• Title/Summary/Keyword: pattern of care

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Towards Routine Clinical Use of Radial Stack-of-Stars 3D Gradient-Echo Sequences for Reducing Motion Sensitivity

  • Block, Kai Tobias;Chandarana, Hersh;Milla, Sarah;Bruno, Mary;Mulholland, Tom;Fatterpekar, Girish;Hagiwara, Mari;Grimm, Robert;Geppert, Christian;Kiefer, Berthold;Sodickson, Daniel K.
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.87-106
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    • 2014
  • Purpose : To describe how a robust implementation of a radial 3D gradient-echo sequence with stack-of-stars sampling can be achieved, to review the imaging properties of radial acquisitions, and to share the experience from more than 5000 clinical patient scans. Materials and Methods: A radial stack-of-stars sequence was implemented and installed on 9 clinical MR systems operating at 1.5 and 3 Tesla. Protocols were designed for various applications in which motion artifacts frequently pose a problem with conventional Cartesian techniques. Radial scans were added to routine examinations without selection of specific patient cohorts. Results: Radial acquisitions show significantly lower sensitivity to motion and allow examinations during free breathing. Elimination of breath-holding reduces failure rates for non-compliant patients and enables imaging at higher resolution. Residual artifacts appear as streaks, which are easy to identify and rarely obscure diagnostic information. The improved robustness comes at the expense of longer scan durations, the requirement for fat suppression, and the nonexistence of a time-to-center value. Care needs to be taken during the configuration of receive coils. Conclusion: Routine clinical use of radial stack-of-stars sequences is feasible with current MR systems and may serve as substitute for conventional fat-suppressed T1-weighted protocols in applications where motion is likely to degrade the image quality.

The Determinants of Community Service Utilization Among Family Caregivers of the Impaired Older Persons (만성질환 및 기능손상노인 가족수발자의 재가복지서비스 이용 결정요인에 관한 연구)

  • Lee, In-Jeong
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.183-205
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    • 2004
  • This Study explored three issues in regard to the determinants of community service utilization among family caregivers of the dependent older persons. First, the differences between users and nonusers of community services were compared regarding to predisposing, enabling, need characteristics of the primary caregiver as well as the elder care recipient. Second, the variables which determined the contact of community services were examined. Third, the influence of the variables on duration of the community services among users was also examined. The data collected from 164 family caregivers were used for analyses. Findings suggest that community service users had higher education and higher emotional support, lower family income than nonusers. The level of cognitive impairment of the elder was also higher for users than nonusers. The entry into community services is more likely for elders cared for by caregivers who have higher educational attainment, lower family income and lower level of instrumental support. Once interaction terms for relationship between need factors and social support are entered, caregivers with poorer level of his/her perceived physical health and lower level of instrumental support are more likely to report use of community services. Among those reporting contact with services, more extensive use occurs for caregivers with lower emotional support and lower depression. The entry of interaction terms for relationship between need and support reveals that the combination of lower support(instrumental and emotional) and elder's greater physical impairment are associated with longer period of community service use. However, the effect of caregivers' depression followed the different pattern. For caregivers with greater depression, more supports are related with more service utilization. According to the results, implications for research and practice are discussed.

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On-site Investigation of Hazardous Substances in Floor Dust of Several Primary Schools (일부 초등학교 바닥 먼지내 포함하고 있는 유해물질 성분에 대한 현장 평가)

  • Kim, Ki Youn;Kim, Hyeon Tae;Lee, Kwon Seob
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.24 no.4
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    • pp.478-483
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    • 2014
  • Objectives: The main objective of this study is to assess the levels of hazardous substances in floor dust in primary schools located in the city of Busan in Korea. Materials and Methods: An on-site investigation of three primary schools was performed between April and May 2013. The hazardous substances measured in this study were 14 heavy metals (Cu, Fe, Pb, Mn, Ni, Zn, Cr, Cd, As, Al, Sn, Co, Mo and Si) and the biological agents were bacteria, fungi and endotoxin). Results: Among the heavy metals, Cd, Co, Pb and Cr were not detected in the floor dust from the three primary schools. The mean levels of other heavy metals were as follows: $20({\pm}10)ng/cm^2$ for As, $30({\pm}20)ng/cm^2$ for Al, $5({\pm}4)ng/cm^2$ for Sn, $20({\pm}20)ng/cm^2$ for Mo, $1,340({\pm}620)ng/cm^2$ for Si, $110({\pm}100)ng/cm^2$ for Cu, $240({\pm}50)ng/cm^2$ for Fe, $30({\pm}30)ng/cm^2$ for Mn, $10({\pm}10)ng/cm^2$ for Ni, and $50({\pm}30)ng/cm^2$ for Zn. It was found that mean concentrations of bacteria, fungi and endotoxin in the floor dust of primary schools were $4.7{\time}10^7({\pm}2.2{\time}10^7)cfu/cm^2$, $6.3{\time}10^6({\pm}6.4{\time}10^6)cfu/cm^2$, and $8,140({\pm}5,801)EU/cm^2$, respectively. The predominant species identified in the floor dust of the primary schools were Pseudomonas spp. for bacteria and Penicillium spp.,Cladosporidium spp.,and Aspergillus spp. for fungi, which would be somewhat similar to the microbial distribution pattern of other general environments. Conclusions: Based on the results obtained from this study, the levels of heavy metals, microbes and endotoxin distributed in the floor dust of primary school were higher than those reported for other general facilities. Thus, preventive measures should be prepared for the health care of children.

