• Title/Summary/Keyword: primary health care

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A Research to Evaluate the Reliability and Validity of Pattern Identifications Tool for Cognitive Disorder: A Clinical Study Protocol (인지장애 변증평가도구의 신뢰도와 타당도 평가: 임상연구 프로토콜)

  • Lee, Ji-yoon;Kim, Hwan;Seo, Young Kyung;Kang, Hyung Won;Kang, Wee-Chang;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.4
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    • pp.255-266
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    • 2018
  • Objectives: The objective of this study was to evaluate the reliability and validity of Pattern Identifications Tool for Cognitive Disorders (PIT-C) and verify the correlation with other related scales. Methods: The study in this protocol is a single group, prospective, observational one. The subjects of the study were men and women between the ages of 45 and 85, diagnosed with neurocognitive disorders by Diagnostic and Statistical Manual of Mental Disorder (fifth Edition) criteria (n=60, Clinical Dementia Rating (CDR)=0.5, Korean Version of Montreal Cognitive Assessment $(MoCA-K){\leq}22$). The reliability of PIT-C was evaluated as test-retest and inter-rater reliability. And correlation between PIT-C and other related scales was also assessed. Results: This study was approved by the Institutional Review Board (IRB) of Dunsan Korean Medicine Hospital of Daejeon University and registered in the Clinical Research Information Service (CRIS), and was made public in advance to ensure transparency of the research process and conduct ethical clinical trials. Conclusions: The results of this study can be used to classify neurocognitive disorders as Korean medicine and PIT-C will be helpful tool for primary health care.

Ethnomedicinal Study of Plants in Begumganj, Noakhali, Bangladesh

  • Akter, Kazi-Marjahan;Sajib, Noor Hassan;Kang, Dong-Min;Ahn, Mi-Jeong;Uddin, Shaikh Bokhtear
    • Natural Product Sciences
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    • v.27 no.4
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    • pp.217-227
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    • 2021
  • This study is a record of ethnomedicinal knowledge in Begumganj province focussed on medicinal plants and their local uses for primary health care. The aim was to document and preserve the ethnomedicinal knowledge used by traditional healers of Begumganj upazila, Bangladesh, to treat human diseases and evaluate the relative efficacy of the medicinal plants. The uses of medicinal plants were documented as an ethnomedicinal data sheet using direct observation, field interview, plant interview and group interview techniques from December 2012 to January 2014 in the study area. Data were collected from 98 traditional healers through a questionnaire survey and analyzed through informant consensus factor and fidelity level. This study revealed comprehensive relationship among various diseases and families, forms and parts of plants and modes of preparation. Overall, 75 plant species under 71 genera of 47 families were documented, which are used to treat 41 diseases. Data analysis revealed that 41.33%, 14.67%, 36% and 8% of the medicinal plant species were herbs, shrubs, trees, and climbers, respectively. Leaves were the most used parts, followed by stem, root, fruit, bark, latex and rhizome. The most frequently treated diseases were dysentery, rheumatism and skin diseases. This is the first ethnobotanical survey, which recorded the importance of medicinal plants in Begumganj upazila, Bangladesh. This study can contribute to preserving the indigenous knowledge on the traditional use of medicinal plants in this region and new drug development with attracting future generations towards traditional healing practice.

Research on National Korean Medicine Policy Priorities using Delphi-AHP : Focusing on the 4th Comprehensive Plan for Korean Medicine Development (델파이-AHP 기법을 사용한 국가한의약정책 우선순위에 관한 연구 - 제4차 한의약육성발전종합계획을 중심으로 -)

