• Title/Summary/Keyword: severity assessment

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The Correlation between Motor Capacity, Capability, and Performance in Children with Cerebral Palsy (뇌성마비 아동의 능력, 수행능력, 수행 간 상관관계)

  • Kim, JangGon;Kim, TaeYoon
    • 재활복지
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    • v.20 no.3
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    • pp.125-139
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    • 2016
  • The aim of this study was to distinguish 3 concepts(capacity, capability, and performance) for the motor activities of children with cerebral palsy(CP) and examinate relation between capacity(can do in a standardized environment), capability(can do in daily environment), and performance(does do in daily environment). Cross-sectional analysis with a assessment record of children with CP (n=40; 19males, 21 females; mean age 6y 6mo, SD 3y 8mo) was performed. Levels of severity according to the Gross Motor Function Classification System(GMFCS) included level1(13%), level2(10%), level3(43%), level 4(33%), and level 5(3%). Motor activities capacity was assessed by the Gross Motor Function Measure (GMFM-66). Capability and performance were assessed using 2 scales(functional skill, caregiver assistance) of the Pediatric Evaluation of Disability Inventory(PEDI). Correlations between capacity and capability was 0.811(p < .05), and between capability and performance were high(r=0.711, p < .05). And the correlation between capacity and performance is the lowest(r=0.711, p < .05). Motor performance levels are only partly reflected by the motor capacity and motor capability levels in children with CP. Because performance is influenced by Contextual factors (particularly, social factors such as family function). This study suggests that it is necessary to distinguish and evaluate the capacity, capability, and performance in children with cerebral palsy.

Preliminary Study on Developing Test Items of Swallowing & Communication Screening Protocols for Patients with Head and Neck Burns (안면부 및 경부 화상 환자의 삼킴 및 의사소통능력 선별 프로토콜 개발을 위한 예비 연구)

  • Kim, JungWan;Lee, HyoJin;Lee, Hyun-Joung
    • 재활복지
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    • v.21 no.2
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    • pp.217-231
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    • 2017
  • We have to consider two parts of the evaluation and treatment for the patients with head and neck burns. The primary consideration is swallowing function for nutrition supply for them and the next is speech function for efficient communication and aesthetic impression of them. The purpose of this study is to summarize the preliminary questions of Communication Screening Protocols which can help understand comprehensively on swallowing disorder, motor speech disorder and voice disorder of patients with head and neck burns. We divided the evaluation into 4 evaluation areas including 'oral mechanism', 'respiration/voice', 'articulation', and 'swallowing' by referring to overseas studies dealing with various communication disorders caused by burns, and prepared the final questionnaires by conducting the content validity verification by five expert (speech & language pathologist). The range of Content Validity Index was shown relatively appropriate with .50~.84. There was a conflict of opinions in experts whether the items in the areas of respiration/voice and swallowing may be appropriate, whereas there was no different view of the oral mechanism and articulation area. Through the different characteristics of communication difficulties of patients with head and neck burns, we expect it will be modified appropriately according to the patients through evaluation of burn patients by type and severity.

Association between physical activity and health - related quality of life in Korean patients with COPD (만성폐쇄성폐질환의 신체활동수준과 삶의 질 간의 관련성)

  • Mok, Hyungkyun;Jo, Kyu-hee
    • The Journal of Korean Society for School & Community Health Education
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    • v.20 no.1
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    • pp.15-27
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    • 2019
  • Objective: Patients with COPD have a lower overall quality of life than normal people. If patients with COPD do not regularly perform physical activities, their exercise capacity is reduced. It could lead to muscle loss, and negatively affect their general physical, social, and psycho-social status. The purpose of this study was to examine association with physical activity, sedentary life time and health-related quality of life in patients with COPD. Method: Of the total of 22,948 participants surveyed in Korean National Health and Nutrition Examination Survey (KNHANES 2013-2015), 8,626 participants were used for this study. Of these, under 40 years, over 80 years, missing values and abnormal values were excluded. Study variables included physical activity level, sedentary time and health-related quality of life variables. The physical activity level assessment tool was measured using International Physical Activity Questionnaire (IPAQ). Sedentary time referred to the amount of sitting time without moving the body. EQ-5D (Euro Quality of Life-5 Dimensions) was used as an index of health-related quality of life. Control variables were age, gender, income level, education level, marital status, comorbidity, smoking, BMI, cough, sputum, COPD severity. For this study, descriptive analysis, T-test, ANOVA and multivariate regression analysis were performed. Results: Of the 1,092 patients with COPD, 76.1% (n=831) were male and 23.9% (n=261) were female, while 39.0% (n=2,939) were male and 61.0% (n=4,595) were female in the comparison group without COPD. The COPD group with high level of physical activity showed a high level of EQ-5D scores ($0.9349{\pm}0.11$, p <0.001). Among patients with COPD, after adjusting for control variables, physical activity and sedentary time (physical activity level, Β=0.047, p <.001), (sedentary time, Β=-0.017, p <.05) were associated with health-related quality of life. Conclusion: Patients with COPD have a higher quality of life as their physical activity increases and the quality of life decreases as the time spent sitting increases. This study suggests that public health experts should consider improving COPD patient physical activity.