Factors affecting on Health-Related Quality Of Life Among Cancer Survivors: Focusing on Gender Difference (암생존자의 건강관련 삶의 질에 대한 영향 요인 -성차를 중심으로)

  • Lee, In-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.497-507
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    • 2018
  • Objectives: The purpose of this article was to evaluate the health related quality of life (HRQoL) of cancer survivors and to identify its predictors according to gender. Methods: The research was conducted with the data for 203 (cancer survivors?) taken from the 6th wave of the Korea National Health and Nutrition Examination Survey and the EQ-5D index score was used for the measurement of the health-related quality of life (HRQoL). The independent variables inluded socio-demographic data, health related factors (survival duration, disability, subjective health recognition), and psychosocial factors (stress, unmet medical needs). The data were analyzed by the t-test, ANOVA, and hierarchical multiple regression analysis. Results: the HRQoL of the female cancer survivors was significantly worse than that of the males in terms of their mobility, usual activities, pain/discomfort and anxiety/depression quality of life. The only statistically significant factor affecting the HRQoL of the male cancer survivors was their subjective health recognition. In the case of the female cancer survivors, the statistically significant factors were their age, subjective health recognition and unmet medical needs. Conclusions: the results of this study showed a different pattern of predictors according to the gender of the cancer survivors. Therefore, gender should be considered when assessing and addressing the individual care needs of cancer survivors, in order to obtain optimal treatment outcomes.

A Study on Hardiness, Knowledge of Menopause, Menopausal Management among Middle Aged Women (중년여성의 강인성, 폐경지식과 폐경관리에 관한 연구)

  • Shin, Hye-Sook;Kown, Sook-Hee
    • Women's Health Nursing
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    • v.5 no.2
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    • pp.247-261
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    • 1999
  • The purpose of this study was to figure out related factors to the self-reported climacteric symptoms and the relationship among the health promoting behaviors, climacteric symptoms and degree of Sanhujori, the Korean traditional postpartal care. A cross-sectional survey design was employed in this study. The subjects were 108 middle-aged women who were non-hystrectomized and ranged in age from 40 to 60 years. They were selected in seoul and Kyoung-ki province, Korea, Data were collected from Oct.25 Nov. 10, 1997 by a structured questionnaire. The instruments used for this study were the revised health Promotion Lifestyle(HPLP) developed by Walker, Sechrist & Pender, and revised Climacteric Symptoms Scale developed by Chi, Sung Ai. the data were analyzed by the SPSS/$PC^+$ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low($2.42{\pm}0.35$). There were statistically significant differences in the score of health promoting behaviors according to the educational background, family income, marital satisfaction, whether or not taking a restorative food and degree of Sanhujori, especially the period (t=-2.07, F=2.60~7.57, p<0.05). 2. The mean score of score self-reported climacteric symptoms was 1.69%;99% of middle-aged women had symptoms. There were statically significant differences in the score of middle -aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormon replacement therapy (HRT) or consultation by a professional, perceived health status and self evaluation of Sanhujori(t=-2.04~3.69, F=2.87~11.63, p<0.05). 3. women's degree of Sanhujori was a positive correlation with health promoting behaviors(r=0.34, p=0.00) and negative correlation with the degree of self-reported climacteric symptoms(r=-0.19,p=0.03). 4. The influencing factors to the climacteric symptoms were self actualization, interpersonal support, and perceived health status among the health promoting behaviors with 57% of variance($R^2$=0.57). 5. The middle-aged women's type of coping pattern for the climacteric symptoms was classified as active behavioral coping, spiritual & psychological coping, and negative coping. In conclusion, to intervene the middle aged women's climacteric symptoms and develop nursing strategies for their health, health promoting behavior, especially ; self actualization, interpersonal support, and perceived health status should be considered. And, as the primary prevention strategy for women's health during the period of childbearing and also middle age, especially for the climacteric symptoms, Sanhujori should be reconsidered.

