• Title/Summary/Keyword: small group care

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Outcomes of Pulmonary Resection and Mediastinal Node Dissection by Video-Assisted Thoracoscopic Surgery Following Neoadjuvant Chemoradiation Therapy for Stage IIIA N2 Non-Small Cell Lung Cancer

  • Jeon, Yeong Jeong;Choi, Yong Soo;Lee, Kyung Jong;Lee, Se Hoon;Pyo, Hongryull;Choi, Joon Young
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.29-34
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    • 2018
  • Background: We evaluated the feasibility and outcomes of pulmonary resection and mediastinal node dissection (MND) by video-assisted thoracoscopic surgery (VATS) following neoadjuvant therapy for stage IIIA N2 non-small cell lung cancer (NSCLC). Methods: From November 2009 to December 2013, a total of 35 consecutive patients with pathologically or radiologically confirmed stage IIIA N2 lung cancer underwent pulmonary resection and MND, performed by a single surgeon, following neoadjuvant chemoradiation. Preoperative patient characteristics, surgical outcomes, postoperative drainage, postoperative complications, and mortality were retrospectively analyzed. Results: VATS was completed in 17 patients. Thoracotomy was performed in 18 patients, with 13 planned thoracotomies and 5 conversions from the VATS approach. The median age was $62.7{\pm}7.9years$ in the VATS group and $60{\pm}8.7years$ in the thoracotomy group. The patients in the VATS group tended to have a lower diffusing capacity for carbon monoxide (p=0.077). There were no differences between the 2 groups in the method of diagnosing the N stage, tumor response and size after induction, tumor location, or histologic type. Complete resection was achieved in all patients. More total and mediastinal nodes were dissected in the VATS group than in the thoracotomy group (p<0.05). The median chest tube duration was 5.3 days (range, 1 to 33 days) for the VATS group and 7.2 days (range, 2 to 28 days) for the thoracotomy group. The median follow-up duration was 36.3 months. The 5-year survival rates were 76% in the VATS group and 57.8% in the thoracotomy group (p=0.39). The 5-year disease-free survival rates were 40.3% and 38.9% in the VATS and thoracotomy groups, respectively (p=0.8). Conclusion: The VATS approach following neoadjuvant treatment was safe and feasible in selected patients for the treatment of stage IIIA N2 NSCLC, with no compromise of oncologic efficacy.

A Study on the Management and Living Environment of the Group-homes for the Elderly -Focusing on Jeonju and Kwangju- (노인그룹홈의 운영과 생활환경에 관한 연구 -전주시와 광주시를 중심으로-)

  • Ahn, Kyung-Ohn
    • Korean Journal of Human Ecology
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    • v.18 no.4
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    • pp.841-855
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    • 2009
  • The main objective of this study is to examine the situations of group-homes for the elderly and clarify the problems of them. This study investigates the present conditions of welfare facilities and supply conditions. 4 group-homes were surveyed in Jeonju and Kwangju cities. Data was collected through various ways including the survey conducted by facility operators, the measurement of living space, and photo-takings. The major results of this study are as follows: 1) With the introduction of nursing care insurance in 2008, the increase of the demand and supply to group-home will be expected, due to less cost for recuperation. The care of elderly in homelike atmosphere is effective to the elderly suffering from dementia. Therefore, it is proper that the supply of group-homes for dementia will be needed. 2) Group-homes for the elderly are being supplied under the standards of welfare facilities in the present. Separate supply standards, however, are needed because they are not suitable for small scale group-homes. 3) To supply Group-homes for the elderly on a one-unit basis would cause various problems such as economical unreality, personnel distribution and so on. It is necessary to supply more than two units for more efficient management. 4) The management of group-homes for the elderly is financially unstable because the operating funds heavily depend on the users or people who are connected with the facilities through private networks. Therefore, additional support is needed to settle the financial problem. It would be helpful to build the public networking that provides information about the group-home for the elderly for the public. 5) In case of the increase in the supply of the group-home in a residential area, it could be helpful to promote the group-home to the public. 6) The operators state that the main problems of group homes for the elderly lie in financial difficulties and the shortage of professionals and volunteers. The financial, personnel, and material support for personnel and the supervision of management are required for the transparency and effectiveness of the facility management. In addition, the closer network and cooperation system with the community is required. 7) The present living environments for group-homes for the elderly leave much room for improvement, considering the physical condition of the elderly. The more careful selections in the color, shape, material, and equipment of the facilities should be made for the convenience of the elderly users.

