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Changes in interpersonal violence and utilization of trauma recovery services at an urban trauma center in the United States during the COVID-19 pandemic: a retrospective, comparative study

  • Kevin Y. Zhu;Kristie J. Sun;Mary A. Breslin;Mark Kalina Jr.;Tyler Moon;Ryan Furdock;Heather A. Vallier
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.60-66
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    • 2024
  • Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

Amelioration of colitis progression by ginseng-derived exosome-like nanoparticles through suppression of inflammatory cytokines

  • Jisu Kim;Shuya Zhang ;Ying Zhu;Ruirui Wang;Jianxin Wang
    • Journal of Ginseng Research
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    • v.47 no.5
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    • pp.627-637
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    • 2023
  • Background: Damage to the healthy intestinal epithelial layer and regulation of the intestinal immune system, closely interrelated, are considered pivotal parts of the curative treatment for inflammatory bowel disease (IBD). Plant-based diets and phytochemicals can support the immune microenvironment in the intestinal epithelial barrier for a balanced immune system by improving the intestinal microecological balance and may have therapeutic potential in colitis. However, there have been only a few reports on the therapeutic potential of plant-derived exosome-like nanoparticles (PENs) and the underlying mechanism in colitis. This study aimed to assess the therapeutic effect of PENs from Panax ginseng, ginseng-derived exosome-like nanoparticles (GENs), in a mouse model of IBD, with a focus on the intestinal immune microenvironment. Method: To evaluate the anti-inflammatory effect of GENs on acute colitis, we treated GENs in Caco2 and lipopolysaccharide (LPS) -induced RAW 264.7 macrophages and analyzed the gene expression of proinflammatory cytokines and anti-inflammatory cytokines such as TNF-α, IL-6, and IL-10 by real-time PCR (RT-PCR). Furthermore, we further examined bacterial DNA from feces and determined the alteration of gut microbiota composition in DSS-induced colitis mice after administration of GENs through 16S rRNA gene sequencing analysis. Result: GENs with low toxicity showed a long-lasting intestinal retention effect for 48 h, which could lead to effective suppression of pro-inflammatory cytokines such as TNF-α and IL-6 production through inhibition of NF-κB in DSS-induced colitis. As a result, it showed longer colon length and suppressed thickening of the colon wall in the mice treated with GENs. Due to the amelioration of the progression of DSS-induced colitis with GENs treatment, the prolonged survival rate was observed for 17 days compared to 9 days in the PBS-treated group. In the gut microbiota analysis, the ratio of Firmicutes/Bacteroidota was decreased, which means GENs have therapeutic effectiveness against IBD. Ingesting GENs would be expected to slow colitis progression, strengthen the gut microbiota, and maintain gut homeostasis by preventing bacterial dysbiosis. Conclusion: GENs have a therapeutic effect on colitis through modulation of the intestinal microbiota and immune microenvironment. GENs not only ameliorate the inflammation in the damaged intestine by downregulating pro-inflammatory cytokines but also help balance the microbiota on the intestinal barrier and thereby improve the digestive system.

With Corona Era, exploring policy measures to prevent non-face-to-face lonely deaths - Focusing on Daegu Metropolitan City's AI and IOT cases of lonely death prevention (With 코로나 시대 비대면 고독사 예방정책 방안 모색 - 대구광역시 AI, IOT 고독사 예방 사례를 중심으로)

  • Ha-Yoon Kim;Tai-Hyun Ha
    • Journal of Digital Convergence
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    • v.21 no.3
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    • pp.49-62
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    • 2023
  • Due to social and cultural changes and the growth of aging people living as a single because of aging, lonely deaths are steadily increasing, and each local government has begun to define them as a social problem. The legal basis began to be established. In order to explore policy measures to prevent lonely deaths, this study examined cases of lonely death prevention policies using smart digital information technology (AI, IOT), which is being promoted by Daegu Metropolitan City to promote non-face-to-face policies to prevent lonely deaths. Policies related to lonely deaths are divided into two axes: lonely death prevention projects and post-excavation support projects. In order to operate these businesses efficiently, the provision of non-face-to-face services through artificial intelligence and the Internet of Things is recognized as a new service delivery system, so the importance and necessity of non-face-to-face services is increasing. It is time that multifaceted changes and preparations are needed, such as establishing a system to expand the non-face-to-face industry at the national level. In order to respond to another national disaster situation in the future, the non-face-to-face smart care system is being expanded in various welfare policies such as preventing lonely deaths. It will have to be activated.