  • Yi, Eunhee;Kim, Dongsu;Park, Soo-Kyung
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.1-9
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    • 2022
  • Objectives : The purpose of this study is to identify priorities for the 4th Comprehensive Plan for Korean Medicine Development using Delphi and AHP techniques. Methods : This study uses Delphi-AHP method to first, select the target priority policy based on the policy content of the 4th Comprehensive Plan. In addition, two surveys on the priorities were conducted to reach consensus between experts. The main results of the first survey were also provided to experts participating in the second survey to help form expert consensus. Finally, the final policy priority was chosen based on the second survey result. Results : Survey results showed that of the 39 policies in the 4th Comprehensive Plan, "improve the accessibility of Korean medicines," was the most important goal. This was followed by "support for Korean medicine R&D from clinical research to industrialization," "provide foundation for a pilot project that provides customized medical services" and "strengthen the public medicine function of Korean medicine by expanding the its infrastructure in national and public hospitals." Conclusion : The results showed that capacity building of Korean medicine in primary care, improvement of the health insurance system, and research centered on industrialization are relatively more important goals, while the need to enhance global competitiveness was much less important. These key points can serve as a reference when formulating the 5th Comprehensive Plan for Korean Medicine Development in the future.

A Keyword Network Analysis of Standard Medical Terminology for Musculoskeletal System Using Big Data (빅데이터를 활용한 근골격계 표준의료용어에 대한 키워드 네트워크 분석)

  • Choi, Byung-Kwan;Choi, Eun-A;Nam, Moon-Hee
    • Journal of Digital Convergence
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    • v.20 no.5
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    • pp.681-693
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    • 2022
  • The purpose of this study is to suggest a plan to utilize atypical data in the health care field by inferring standard medical terms related to the musculoskeletal system through keyword network analysis of medical records of patients hospitalized for musculoskeletal disorders. The analysis target was 145 summaries of discharge with musculoskeletal disorders from 2015 to 2019, and was analyzed using TEXTOM, a big data analysis solution developed by The IMC. The 177 musculoskeletal related terms derived through the primary and secondary refining processes were finally analyzed. As a result of the study, the frequent term was 'Metastasis', the clinical findings were 'Metastasis', the symptoms were 'Weakness', the diagnosis was 'Hepatitis', the treatment was 'Remove', and the body structure was 'Spine' in the analysis results for each medical terminology system. 'Oxycodone' was used the most. Based on these results, we would like to suggest implications for the analysis, utilization, and management of unstructured medical data.

Golf participation after rotator cuff repair: functional outcomes, rate of return and factors associated with return to play

  • Thomas R Williamson;Patrick G Robinson;Iain R Murray;Andrew D Murray;Julie M McBirnie;C Michael Robinson;Deborah J MacDonald;Nicholas D Clement
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.109-116
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    • 2023
  • Background: Golf is a popular sport involving overhead activity and engagement of the rotator cuff (RC). This study aimed to determine to what level golfers were able to return to golf following RC repair, the barriers to them returning to golf and factors associated with their failure to return to golf. Methods: Patients preoperatively identifying as golfers undergoing RC repair at the study centre from 2012 to 2020 were retrospectively followed up with to assess their golf-playing status, performance and frequency of play and functional and quality of life (QoL) outcomes. Results: Forty-seven golfers (40 men [85.1%] and 7 women [14.9%]) with a mean age of 56.8 years met the inclusion criteria, and 80.1% were followed up with at a mean of 27.1 months postoperatively. Twenty-nine patients (76.3%) had returned to golf with a mean handicap change of +1.0 (P=0.291). Golf frequency decreased from a mean of 1.8 rounds per week preinjury to 1.5 rounds per week postoperatively (P=0.052). The EuroQol 5-dimension 5-level (EQ-5D-5L) index and visual analog scale (EQ-VAS) score were significantly greater in those returning to golf (P=0.024 and P=0.002), although functional outcome measures were not significantly different. The primary barriers to return were ipsilateral shoulder dysfunction (78%) and loss of the habit of play (22%). Conclusions: Golfers were likely (76%) to return to golf following RC repair, including mostly to their premorbid performance level with little residual symptomatology. Return to golf was associated with a greater QoL. Persistent subjective shoulder dysfunction (78%) was the most common barrier to returning to golf.

