• Title/Summary/Keyword: sub-health center

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Dynamic Cardiac Magnetic Resonance Fingerprinting During Vasoactive Breathing Maneuvers: First Results

  • Luuk H.G.A. Hopman;Elizabeth Hillier;Yuchi Liu;Jesse Hamilton;Kady Fischer;Nicole Seiberlich;Matthias G. Friedrich
    • Journal of Cardiovascular Imaging
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    • v.31 no.2
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    • pp.71-82
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    • 2023
  • BACKGROUND: Cardiac magnetic resonance fingerprinting (cMRF) enables simultaneous mapping of myocardial T1 and T2 with very short acquisition times. Breathing maneuvers have been utilized as a vasoactive stress test to dynamically characterize myocardial tissue in vivo. We tested the feasibility of sequential, rapid cMRF acquisitions during breathing maneuvers to quantify myocardial T1 and T2 changes. METHODS: We measured T1 and T2 values using conventional T1 and T2-mapping techniques (modified look locker inversion [MOLLI] and T2-prepared balanced-steady state free precession), and a 15 heartbeat (15-hb) and rapid 5-hb cMRF sequence in a phantom and in 9 healthy volunteers. The cMRF5-hb sequence was also used to dynamically assess T1 and T2 changes over the course of a vasoactive combined breathing maneuver. RESULTS: In healthy volunteers, the mean myocardial T1 of the different mapping methodologies were: MOLLI 1,224 ± 81 ms, cMRF15-hb 1,359 ± 97 ms, and cMRF5-hb 1,357 ± 76 ms. The mean myocardial T2 measured with the conventional mapping technique was 41.7 ± 6.7 ms, while for cMRF15-hb 29.6 ± 5.8 ms and cMRF5-hb 30.5 ± 5.8 ms. T2 was reduced with vasoconstriction (post-hyperventilation compared to a baseline resting state) (30.15 ± 1.53 ms vs. 27.99 ± 2.07 ms, p = 0.02), while T1 did not change with hyperventilation. During the vasodilatory breath-hold, no significant change of myocardial T1 and T2 was observed. CONCLUSIONS: cMRF5-hb enables simultaneous mapping of myocardial T1 and T2, and may be used to track dynamic changes of myocardial T1 and T2 during vasoactive combined breathing maneuvers.

Development of a Model of a Day Care Center for Rural Elderly People (농촌형 노인 주간보호시설 모형개발)

  • Kang, Kyung-Sook
    • Research in Community and Public Health Nursing
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    • v.15 no.4
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    • pp.551-565
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    • 2004
  • Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

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Relationship between the Change in Body Weight or Body Mass Index and Pulmonary Function (체중 및 체질량지수 차이에 따른 폐 기능과의 연관성)

  • Kim, Taeyoung;Woo, Jeonghyun;Lee, Woohyun;Jo, Seonkyung;Chun, Hyejin
    • Korean journal of health promotion
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    • v.19 no.2
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    • pp.91-95
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    • 2019
  • Background: Obesity and deterioration of pulmonary function are known to increase all-cause mortality and morbidity associated with chronic diseases. Obesity is a known risk factor for decreasing pulmonary function; however, studies on the effect of changes in body weight or body mass index (BMI) on pulmonary function are rare. This study aimed to investigate the relationship between the change in body weight or BMI and the pulmonary function test (PFT) in Koreans who underwent consecutive screening at a health promotion center. Methods: We enrolled 5,032 patients who underwent consecutive screening health check-ups at a health promotion center in 2015 and 2017. The BMI was calculated as the body weight (kg) divided by the square of the height (m2) in 2015 and 2017. We analyzed the association between the change in body weight or BMI and PFT. Results: In males, PFT and changes in body weight were associated with forced expiratory volume in 1 second (FEV1) but not with changes in BMI. In females, FEV1/forced vital capacity and forced expiratory flow between 25-75% of vital capacity (FEF25-75%) were significantly associated with the changes in body weight and BMI. A correlation analysis between body weight and BMI showed a negative correlation with FEF25-75% in males. In females, FEV1/FVC and FEF25-75% were negatively correlated. Conclusions: We observed that the increase in body weight and BMI was significantly associated with pulmonary function. This finding suggests that careful monitoring of body weight and BMI may aid in maintaining proper pulmonary function, thereby, reducing mortality and morbidity.