Exploring the Essence of Missionary Kid's Experience of Ethnic Identity as TCK(Third Culture Kids) (선교사 자녀의 TCK(Third Culture Kids)로서의 민족정체성 겪음에 대한 본질 탐색)

  • Mun Mikyung
    • Journal of Christian Education in Korea
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    • v.76
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    • pp.193-212
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    • 2023
  • Purpose of Study: This study is a qualitative study to understand the essential experiences of missionary children related to national identity. Research Contents and Methods: Ten children of missionaries who were re-entered to their home countries to receive university education were selected as participants for the study. Two preliminary surveys (2016, 2019) were conducted to determine the direction and subject of the study. Two in-depth interviews and one non-face-to-face survey were conducted with the study participants. Based on preliminary research and prior research, the questionnaire explored identity experiences by discovering four areas: language, culture, group, and place. In addition, rich research results were derived with schematic interview data, surveys using Phinney's 1992 national identity test tool, non-face-to-face surveys with parents of study participants, and self-report identity graphs. Conclusions and suggestions: As a result of the study, missionary kids as TCKs were able to know their names in identity confusion by sequentially experiencing international mobility, separation, and discrepancy in four areas. After all, TCK seems to suffer from identity difficulties because it remains primarily 'minority' in relation to the four domains. This study is meaningful in that it specifically revealed the support needed for TCK missionary children with multicultural background by revealing the importance of providing visiting experience in Korea and schoo(herd)l experience before entering Korean universities to re-adaptate TCK.

Study of the Actual Condition and Satisfaction of Volunteer Activity in Australian Hospital (호주 일 지역의 병원 자원봉사활동 실태와 만족도)

  • Park, Geum-Ja;Choi, Hae-Young
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.17-29
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    • 2006
  • Purpose: This research aimed to investigate the actual condition and satisfaction of volunteer activity in Australian hospital. Methods: Data was collected by self reported questionnaire from 101 volunteers and analyzed by frequency and percentage, t-test, ANOVA and Sheffe and Pearson's correlation coefficients using SPSS 12.0. Results: 1. Years involved in volunteer work were $5{\sim}10$ years (32.7%), above 10 years (30.7%), $2{\sim}3$ years (11.9%) and $3{\sim}5$ years (10.9%). Types of volunteer work were physical care (32.7%), physical and emotional care (14.9%), and others (18.8%). Types of allocation of tasks were by volunteer coordination (55.7%), and by volunteer preference and consent between volunteer and coordinator (both respectively, 20.5%). Main reasons for volunteer work were to help sick people (61.4%) and to make good use of leisure time (22.8%). Routes to start volunteer work were from his (her) own inquiries (43.4%), from hearing from other volunteers (30.7%) and from mass media (13.1%). 80.2% of volunteers had received some kinds of training or preparation for volunteer work. Suitability of volunteer's skill and ability to voluntary work were 'very well' (74.0%) and 'mostly well' (18.0%). Reimbursements or benefits received for volunteer work were token or lunch or group outing (31.7%), and token and lunch or group outing (19.8%). Evaluation frequency for volunteer work was occasionally (372%), frequently (30.9%), always (17.0%) and never (14.9%). Relationship with volunteer work coordinator was very good (85.0%). The relationship with other volunteers was very good (81.2%). The relationship with hospital staffs was very good (69.7%) and mostly good (21.2%). Family and friend's support for volunteer work was very good (83.2%). 2 The mean score of satisfaction for the hospital volunteer activity was $3.09{\pm}0.49\;(range:\;1{\sim}4)$. The highest score domain was 'social contact', $3.48{\pm}0.61$, and the lowest was 'social exchange', $1.65{\pm}0.63$. An item of the highest score was 'I have an opportunity to help other people' ($3.83{\pm}0.40$), and the lowest score item was 'I will receive compensation for volunteer work I have done ($1.10{\pm}0.78$).' 3. The satisfaction from hospital volunteer activity was shown by significant difference according to sex (t=2.038, P=0.044), marital status (F=3.806, P=0.013), years involved in volunteer work (F=3.326), nam reason to do volunteer work (F=2.707, P=0.035), receive any training or preparation for volunteer work (t=-1.982, 0=0.050), frequency of evaluation for volunteer work (F=7.877, P=0.000), suitability of volunteer's skill and ability to voluntary work (t=2.712, P=0.049), relationship with volunteer work coordinators (F=-2.517, P=0.013), relation with hospital staffs (F=5.202, P=0.007), and support of their volunteer work by their family and friends (t=-3.394, P=0.001). Conclusion: The satisfaction of hospice volunteer activity was moderate. The satisfaction for hospice volunteer activity was shown by significant difference according to sex (t=2.038, P=0.044), marital status (F=3.806, P=0.013), years involved in volunteer work (F=3.326), main reason to do volunteer work (F=2.707, P=0.035), receive any training or preparation for volunteer work (t=-1.982, 0=0.050), frequency of evaluation for volunteer work (F=7.877, P=0.000), suitability of volunteer's skill and ability to voluntary work (t=2.712, P=0.049), relationship with volunteer work coordinator (F=-2.517, P=0.013), relation with hospital staffs (F=5.202, P=0.007), and family and friend's support for volunteer work (t=-3.394, P=0.001). Therefore, it is necessary to consider various factors to improve the satisfaction of voluntary work.