Protocol for management of pregnant patients requiring emergency minor oral surgical procedures: a prospective study in 52 patients

  • Ajinath Nanasaheb Jadhav;Shushma G;Uzma Hamidullah Siddiqui;Minal Sharma;Yaseer Irfan Shaikh;Pooja Raosaheb Tarte
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.49 no.1
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    • pp.21-29
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    • 2023
  • Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

Development of an Evidence-based Nutritional Intervention Protocol for Adolescent Athletes

  • Lee, Saningun;Lim, Hyunjung
    • Korean Journal of Exercise Nutrition
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    • v.23 no.3
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    • pp.29-38
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    • 2019
  • [Purpose] Effective nutritional intervention can help reduce the risk of nutritional problems and improve athletic performance in adolescents. The five A's (assess, advise, agree, assist, and arrange) model is widely used as the theoretical framework for advice on nutrition, smoking, drinking, and physical activity and it recommends that practitioners in primary health care promote behavior change to facilitate positive outcomes. This model has also been useful in understanding the underlying processes of behavior change. This study aimed to develop both a novel evidence-based nutritional intervention protocol, rooted in sound nutritional theory, and a customizable nutritional intervention program to support sustainable healthy eating, enhance nutrient intake, and improve athletic performance in adolescent athletes. [Methods] In this study, we adapted the 5 A's behavioral change model and motivational interview to develop a theoretical framework to help adolescent athletes change their behavior and achieve their goals. [Results] During each step of the 5 A's protocol, a customized nutritional intervention protocol was developed by nutrition experts for each of adolescent athletes. Each plan was developed to improve the eating habits of adolescent athletes through group education and counseling. All nutritional counseling sessions were designed to enable participants to apply nutritional knowledge and practical action plans to their training and competition conditions to enable each of them to achieve individual athletic goals and facilitate self-management. [Conclusion] A theoretical and evidence-based nutritional intervention protocol was developed to identify and address obstacles to healthy dietary habits in adolescent athletes. This could be used as the basis for further studies aimed at improving nutrient intake and athletic performance in adolescent athletes.

Potentially Inappropriate Prescriptions of Antibiotics in Patients with Acute Rhinosinusitis in Ambulatory Settings in South Korea (외래 급성 비부비동염 환자의 잠재적으로 부적절한 항생제 사용)

  • Daei Jung;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.261-269
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    • 2023
  • Background: Acute rhinosinusitis (ARS) is a common condition encountered in ambulatory practice and is one of the most common reasons for antibiotic prescriptions. This study aimed to evaluate the potentially inappropriate antibiotic prescribing for ARS in South Korea and identify influencing factors. Methods: We analyzed Health Insurance Review and Assessment Service-National Patient Samples data. We selected outpatients aged 20 to 64 with ARS, prescribed antibiotics between February and November 2020. Potentially inappropriate antibiotic prescribing was categorized as: 1) inappropriate antibiotic selection and 2) inappropriate antibiotic dosage or duration. Multiple logistic regression was conducted to estimate the impact of various factors on inappropriate antibiotic prescribing. Results: Of 1,210 patients, 80.83% received potentially inappropriate ARS antibiotic prescriptions. Inappropriate antibiotic selection accounted for 43.55%, and inappropriate antibiotic dosage and duration contributed to 37.28%. Otolaryngologists had higher odds ratio (OR) of potentially inappropriate antibiotic prescribing compared to internal medicine practitioners, while dentists had lower OR. Patients aged 20 to 29 years had a higher OR than other age groups, and those who visited primary care clinics had a higher OR than those who visited hospitals. Conclusion: Potentially inappropriate antibiotic prescribing for ARS is prevalent in South Korea. This study identified physician specialty, patient age group, and the level of healthcare facility as factors influencing potentially inappropriate antibiotic prescriptions. Addressing this issue through targeted interventions, such as improved guidelines adherence and patient education, is imperative to mitigate the risks associated with antibiotic misuse and antibiotic resistance.