Outcomes of small for gestational age micropremies depending on how young or how small they are

  • Yu, Hee-Joon;Kim, Eun-Sun;Kim, Jin-Kyu;Yoo, Hye-Soo;Ahn, So-Yoon;Chang, Yun-Sil;Park, Won-Soon
    • Clinical and Experimental Pediatrics
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    • v.54 no.6
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    • pp.246-252
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    • 2011
  • Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

The Effect of STEAM-based Unplugged Play Activities Using Robots on the Improvement of Children's Creative and Social Personalities (STEAM교육 접근에 의한 언플러그드 로봇 놀이프로그램이 유아의 창의적 및 사회적 인성 함양에 미치는 효과)

  • Chun, Hui Young;Park, Soyeon
    • Korean Journal of Childcare and Education
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    • v.16 no.5
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    • pp.1-26
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    • 2020
  • Objective: This study investigated 5-year-old children's developmental levels for creative and social personalities according to gender, and whether participation in STEAM-based unplugged robotic activities can improve their creative and social personalities. Methods: Participants were 5-year-old children (N=125) from 11 child care centers. The experimental group included 29 boys and 24 girls enrolled in classrooms that implemented an unplugged activities curriculum over five weeks. The control group consisted of 38 boys and 34 girls. Data were analyzed using a t-test and analysis of covariance, and Hedges' g was used to measure effect size. Results: First, the participating children's mean scores on creative and social personalities were 3.20 and 3.53 on a 5-point Likert scale, respectively. Girls scored higher than boys in sensitivity-various interests and imagination-playfulness domains of creative personality and all three domains of social personality. Second, children in the experimental group showed improvement in all domains of social personality and the effect size was large. They also improved in three domains (openness-humor, imagination-playfulness, independency-immersion) of creative personality, although the effect size was small. Conclusion/Implications: The results imply that implementing a robotics curriculum with unplugged play activities in early childhood classrooms contributes to 5-year-old children's development of creative and social personalities.

Impact of the Private Insurance Benefits and the medical Care Expenditure on Household Income Inequality (가구소득불평등에 민간보험수입과 의료비본인부담지출이 미친 영향)

  • Lee, Yong-Jae;Kim, Hyung-Eick
    • Journal of Digital Convergence
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    • v.15 no.12
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    • pp.625-633
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    • 2017
  • The purpose of this study is to investigate the effect of private insurance revenues and household spending on household income inequality. To this end, we conducted a concentration index and concentration curve analysis for the income level of medical panel survey data in 2015. The main results are as follows. First, the household income concentration ratio is 0.3580, which means that income is concentrated in the high income group, and the degree of inequality is considerably large. Second, although the portion of the private insurance benefits was small on the high-income household, it helped to strengthen the benefits concentration on this group. Third, the low income group has a large self-pay medical expense. Finally, the index of the income excluding the burden of the total medical expenses in the household income was 0.3676, so that even accounting for medical expenses, the income was concentrated in the high income class. Therefore, private insurance benefits and medical expenses were all contributing factors to the inequality of household income, and this study provides the essential materials for research and policy planning which could lead to the convergence of different fields.

Primary Surgical Closure of Large Ventricular Septal Defects in Small Infants (조기 영아기 심실 중격 결손의 개심술)

  • 최종범;양현웅
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.486-492
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    • 1997
  • We r viewed a policy of primary surgical closure of large ventricular septal defects in small infants. Sixty-three infants met criteria for inclusion in the study, and were divided into two groups based on age: group 1 infants aged less than 5 months(n = 31), and group 2 infants aged 5 months or more(n = 32). Both groups had similar variation in ventricular septal defect location(paramembranous versus muscular), and showed no significant difference in left to right shunt and in ratio of systemic and pulmonary vascualr resistance. Three early deaths(9.7%) occurred in group 1, but no death(0%) in group 2. The causes of death were preoperative cardiac arrest and cerebral injury followed by postoperative respiratory insufficiency in two patients, and preoperative tracheomalacia followed by laryngeal edema and respiratory arrest in one Two patients in group 1 showed postoperative low cardiac output syndrome(6.5% in group 1 versus 0% in group 2). There was no late death during the follow-up per od in both groups. No surviving patients had postoperative patch leakage, or required a second operation. These results indicate that primary surgical closure of large ventricular septal defects, if logical perioperative care is accompanied, can be saefly performed in small infants aged less than 5 months with low postoperative mortality or morbidity rates.

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A Study of Nutritional Knowledge, Dietary Attitudes and Dietary Behaviors of Adult Women by Acne Status

  • Jinkyung Kwack;Kim, Kyungwon
    • Journal of Community Nutrition
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    • v.3 no.2
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    • pp.87-95
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    • 2001
  • This study was conducted to investigate nutritional knowledge, dietary attitudes, and dietary behaviors of adult women, and to examine if these characteristics were different by acne status. Subjects were 106 adult women residing in Seoul recruited from clients and employers at skin care centers, and housewives from apartment complexes. Surrey instrument was adapted or modified based on literature review and dietary intakes were assessed using 24-hour recalls for two days and CAN-pro. All data was statistically analyzed using x$^2$test and ANOVA. When examined by acne status, 41.5% of subjects were categorized into acne group, 20.8% were as ex-acne group, and 37.7% as no-acne group. Parental experience of acne was significantly related to acne status(p〈 0.01). Education, employmental status, and smoking or drinking status were not related to acne status. Subjects had a moderate level of nutritional knowledge(72.7 point) and the nutritional knowledge store was not significantly different by acne status. When examined by individual items, the groups showed significant difference on the items regarding vitamin C and necessity of carbohydrates(p 〈 0.05). Subjects showed favorable dietary attitudes. Although the acne group showed more favorable attitudes on the importance of nutrition on acne, the overall dietary attitudes of the acne group were not significantly different from the ex-acne group or no-acne group. Similarly only small differences were noticed in dietary behaviors or nutrient intakes by acne status. Cholesterol consumption was hitgher in the no-acne group than in the acne group or ex-acne group(p 〈 0.01). The intakes of energy, iron, and calcium was much below the RDA in three groups. Although there were not many significant differences in nutritional knowledge, dietary attitudes, and dietary behaviors by acne status, this study provided some baseline information regarding study variables by acne status.