Study on Quality Changes Caused by Rancidity and Methods to Reduce Rancidity for Domestically Distributed Herbal Medicines (유통 한약재의 산패에 따른 품질변화 및 산패 저감화 연구)

  • Young-Ae Park;Suk-Kyung Ko;Hyun-Kyung Lee;Eun-Jung Choi;Sung-Cho Hong;Yun-Seon Park;Ji-Hun Jung;Ju-Sung Park;Yong-Seung Shin
    • Korean Journal of Pharmacognosy
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    • v.54 no.2
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    • pp.80-87
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    • 2023
  • Rancidity changes were examined for 6 herbal medicines, namely Persicae Semen, Armeniacae Semen, Lini Semen, Trichosanthis Semen, Arecae Semen, Myristicae Semen known to have relatively high fat content. In order to reduce rancidity of herbal medicines, samples were stored at 3 different conditions of room, refrigerating and freezing temperatures, and the rancidity was measured for 10 months with every 2 month interval. Fat content was extracted by using ethyl ether, and acid values and peroxide values, which are generally accepted indicators of fat rancidity, were measured. When storing Persicae Semen, Lini Semen and Arecae Semen at room temperature, the acid values increased as the storage period increased, and it was higher than when stored in refrigeration or freezing. The measurement of peroxide value showed more significantly higher initial degree of rancidity when Persicae Semen, Trichosanthis Semen, Arecae Semen and Myristicae Semen were stored at room temperature. It was observed that storing herbal medicines in refrigeration or freezing inhibited their rancidity compared to storing them at room temperature. To investigate the quality changes according to rancidity, the analysis of aflatoxins and indicator components showed that aflatoxins B1 and B2 were detected in Armeniacae Semen, Arecae Semen and Myristicae Semen, and the amount of amygdalin was well maintained within the specification standard.

Factors Related to the Medical Service Performance of Rural Health Sub-centers (농어촌 보건지소 진료실적과 관련 요인)

  • Lee, Su-Jin;Na, Baeg-Ju
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.350-360
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    • 2010
  • Objectives: This study was conducted to identify factors that affect medical service performance in rural health sub-centers and to develop a method to improve health sub-center performance that takes advantage of these insights. Methods: This study included 1,242 South Korean health sub-centers that had been in operation at least since December 31, 2009 as units of analysis. After adjusting for population differences between areas, the performance of medical service among health sub-centers was analyzed according to medical services performed per person. We performed t-tests, ANOVA, Scheffe's tests and multiple regression analyses. Results: The following were significant variables affecting the medical service performance of rural health sub-centers: number of hospitals and clinics, presence of community health practitioner posts, distance from health sub-centers to main public health centers, distance from health sub-centers to the nearest emergency medical facilities, and proportion of the local population aged 65 and over. In contrast, the proportion of the local population between ages 0-4 and the placement of public health doctors that had already completed their internship were not significant variables. Conclusions: The medical service performance of health sub-centers located in rural areas is significantly affected by local population and health care environment characteristics, and therefore, it is imperative to develop strategies to provide differentiated service based on these factors.

A Study on Public Health Doctors' Participation in District Public Health Program of Health Sub-centers in Korea (보건지소 공중보건의사의 지역보건사업 참여 실태)

  • Lee, Jae-Chun;Park, Yong-Moon;Ahn, Song-Vogue;Lee, Hae-Young;Hwang, Jin-Won
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.53-66
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    • 2003
  • Objectives: To investigate the state of medical care around health sub-centers, public health doctors' participation and opinion in the process of district public health programs. Methods: The study included 1,036 public health doctors who worked at health sub-center all over the country. The data were collected for Feb, 2002 using self-administered questionnaire by mail. Results: One or two doctors were working at health sub-center and 33.5% of health sub-centers was located in the region of the separation of prescription and dispensing. There were another medical facilities in 45.9% of the administrative district(eup or myon) where health sub-centers were located. The count of medical utilization went down to 14.8${\pm}$14.8 per a day in Nov, 2001 from 18.0${\pm}$15.6 in May, 2000, and the decline was much more in the region of the separation of prescription and dispensing. Among public health programs in health sub-centers, public health doctors participated mostly in preliminary medical examination for vaccination and least in health education. They participated in implementation rather than planning or evaluation of health program. Over a half of public health doctors were found to be positive that health programs implemented in their health sub-centers would promote the level of health in community people and they were willing to participate in district public health program if community people were in need. Conclusions: Recently health sub-centers are required to turn into health promotion facilities rather than medical practice facilities. Health program in health sub-centers will be advanced in both quality and quantity by turning the role of public health doctors who have provided medical services mainly into managing health program. Persistent education about managing health program and the policy to motivate participation in health program should be provided for public health doctors.

