of the awareness for them regarding the need for the health management (as evidenced by the improvement in occupational performance). It is expected that effective health management through participation in programs such as this will help maintain a healthy lifestyle and contribute to improve the quality of life.

• Journal of Digital Convergence
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• v.16 no.12
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• pp.489-503
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• 2018

The purpose of this study was to explore traumatic experiences and posttraumatic growth of nursing students who were in clinical training. The data were collected from 490 nursing students at four nursing colleges with clinical training experience more than 1 year, from November 20th 2017 to December 20th. Collected data were analyzed through t-test, ANOVA, and $Scheff{\acute{e}}$ test with the SPSS/WIN 25.0 program, and qualitative data were analyzed by content analysis. 26.5% of the subjects had traumatic experiences in their daily life, 61.2% in the clinical practice. Their posttraumatic growth was scored 2.63 out of 5 on average. The contents of traumatic experiences were 'Violence experienced by medical staff','Negative perception of nursing care','Non-Educational Practical Environment' Clinical practice in a harsh environment, Witness of a serious patient, et al. The findings can be used as important basic data for the development of nursing practice education program for encouraging the posttraumatic growth of nursing students.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.45-49
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• 2019

Bartter syndrome is an inherited renal tubular disorder characterized by hypokalemia, hypochloremic metabolic alkalosis, hyperreninemia, hyperprostaglandinism, and normal blood pressure. Bartter syndrome is classified by neonatal and classic type. Clinical manifestation of Bartter syndrome considered in dental treatment include tendency to dehydration, vomiting and erosion, attrition and abrasion of the teeth. A 2-year-4 month old boy with Bartter syndrome type III was referred to the Seoul National University Dental Hospital for dental evaluation and treatment. He showed hypokalemic hypochloremic metabolic alkalosis and had been treated with indomethacin and potassium chloride. He had hypocalcified teeth with or without multisurface caries lesions in all dentition and the erosion of maxillary teeth was detected. Dental procedure under general anesthesia was scheduled due to multiple caries and his medical condition. The dental procedure was successfully performed. This case suggests that electrolyte imbalances need to be treated prior to dental treatment and complete coverage restoration is necessary to protect the eroded teeth. An appropriate management plan for the patients with Bartter syndrome should include considerations of the need for close interaction with the pediatrician for pre- and post-operative care. General anesthesia may be recommendable to manage the patients having multiple caries with Bartter syndrome.

• Journal of Convergence for Information Technology
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• v.9 no.8
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• pp.260-267
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• 2019

The purpose of this study is to find out how underwater rehabilitation exercises affect physical fitness and blood lipids for 10 weeks and provide basic data to help prevent middle-aged women from cardiovascular diseases. The subjects of this study were middle-aged women living in Seoul, Korea. The underwater rehabilitation exercise was performed for 1 week and 3 times for 10 weeks, and the exercise time was 60 minutes for 1 time including the warm up, the main exercise and the cool down. The exercise intensity was set at 60-70% of the heart rate reserve calculated from the pre-exercise test. The measurement variables were physical fitness and blood lipid. In the data processing, descriptive statistics were presented for each measurement item and a 2-way RGRM ANOVA was conducted to examine the interaction effects between groups. The results have shown significant interaction effects in physical fitness(Flexibility, Cardiorespiratory Endurance, Muscular Endurance) and the blood lipids(TG, TC, HLD-C, LDL-C). This study found that the 10-week underwater rehabilitation exercise program of middle-aged women increased physical fitness level and decreased and increased blood lipid, which could be an effective and convergent program to prevent and reduce cardiovascular disease.