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Differences in the Effects of a Horticultural Activity Program Depending on the Level of Resilience of College Students

  • Kim, Yong Hyun;Bae, Hwa-Ok;Huh, Moo Ryong
    • Journal of People, Plants, and Environment
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    • v.22 no.3
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    • pp.255-268
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    • 2019
  • Horticultural therapy, as a kind of complementary alternative therapies using nature as a medium, is an intervention method that can be applied to various subjects by utilizing horticultural activities that anyone can enjoy as a leisure activity. This research defined the resilience of individuals as a personal characteristic, and examined differences in the intervention effect of horticultural activities depending on the level of resilience. The results obtained in this study can be utilized in planning a horticultural activity program and setting the purpose and goals of horticultural activity programs. The subjects of this study were divided into the high resilience experimental group (Group A), the low resilience experimental Group (Group C), the high resilience control group (Group B), and the low resilience control group (Group D). The experiment was conducted in the campus of G University from September to November 2017, and the experimental group participated in the program once per week, a total of 10 sessions. The Korean version of the Connor-Davidson Resilience Scale, autonomic nervous assessment, and the interpersonal relationship change scale were carried out as pre- and post-assessment. Statistical analysis was performed using a non-parametric test. Group A showed statistically significant positive changes in relaxation of physical tension and stability. In conclusion, those with high resilience showed the higher intervention effects of horticultural activities on physical relaxation and stability than those with low resilience. However, there were some possible limitations in this study. Since the number of subjects was small and subjects were limited to college students, it is impossible to generalize the results of this study. Therefore, it is necessary to conduct follow-up studies to address and overcome these limitations.

A Study on Factors Influencing Consumer Purchase Intentions and Purposes in Direct-To-Consumer Genetic Test (소비자의뢰 유전자검사 구매 의도 및 목적에 영향을 미치는 요인 연구)

  • Park, Imsu;Jung, Ilyoung
    • Journal of Digital Convergence
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    • v.17 no.7
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    • pp.167-177
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    • 2019
  • Innovation of genomics technology has recently been extended to Direct To Consumer Genetic Test (DTC-GT) which consumers purchase without requesting the service on medical institutes. In 2016, Korea has introduced the DTC-GT but the market size is small comparing to global market. This study analyzes consumers' purchase intentions and purposes and their influential factors based on 2018 consumer survey. According to the results of binominal and multinominal logistic regression, knowledge after purchase, attitude on medical care benefit, health status are statistically significant on purchase intentions. Purchase purposes are different on age group and related on medical care rather than health care. These results imply that DTC-GT is needed to improve consumer satisfaction, re-purchase and effective care service. This paper is expected to contribute on strategic directions for the new DTC-GT product development.

Association between oral health-related factors and grip strength using the 6th Korea National Health and Nutrition Examination Survey data (국민건강영양조사 제6기 자료를 활용한 구강건강관련요소와 악력과의 연관성)

  • Kang, Hyun-Kyung
    • Journal of Korean society of Dental Hygiene
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    • v.19 no.5
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    • pp.743-752
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    • 2019
  • Objectives: Grip strength is a measure for assessing overall muscle strength, muscle mass, and nutritional status, and is a useful tool for early examination of a person's general health. Thus, this study analyzed the association between oral health-related factors and grip strength, using the 6th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: Data were analyzed using the IBM SPSS version 25.0 (IBM Co., Armonk, NY, USA) software with a complex sampling analysis of stratified and clustered variables, all with weighted values, applied for every analysis conducted. From the 6th KNHANES data, a total of 26,101 people were selected as the study population. A complex sample generalized linear model analysis was performed for participants' sociodemographic characteristics, health status, use of oral care products, and factors such as adult mastication and speaking habits. Results: Grip strength was found to be higher among men compared to women. Grip strength was the highest in the 20-39 year old group. Furthermore, grip strength was statistically significantly higher among married and employed individuals, and in the right hand (p<0.001). Grip strength was statistically significantly higher among people who perceived themselves to have good health and among those who did not have health-related problems in the past two weeks (p<0.001). It was also higher among those who used interdental brushes and electronic toothbrushes (p<0.001), but decreased with greater discomfort in mastication and speaking among adults (p<0.05). Conclusions: Grip strength was found to be associated with oral health-related factors and therefore, these could be helpful tools in evaluating both general and subjective health statuses. In general, oral care products are small in size with oral care involving the use of hands and certain precise motions and actions to remove foreign substances in the oral cavity. As shown in the findings, grip strength declines with increased age and as a result, the use of oral care products should be strongly recommended in order to promote better general health.