Humoral immune response to SARS-CoV-2 mRNA vaccines is associated with choice of vaccine and systemic adverse reactions

  • Hanna Klingel;Alexander Kruttgen;Matthias Imohl;Michael Kleines
    • Clinical and Experimental Vaccine Research
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    • v.12 no.1
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    • pp.60-69
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    • 2023
  • Purpose: Although the fast development of safe and effective messenger RNA (mRNA) vaccines against severe acute respiratory syndrome coronavirus 2 has been a success, waning humoral immunity has led to the recommendation of booster immunization. However, knowledge of the humoral immune response to different booster strategies and the association with adverse reactions is limited. Materials and Methods: We investigated adverse reactions and anti-spike protein immunoglobulin G (IgG) concentrations among health care workers who received primary immunization with mRNA-1273 and booster immunization with mRNA-1273 or BNT162b2. Results: Adverse reactions were reported by 85.1% after the first dose, 94.7% after the second dose, 87.5% after a third dose of BNT162b2, and 86.0% after a third dose of mRNA-1273. They lasted for a median of 1.8, 2.0, 2.5, and 1.8 days, respectively; 6.4%, 43.6%, and 21.0% of the participants were unable to work after the first, second, and third vaccination, respectively, which should be considered when scheduling vaccinations among essential workers. Booster immunization induced a 13.75-fold (interquartile range, 9.30-24.47) increase of anti-spike protein IgG concentrations with significantly higher concentrations after homologous compared to heterologous vaccination. We found an association between fever, chills, and arthralgia after the second vaccination and anti-spike protein IgG concentrations indicating a linkage between adverse reactions, inflammation, and humoral immune response. Conclusion: Further investigations should focus on the possible advantages of homologous and heterologous booster vaccinations and their capability of stimulating memory B-cells. Additionally, understanding inflammatory processes induced by mRNA vaccines might help to improve reactogenicity while maintaining immunogenicity and efficacy.

Stress and Coping among Parents of Mentally Retarded Children in the Kyoung-in area (경인 지역의 정신 지체아 부모의 스트레스와 대응)

  • 구현영
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.668-680
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    • 1995
  • The purpose of this study was to contribute to family nursing for reducing stress and improving coping of the parents of mentally retarded children. Data were collected through self-reported questionnaires during a period of 2 months between November 1994 and January 1995 in the Kyoung-in area. The subjects consist of 180 parents (90 mothers and 90 fathers) of mentally retarded children attending schools for the handicapped and 186 parents (93 mothers and 93 fathers) of normal children. The levels of general stress and of parental role stress were measured with the General stress scale and the Parental role stress scale, respectively, while the Coping scale was adopted to measure the level of coping. The data were analyzed by using Chi-square test. fisher's exact test, Repeated masured ANOVA, oneway ANOVA and Scheffe comparison test. The results were as follows ; 1. The level of general stress was significantly higher in the mothers and the fathers of the men-tally retarded than in the respective parents of the normal. Of the parents, the mothers experienced significantly greater level of general stress than the fathers did in both groups of the retarded and of the normal. 2. As for the parental role stress, the mothers and the fathers of the mentally retarded experienced significantly greater stress than respective parents of normal children did. In particular, the stress was significantly higher in the mothers than the fathers of these children in both groups. The difference in the levels of parental role stress experienced by mothers and by fathers was significantly bigger among those of the mentally retarded tnan among those of normal children. 3. No significant difference in the level of coping was observed between the mothers of both groups and the fathers of both groups. By contrast, the fathers revealed significantly greater scores in coping than the mothers in both groups. 4. General stress experienced by the fathers of the mentally retarded was different by health status, satisfaction with spouses, and the supports from their spouses. Health status, satisfaction with spouses, and monthly income Influenced parental role stress experienced by those fathers. Their level of coping was associated with their satis-faction with spouses and family life. 5. Of the mothers of the mentally retarded, the level of general stress was different by their health status, while parental role stress was related to the satisfaction with their spouses and the child's age. The level of coping among the mothers was different by the supports from their spouses. The above findings indicate that those parents of the mentally retarded did not take more coping strategies than those of the normal did, despite greater stress experienced among themselves. Hence, nursing intervention for managing stress should be given to those parents including fathers of mentally retarded children. Mothers of the mentally retarded, in particular, should receive high priority in planning nursing care, since they experience greater levels of both general stress and parental role stress than their spouses, which is most likey due to primary responsibility in child rearing given to them at home.

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