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Immuno-stimulatory Activities of a High Molecular Weight Fraction from Cynanchum wilfordii Radix Obtained by Ultrafiltration (한외거르기(Ultrafiltration)에 의하여 분리된 백수오 고분자 분획물의 면역증진 활성)

  • Jang, Mi;Lim, Tae-Gyu;Hong, Hee-Do;Rhee, Young Kyoung;Kim, Kyung-Tack;Lee, Eunjung;Lee, Jeong Hoon;Lee, Yun Ji;Kim, Yeon Bok;Cho, Chang-Won
    • Korean Journal of Food Science and Technology
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    • v.48 no.3
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    • pp.268-274
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    • 2016
  • The purpose of this study was to investigate the immuno-stimulatory activity of the high-molecular-weight fraction (HMWF) of Cynanchum wilfordii (CW) extracts obtained by ultrafiltration in murine macrophage RAW 264.7 cells and to assess its immuno-stimulatory effect in mice. Ultrafiltration was performed with polyethersulfone membranes (30 kDa cutoff) in a cross-flow filtration system to obtain the HMWF of CW. The results showed that the HMWF increased the production of various cytokines such as tumor necrosis factor-${\alpha}$, interleukin-6, and nitric oxide in dose-ependent manners. In addition, HMWF treatment increased the relative spleen weight as well as splenocyte proliferation induced by concanavalin A or bacterial lipopolysaccharide in mice. Natural killer (NK) cell activity in the HMWF-treated group was significantly increased compared to that in the control group. These results suggest that the HMWF of CW can support the immune system through secretion of macrophage cytokines, thereby enhancing NK cell activity and murine splenocyte proliferation.

Evaluation of Applicability of Food and Nutrition Standards for Child Care Setting in the Seoul Metropolitan Government (서울시 영유아 공공급식 식품영양관리 기준의 적용 가능성 평가)

  • Jeon, Hye-Min;Kim, Kirang;Yi, Hae-Yeon;Hwang, Ji-Yun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.8
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    • pp.997-1011
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    • 2017
  • This study aimed to evaluate the applicability of "food and nutrition standards for child care setting in the Seoul Metropolitan Government" using quantitative and qualitative surveys and lay the groundwork for future expansion. To evaluate the understanding and applicability of each item of the standards and utilize goodness of fit as an evaluation item to improve practicality of the child care center's health foodservice, we surveyed 82 child care centers, kindergartens, and community children centers in Seoul by e-mail through the Seoul Metropolitan Government in November 2015. Using focus group interviews with directors of child care centers and kindergartens as well as dieticians of child care support centers who had conducted public foodservice in Seoul, the appropriateness of each standard was finally reviewed, and amendments to extend this standard were derived. Results of the survey show an understanding of 86.9% and an applicability of 80.7%. Moreover, the applicability of the evaluation items for assessing improvement of health foodservice practices at the child care center was 82.6%. Qualitative evaluation of the applicability of standards through focus group interviews identified four factors for extended application: necessity of a guideline for separate food ingredient suppliers, conformity of the basis and purpose of the item, consideration of contextual situations, and necessity of establishing a Seoul-level foundation. Therefore, guidelines for the standards should be suggested for those providing public food services for children. Furthermore, separate guidelines categorized by items that food ingredient suppliers need to provide should be mandatory or recommended. Evaluation of the applicability of the standards suggests that revising and supplementing the guidelines in order to extend the standards can contribute to health promotion and a sustainable environment for children using public foodservice. Follow-up studies and supports are needed for sustainable food and nutrition management programs.