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Analysis of Respiratory and Cardiovascular Diseases according to PM Concentration in the Incheon Area (인천시 자치구별 미세먼지 농도에 따른 호흡기 및 심혈관계 외래환자 수 상관분석)

  • Lee, Seungwoon;Jung, Seungkwon
    • Journal of Environmental Health Sciences
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    • v.46 no.3
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    • pp.276-284
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    • 2020
  • Objectives: This study was conducted to identify the effects of PM10 and PM2.5 on hospital visits in the Incheon area over the period of 2016-2018. Methods: We applied correlation analysis and Poisson regression to perform the analysis using cardiovascular disease and respiratory disease data from the National Health Insurance Service and the daily average PM10 and PM2.5 from the Korea Environment Corporation adjusting for time lag. Results: When the daily average PM10 concentration increased by 10 ㎍/㎥, the number of cardiovascular disease patients were 1.002 times higher (95% CI [Confidence Interval]; 1.000-1004) in Ganghwa County. As the daily average PM2.5 concentration increased by 10 ㎍/㎥, the number of cardiovascular disease patients were 1.012 times higher (95% CI; 1.008-1.016) in Ganghwa County. As the daily average PM10 concentration increased by 10 ㎍/㎥, the respiratory disease patients were 1.003 times (95% CI; 1.002-1.004) higher in Gyeyang and Michuhol Counties. As the PM2.5 concentration increased by 10 ㎍/㎥, the respiratory disease patients were 1.003 times higher (95% CI; 1.002-1.005) in Bupyeong County. Conclusions: In some parts of the Incheon area there was a correlation between the number of patients with respiratory and cardiovascular conditions and the concentration of PM10 and PM2.5.

Factors Related to the Job Stress of Home Health Care Nurses at Health Centers in Seoul Korea (서울시 보건소 맞춤형 방문건강관리 간호사의 직무스트레스 관련 요인)

  • Kim, Ki-Suk;Kim, Soon-Lae
    • Journal of Home Health Care Nursing
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    • v.20 no.1
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    • pp.44-52
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    • 2013
  • Purpose: To identify factors that affect the job stress of visiting nurses at health centers in Seoul, Korea, who perform home care services. Methods: Data were collected in the period from November 20 to December 10, 2008, from 206 visiting nurses working at 25 health centers in Seoul metropolitan city. Self-report questionnaires of the Organization-Based Self-Esteem (OBSE) and the Korean Occupational Stress Scale (KOSS) were used. Data were analyzed by the SPSS win 15.0. Results: Several findings were obtained from the study. First, the mean of job stress was 52.4 points, which was higher than that of Korean women. Second, it was shown that by the sub-domain of job stress, the mean value belonged to the top 50% in the four sub-domains of physical environment, job demand, interpersonal conflict, and organizational system. Additionally, it belonged to the top 25% in the sub-domain of job insecurity, wherein the job stress was the highest. Third, the self-esteem of the nurses had the most significant effect on their job stress. Conclusion: Stress related to job insecurity was the highest among the visiting nurses at health centers in Seoul who perform the custom home care service thus, institutional support is urgently needed to alleviate such stress and secure their employment.

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Evaluation of PM2.5 Exposure Contribution Using a Microenvironmental Model (국소환경 모델을 이용한 초미세먼지(PM2.5) 노출 기여율 평가)

  • Shin, Jihun;Choe, Yongtae;Kim, Dongjun;Min, Gihong;Woo, Jaemin;Kim, Dongjun;Shin, Junghyun;Cho, Mansu;Sung, Kyeonghwa;Lee, Jongdae;Yang, Wonho
    • Journal of Environmental Health Sciences
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    • v.48 no.2
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    • pp.59-65
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    • 2022
  • Background: Since people move through microenvironments rather than staying in one place, they may be exposed to both indoor and outdoor PM2.5 concentrations. Objectives: The aim of this study was to assess the exposure level of each sub-population group and evaluate the contribution rate of the major microenvironments. Methods: Exposure scenarios for sub-population groups were constructed on the basis of a 2019 Time-Use survey and the previous literature. A total of five population groups were classified and researchers wearing MicroPEM simulated monitoring PM2.5 exposure concentrations in real-time over three days. The exposure contribution for each microenvironment were evaluated by multiplying the inhalation rate and the PM2.5 exposure concentration levels. Results: Mean PM2.5 concentrations were 33.0 ㎍/m3 and 22.5 ㎍/m3 in Guro-gu and Wonju, respectively. When the exposure was calculated considering each inhalation rate and concentration, the home showed the highest exposure contribution rate for PM2.5. As for preschool children, it was 90.8% in Guro-gu, 94.1% in Wonju. For students it was 65.3% and 67.3%. For housewives it was 98.2% and 95.8%, and 59.5% and 91.7% for office workers. Both regions had higher exposure to PM2.5 among the elderly compared to other populations, and their PM2.5 exposure contribution rates were 98.3% and 94.1% at home for Guro-gu and Wonju, respectively. Conclusions: The exposure contribution rate could be dependent on time spent in microenvironments. Notably, the contribution rate of exposure to PM2.5 at home was the highest because most people spend the longest time at home. Therefore, microenvironments such as home with a higher contribution rate of exposure to PM2.5 could be managed to upgrade public health.