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An analysis of the impact of Korean medicine health counseling on health perception change and satisfaction (한의건강상담이 건강인식 변화에 미치는 영향 및 만족도 분석)

  • Lee, Eunyoung;Jang, Eunsu;Kim, Sujung;Baek, Younghwa;Lee, Siwoo;Mun, Sujeong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.1
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    • pp.19-30
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    • 2017
  • Objectives : The purpose of this study was to examine the changes of health perception, satisfaction survey and lifestyle in Korean medicine counseling for Daejeon University faculty members. Methods : In this study, the demographic questionnaire, lifestyle habit questionnaire, Mibyeong questionnaire, quality of life questionnaire(SF-12, EQ5D), pattern-based questionnaire, constitutional questionnaire(KS-15) and instrumental examination were performed on the first and second visit. We carried out 1:1 consultation at every visit. Results : A total of 189 participants participated in this study. 66% of respondents answered that they felt the change in health perception and more than 93% of the respondents felt satisfaction due to the Korean medicine health counseling. In the demographic characteristics, it was found that women were more satisfied with the Korean medicine health counseling than men(p <.05), the higher the education level(p <.05) and the higher the age(p <.05), managed their health continuously after receiving Korean medicine health counseling.(p <.05) In addition, in the change of lifestyle habit, the group who smoked and drank in the past answered that the consciousness to manage and improve health was higher than other group after Korean medicine health counseling.(p <.05) Conclusions : Korean medicine health counseling had a positive effect on overall health perception change and satisfaction was high. Since the Korean medicine health counseling has different effects on lifestyle and health perception change and the satisfaction of Korean medicine health counseling is different according to demographic characteristics and existing lifestyle habits. In the future, it will be expected that the effect of Korean medicine health counseling program on health care and disease prevention will be further enhanced if the Korean medicine health counseling program reflecting such characteristics is implemented.

The Changing Patterns of Antibiotic Susceptibility for Acinetobacter baumannii in Pediatric Burn Patients (소아 화상환자에서 배양된 Acinetobacter baumannii에 대한 항생제 감수성 양상의 변화)

  • Lee, Sang-Min;Lee, So-Yeon;Kim, Young-Ho;Lee, Kyu-Man;Jang, Young-Chul;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.146-151
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    • 2008
  • Purpose : Multidrug-resistant Acinetobacter baumannii (A. baumannii) is recognized to be the most difficult pathogen to control and treat in pediatric burn centers. We analyzed the antibiotic susceptibility pattern of A. baumannii in our pediatric burn intensive care unit during the past 7 years. Methods : We retrospectively evaluated 56 patients (105 samples) under the age 15 years and who were infected with A. baumannii between January 1999 and December 2005. Results : Fot the 56 patients, the ratio of males to females was 1.15:1 and the median age was 48.3 months. The sites of 105 isolates were wounds (65%), sputum (20%), blood (6 %), cutdown tips (5%), endo-tip tubes (2%) and urine (2%). A. baumannii presented yearround. The annual antimicrobial resistance rate increased and the multidrug resistant rate for two or more antibiotics was 93.33%. For 3 patients in whom resistance emerged, the interval period between the susceptible and resistant strains after antibiotic use was a mean of 10 days. The A. baumannii isolated from blood were all multi-drug resistant pathogens. Conclusion : Multidrug resistance of A. baumannii is increasing. Strict infection control guidelines and active surveillance are needed for the prevention and treatment of A. baumannii in hospitals.

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A Literature Study on the Korean Acupuncture for the Treatment of Stroke (국내침구서적의 중풍치료에 관한 문헌 연구 - $\ll$치종지남(治腫指南)$gg$$\ll$동의보감(東醫寶鑑)$gg$$\ll$침구경험방(鍼灸經驗方)$gg$$\ll$교감 사암도인침법(校勘 舍岩道人鍼法)$gg$의 비교연구 -)