• Journal of the Korea Convergence Society
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• v.10 no.8
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• pp.37-44
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• 2019

The purpose of this study is to determine the inhibiting factors of dying well for people who want to have a good death. The final respondents in this study were sampled using stratified proportional allocation using a stratified random sampling method, and 1,000 adults aged between 19 and 75 years were selected. The questionnaire used consisted of four items on general characteristics and 20 items related to the inhibiting factors of dying well scored on a 7-point Likert scale. Analysis was conducted using descriptive statistics, correlation analysis, and decision tree analysis. Results showed that, among the inhibiting factors of dying well, "degenerative diseases (such as dementia)" and "loss of control (mental / physical)" scored 5.502 and 5.268 points, respectively; the highest significant positive correlation was found between "bad marital relationship" and "bad relationship with children," followed by "did not receive death education" and "lack of medical policy promotion (dying well)" and "bad relationship with children" and "indifference of others." Considering these findings, it appears that the whole society will make efforts to improve the perception and practice of good death, and life and death education will be expanded if death education for dying well is organized and implemented.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.19 no.4
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• pp.77-83
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• 2019

With the increase in population, the number of such senior citizens is increasing day by day. These senior citizens have a variety of care needs, but there are not enough health workers to look after them. Ambient Assisted Living (AAL) aims at ensuring the safety and health quality of the older adults and extending the number of years the senior citizens can live independently in an environment of their own preference. AAL provides a system comprising of smart devices, medical sensors, wireless networks, computer and software applications for healthcare monitoring. AAL can be used for various purposes like preventing, curing, and improving wellness and health conditions of older adults. While information security and privacy are critical to providing assurance that users of AAL systems are protected, few studies take into account this feature. In this paper, we propose a secure and lightweight authentication scheme for the AAL systems. The proposed authentication scheme not only supports several important security requirements needed by the AAL systems, but can also withstand various types of attacks. Also, the security analysis results are presented to show the proposed authentication scheme is more secure and efficient rather than existing authentication schemes.

• The Journal of the Korea Contents Association
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• v.19 no.9
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• pp.271-279
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• 2019

The life expectancy of people has been steadily extended due to the improvement of living standards and the development of medical technology. Besides, the low birth rate and long life expectancy decrease the youth population while the elderly population is steadily increasing. Many elderly people have enough time and financial allowance, and the interest in health care is increased all over society. There are also increasing numbers of elderly people who exercise lightly in the playgrounds and parks such as running and walking. Outdoor fitness equipment that can be easily seen in neighbourhood parks, public spaces, etc. can be good health promotion tools that can be easily accessed in the daily life of the elderly. Outdoor fitness equipment Description Signs require a design that takes into account the declining vision of older users. Proper design is also important for the prevention of safety accidents in use. The purpose of this study is to find out the perception of the elderly about outdoor fitness exercise equipment sign system and to find the problem of recognition. To do this, we conduct user observation and interview surveys for the elderly. As a result, the emphasis of the caveat or problems with the size of the writing were pointed out, and it was necessary to explain the picture rather than the text. Also, there was a high demand for refraining from using foreign words, using universal words and including motor effects in signs. Based on the results of the user observation and interviews, we propose guidelines for the use of outdoor exercise equipment.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.61-67
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• 2018

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.391-399
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• 2018

Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.

• Korea Journal of Hospital Management
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• v.25 no.4
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• pp.94-102
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• 2020

Purposes: The purpose of this study was to analyze the trends of hospitalization and emergency room visits of asthma patients over the three years in 25 districts of Seoul. And analyzed the relationship between preventable hospital service uses and number of clinics for asthma patients. Methods: Data was collected from a customized database of the NHI(National Health Insurance) for 2016 to 2018. The number of clinics means Internal Medicine, Pediatrics, Ear-Nose-Throat, and Family Medicine clinics. The hospital service means the number of adults admission for asthma and the number of total asthma emergency visits. This study used kappa analysis to assess the agreements of indicators between years, and structural equation modeling analysis was applied to analyze the relationship. Findings: The kappa value of the number of adults admission for asthma was compared between 2016 and 2017(kappa score=0.68), and was lowered when compared between 2016 and 2018(kappa score=0.26). And the value of kappa in the number of total asthma emergency visits due to asthma between 2016 and 2017(kappa score=0.51) was lower than that of between 2016 and 2018(kappa score=0.60). And the results showed that the number of clinics significantly negatively related to the uses of hospital services in asthmatic patients(β=-0.5, p=0.005). Practical Implication: This research could provide policy implications for strengthening primary care services that can contribute to the reduction of preventable hospital services.