Review of Non-invasive Interventions for Drooling Problems in Children With Cerebral Palsy: Trends and Analysis of Interventions for Drooling (신경발달장애 아동의 침흘림치료를 위한 비침습적 중재방법에 관한 고찰: 경향 및 중재방법 분석)

  • Jeon, Joo young;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.37-51
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    • 2021
  • Objective : The purpose of this study was to analyze non-invasive treatments and drooling assessment methods in children with cerebral palsy and developmental disabilities, who drool. Methods : This study searched two hundred papers published in 2005-2019. Forty-four papers were selected based on their abstract and title, and ten papers were finally selected following a secondary search. Results : The PEDro Scale of the selected papers was high with an average of seven points. As a result of analyzing the overall trends, the study participants were primarily patients with cerebral palsy, and recently, the therapeutic intervention of oral sensory exercise was more actively studied than behavioral modification. Studies of behavioral modification and oral sensory exercise intervention methods were found to have differences in participant age and, cognitive level, number of participants, research design, treatment time, and duration. Studies to confirming the frequency and severity of the drooling measurement method were found to be the main factor. Conclusion : This study analyzed typical behavioral modification and oral sensory exercise interventions as examples of non-invasive therapeutic interventions for children with cerebral palsy and developmental disabilities and provided information to help select appropriate therapeutic intervention methods when planning non-invasive therapy using behavioral modification and oral sensory exercise therapy.

A Prognostic Factor for Prolonged Mechanical Ventilator-Dependent Respiratory Failure after Cervical Spinal Cord Injury : Maximal Canal Compromise on Magnetic Resonance Imaging

  • Lee, Subum;Roh, Sung Woo;Jeon, Sang Ryong;Park, Jin Hoon;Kim, Kyoung-Tae;Lee, Young-Seok;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.791-798
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    • 2021
  • Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

Mask-wearing Characteristics an COVID-19 in Indoor and Outdoor Environments in Seoul in 2020 (2020년 코로나바이러스감염증-19 유행 상황에서 서울시 다중이용 시설 및 실외에서의 마스크 착용 행태)

  • Kang, Sohyun;Guak, Sooyoung;Bataa, Altangerel;Kim, Donghyun;Jung, Youngdeok;Shin, Jiyoon;Lee, Kiyoung
    • Journal of Environmental Health Sciences
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    • v.46 no.6
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    • pp.750-756
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    • 2020
  • Objectives: After coronavirus disease 2019 (COVID-19) was declared a pandemic, the South Korean government announced guidelines on wearing masks to prevent its spread. The guidelines have changed depending on the severity of the spread of COVID-19. This study aimed to identify mask-wearing behaviours to counter the spread of COVID-19 in indoor and outdoor environments. Methods: The type of mask worn and proper wearing were observed in cafés, supermarkets, underground shopping malls, and streets in Seoul. Behavioral assessment was repeated in August at social distancing levels 1 and 2, in October at social distancing level 1, and in November after the mask mandates. Results: In August, 22.1% of subjects in cafés, 90.8% in supermarkets, 91.8% in underground shopping malls, and 83.6% on outdoor streets wore masks properly. In October, the proportion of correct wearers increased in all locations. After masks became mandatory in November, about 97% of users of supermarkets, underground shopping malls, and streets wore masks properly. In cafés, the proportion of proper wearers was 61.5% with both social distancing level 2 in August and the mandate in November. The number of KF-certified mask wearers continued to increase from August to November. Conclusion: This study investigated mask-wearing behaviors to counter COVID-19 through observations in indoor and outdoor places in Seoul. Mask-wearing behavior was different depending on the place and the government guidelines in place. The results could be used for evaluation of the current guidelines for COVID-19.

Assessment of the Relationship between Sella Turcica Morphology and Delayed Dental Age (안장(Sella turcica)의 형태와 지연된 치령의 연관성 평가)

  • Soojin, Choi;Jihyun, Song
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.3
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    • pp.241-252
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    • 2022
  • The purpose of this study was to evaluate the relationship between sella turcica morphology and delayed dental age. In total, 389 participants under 16 years old were selected. Dental age was evaluated by the Demirjian method and age discrepancy (AD), the value subtracted from dental age to chronological age, was calculated. The participants were divided into 8 groups based on the sella turcica type. Bridging ratio (BR) was defined as interclinoid distance divided by sella turcica length to determine the degree of sella turcica bridging (STB) and the participants were classified into 4 groups by BR. The data were statistically analyzed using the Kruskal Wallis test and the Mann Whitney test. Some groups with sella turcica abnormality showed lower AD than that of the normal group and the AD differences varied from 4 months to 1.3 year. As the STB severity increased, AD decreased. AD differences varied from 7 months to 1.19 year. No distinct differences were observed in sella turcica type and STB groups according to sex. The results indicate that sella turcica morphology is associated with delayed dental age. Sella turcica can be used as a supplementary indicator to predict dental development.