  • Han, Chang-Hyun;Park, Sang-Young;Ahn, Sang-Young;Kwon, Oh-Min;Ahn, Sang-Woo
    • Korean Journal of Acupuncture
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    • v.26 no.2
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    • pp.145-163
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    • 2009
  • Background : Stroke occurrences are prevalent and require intensive care for its treatment and rehabilitation. Acupuncture has been widely used in Korea throughout the history and provides an efficient method in the treatment of it. Objectives : To establish a distinctive and efficient acupuncture method for the treatment of stroke based in literature research. Method : We reviewed four Korean medical literature, $ll$治腫指南Guide to Swollen Sore Treatment$gg$, $ll$東醫寶鑑Treasured Mirror of Eastern Medicine$gg$, $ll$鍼灸經驗方Experiential Prescriptions of Acupuncture and Moxibustion$gg$, and $ll$舍岩鍼法Essential Rhymes on Acupuncture and Moxibustion by Master Sa-am$gg$, and analyzed the therapeutic characteristics in the treatment of stroke. Result : 1. In $ll$治腫指南Guide to Swollen Sore Treatment$gg$, various types of treatment can be found. Besides acupuncture, cupping, moxibustion with moxa tube, and bath therapy using Duchesneae Indicae Herba and Sal was applied. Needling in sublingual and vocal region, and also points like GB20, GB31, LI15, BL60, GV20, GV20, TE4, GB39, LU5, ST36, GB30 were frequently inserted. 2. In $ll$東醫寶鑑Treasured Mirror of Eastern Medicine$gg$, moxibustion treatment were in top priority. Points like GV20, LI15, LI11, GB31, ST36, GB39, LI4, GB20 pertinent to Governor, Conception, Gallbladder, Large Intestine, and Stomach meridian were most frequently needled. Selection of adjacent point was widely applied. 3. $ll$鍼灸經驗方Experiential Prescriptions of Acupuncture and Moxibustion$gg$ has some similarity compared to $ll$東醫寶鑑 Treasured Mirror of Eastern Medicine$gg$ in considering the moxa in top priority. But selected points far from the disease site. Main points were LI4, ST36, GB39, PC5, GV20, LI11, LR3, BL40, HT7. 4. $ll$校勘 舍岩道人鍼法Essential Rhymes on Acupuncture and Moxibustion by Master Sa-am$gg$ having the same content orders with $ll$鍼灸經驗方Experiential Prescriptions of Acupuncture and Moxibustion$gg$, it may had some influence from it. But the differences are also apparent. It emphasized in using mother-supplementing child-draining method, experiential prescriptions and visceral pattern identification. Conclusions : We could find various efficient methods through literature research of medical classics. This will not be limited in stroke alone but also will be applied in other diseases. This study will concurrently result in establishing distinctive therapeutic method characteristic of Korea.

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Temporal and Spatial Distributions of Emergency Medical Services: Busan (부산시 응급의료서비스의 시공간적 분포특성)

  • Nam, Kwang-Woo;Kim, Jeong-Geon
    • Journal of the Korean Association of Geographic Information Studies
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    • v.10 no.1
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    • pp.113-123
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    • 2007
  • This study analyzed the appropriateness of the spatial distribution of fire stations and emergency medical facilities, the main providers of emergency medical care, in Busan. The area over which the 119 emergency medical services were situated in relation to the dispatch and transport of urgent rescue services was examined. Addresses of patients requiring 119 emergency services were obtained and stored as individual units so that they could be analyzed in a Geographic Information System(GIS). The time taken by emergency services to reach patients and transport them to a hospital or other facility was measured in seconds. By inputting additional information such as the location of the 119 dispatch centers, jurisdictions, and emergency medical facilities, the GIS allowed for analyses not only of the temporal but also the spatial aspects of emergency medical services. The results showed that of 16 Gu/Gun and 226 Eup/Myen/Dong in the Busan area, only 41% of Busan's emergency medical services could respond to and transport patients within five minutes. In all districts, most emergency medical services were provided within five to ten minutes. However, the pattern of hospital use to transfer patients to hospitals was inefficient. Based on the temporal and spatial distributions of fire stations and emergency medical agencies, and on their dispatch and transport times, this study sets out and compares ideal dispatch and transportation patterns for the efficient use of Busan's emergency medical services and resources.

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A Study on the Relationship Methods of Oksuki (『옥수기』의 남녀결연담 연구)

  • Kwon, KyongSoon
    • (The)Study of the Eastern Classic
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    • no.67
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    • pp.69-104
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    • 2017
  • This paper examines the aspect of the novel which appeared in the union of the male and female relationship of "OkSuki", one of the novels of the 19th century. "Oksuki" is a work focusing on the relationship between men and women. It takes a narrative structure based on the relationship. It shows various aspects of the relationship through the structure in which the pluralities of plural persons are repeated. Other events and illustrations, except for the talk, are both an occasion of the alliance and an auxiliary role. At the beginning of the work, the main character's parents are described in detail.By arranging the prophecies related to the relationship between the protagonist and the brothers, it suggests that subsequent narratives will flow into the center of the relationship. The male characters that make up the alliance are characteristically trained and have a good taste, and the Caines are colorfully colored. It is believed that the marriage pattern faithfully follows the medieval status order. The reason why the figure of the person who becomes his wife and the person of the concubine are set differently is because the image of the wife and the concubine are different from each other ideally. The characters who are going to be hungry are emphasized on the clause, efficacy, knowledge, and inner peace, and are actively involved in. On the other hand, conciliatory characters emphasize talent and craftsmanship, and their role is reduced after marriage. The wife is a person who has both Confucian culture and knowledge and is able to care for her husband and family well. Concultation is shaped as a person who can enjoy joyful life and emphasize more affection in relation with his wife.