Drought risk assessment considering regional socio-economic factors and water supply system (지역의 사회·경제적 인자와 용수공급체계를 고려한 가뭄 위험도 평가)

  • Kim, Ji Eun;Kim, Min Ji;Choi, Sijung;Lee, Joo-Heon;Kim, Tae-Woong
    • Journal of Korea Water Resources Association
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    • v.55 no.8
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    • pp.589-601
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    • 2022
  • Although drought is a natural phenomenon, its damage occurs in combination with regional physical and social factors. Especially, related to the supply and demand of various waters, drought causes great socio-economic damage. Even meteorological droughts occur with similar severity, its impact varies depending on the regional characteristics and water supply system. Therefore, this study assessed regional drought risk considering regional socio-economic factors and water supply system. Drought hazard was assessed by grading the joint drought management index (JDMI) which represents water shortage. Drought vulnerability was assessed by weighted averaging 10 socio-economic factors using Entropy, Principal Component Analysis (PCA), and Gaussian Mixture Model (GMM). Drought response capacity that represents regional water supply factors was assessed by employing Bayesian networks. Drought risk was determined by multiplying a cubic root of the hazard, vulnerability, and response capacity. For the drought hazard meaning the possibility of failure to supply water, Goesan-gun was the highest at 0.81. For the drought vulnerability, Daejeon was most vulnerable at 0.61. Considering the regional water supply system, Sejong had the lowest drought response capacity. Finally, the drought risk was the highest in Cheongju-si. This study identified the regional drought risk and vulnerable causes of drought, which is useful in preparing drought mitigation policy considering the regional characteristics in the future.

Association of Korean Medicine Pattern Identifications and Liver Blood Markers with the Severity of Cognitive Impairment in an Elderly Population (경도인지장애와 경도치매 단계에서의 한의 변증 및 간 혈액지표 연관성 탐색 연구)

  • Kahye Kim;Jiyun Cha;Seul Gee Kim;Hyung-Won Kang;Yeoung-Su Lyu;In Chul Jung;Jaeuk U. Ki
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.141-150
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    • 2023
  • Objectives: This study aimed to comprehend the characteristics of Korean medicine patterns in relation to varying degrees of cognitive impairment in an elderly population. Methods: The dataset included 127 elderly individuals with cognitive impairment obtained from three Korean medicine hospitals between 2018 and 2021. The participants were categorized into two groups based on Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores: those with questionable impairment (QI) and those with very mild dementia (VMD). A diagnostic framework for Korean medicine patterns encompassing Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire was employed. Liver blood markers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and the AST/ALT ratio, were also analyzed. Results: The scores of the cognitive assessment tools (MoCA-K, MMSE-DS, and K-IADL) of the QI group significantly differed from those of the VMD group. CDR-SB exhibited a positive correlation with the scores of each pattern of Qi deficiency, Yin deficiency, Phlegm dampness, and Heat-fire, whereas ALT and AST values displayed negative correlations. Binomial logistic analysis, controlling for potential confounders, such as age, education years, body mass index, the presence of chronic disease, and the presence of medication, verified that the VMD group showed higher pattern scores and lower ALT and AST values than the QI group. Conclusions: Increases in pattern scores along with decreased AST and ALT levels might be indicative of more severe cognitive impairment.

Assessment of Risk Factors for Developmental Defects of the Enamel in Preterm (조산아의 발육성 법랑질 결함의 위험 요인 평가)

  • Shang-yon Park;Jaeho Lee;Hyung-Jun Choi;Chung-Min Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.2
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    • pp.192-204
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    • 2023
  • This study aimed to determine the criteria for quantifying developmental defects of enamel in primary teeth in premature babies and to investigate the severity of developmental defects according to the gestational age, birth weight, systemic complications, and treatments received after preterm birth. Birth information, a history of complications, the duration of parenteral nutrition, and endotracheal intubation were investigated by retrospectively reviewing the admission and discharge records of premature babies in the neonatal intensive care unit. The Preterm Developmental Defects of Enamel (PDDE) index was designed by modifying the existing developmental defects of enamel index. Based on PDDE index, the evaluator scored developmental defects of enamel by classifying them as enamel hypomineralization and hypoplasia. The PDDE scores in the extremely preterm and extremely low birth weight groups were significantly higher than those in other groups. Furthermore, PDDE scores of premature babies with bronchopulmonary dysplasia, rickets, intraventricular hemorrhage, or necrotizing colitis were significantly higher than those in the control group. In addition, more than 50 days of endotracheal intubation and more than 20 days of parenteral nutrition were associated with significantly higher PDDE scores than those in the control group and were risk factors for developmental defects of enamel. This study provides basic information for identifying risk factors for developmental defects of enamel in premature babies.