Study of heat transfer to the implant-bone interface induced by grinding of occlusal surface of implant gold prosthesis (금 합금 보철물의 교합면 삭제로 인한 임플란트-골 계면으로의 열전달에 관한 연구)

  • Jo, Jae-Young;Kang, Sun-Nyo;Jeong, Chang-Mo;Yun, Mi-Jung;Huh, Jung-Bo;Jeon, Young-Chan
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.1
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    • pp.29-35
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    • 2012
  • Purpose: The purpose of this study was to analyze temperature change along the implant-bone interface induced by grinding the occlusal surface of implant gold prosthesis and to compare the temperature generated by grinding of prosthesis with different cooling methods. Materials and methods: The experimental gold prostheses were fabricated with dental gold alloy and castable abutment. The prostheses had 3 cylindrical protrusions on the occlusal surface with 1mm in height. Temperature was measured using 16 thermocouple wires attached to the implant fixture surface and the fixture was embedded in an acrylic resin block inside the $37^{\circ}C$ water bath. Cylinders were grinded for a period of 30 second with a low-speed handpiece with green stone point. One cylindrical protrusion was grinded without cooling, the second one was grinded with air blow, and the third one was grinded with water-spray. Results: The mean maximum temperature was measured more than $47^{\circ}C$ of the implant and the maximum temperature was measured at the cervical portion of the implant in the group without cooling. There was statistically significant difference between the group without cooling and the groups with cooling (P<.05). However, there was no significant difference at all portion of implant in the groups with cooling (P>.05). Conclusion: The results of this study support that the grinding of implant gold prosthesis without cooling may damage the peri-implant tissue. The continuous use of air blow and water-spray adjacent to prosthesis during the grinding of implant gold prosthesis may prove to be beneficial for cooling of the implant.

Survey on the Care Burden and Quality of Life in Family Caregivers of Patients Using Home Mechanical Ventilator in Yeongnam Region, Korea (영남권역에서 가정용 인공호흡기를 사용하는 환자 가족간병인의 간병 부담과 삶의 질)

  • Son, Ju-Hyun;Moon, Myung-Hoon;Cho, Mi-Kyung;Yun, Ra-Yu;Huh, Sung-Chul;Min, Ji-Hong;Moon, Jung-In;Kim, Soo-Yeon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.1
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    • pp.39-49
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    • 2020
  • Objective : The aim of this study was to investigate the care burden and life quality in family caregivers of community-dwelling patients using home mechanical ventilator(HMV) in Yeognam region. Methods : Survey performed to family caregivers of the patients using HMV in Yeognam region, Korea. The questionnaire is composed with patient care and the burden on caring. Korean version of Short Form Zarit Burden Interview(K-ZBI-12) and 3-Level version of EuroQol-5 Dimension applying Korean weight(KEQ-5D-3L) were also investigated. Statistical significance was accepted for p<.05. Results : A total 98 out of 150 questionnaires were analyzed. The K-ZBI-12(33.08±10.34) had a correlation with KEQ-5D-3L(0.71±0.25) negatively(p=.038). Patients' age, duration of HMV, financial burden and professional caregivers' care time had correlations with K-ZBI-12 positively(p<.05). KEQ-5D-3L correlated duration of HMV negatively(p=.017). Invasive ventilator group had lower KEQ-5D-3L than the non-invasive ventilator group(p=.008). K-ZBI-12 was lower in more than one caregiver care of patients than in one(p=.001). Conclusion : This study revealed high care burden and low quality of life in family caregivers of the patients with HMV in Yeongnam region, Korea. Efforts are needed to continually identify the needs of patients and their families, and the socioeconomic support and medical services associated with HMV.

A Study Security Measures for Protection of VIP in the G20 Summit (G20 정상회의 시 주(主)행사장에서의 VIP 안전대책 방안에 관한 연구)

  • Lee, Sun-Ki;Lee, Choong-Soo
    • Korean Security Journal
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    • no.24
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    • pp.91-123
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    • 2010
  • The threat factors available for occurrence given G20 Summit Meeting are expected leader terrorism, hostage terrorism, bomb terrorism, public facilities terrorism, and aircraft terrorism. As for the threat groups, which are expected in Korea, the North Korea, Islam extremist group, and the group such as NGO organization of being opposed to international meeting are regarded as having possibility of causing hazard. Thus, the purpose of this study is to suggest VIP Security-measure plans in the main site in preparation for G20 Summit Meeting. Accordingly, each country in the world is adopting 'the principle of Triple Ring' in common. Thus, it elicited a coping plan by 1st line(inner ring) 2nd line(middle ring) 3rd line(outer ring) based on this principle, and proposed even an opinion together that will need to be reflected in light of policy for the VIP security measures. In conclusion, as for the VIP Security-measure plans in the main site in preparation for G20 Summit Meeting, In the inner ring(safety sector), first, an intercepting measure needs to be devised for a spot of getting into and out of vehicles given the Straight Street. Second, the Walking Formation needs to be reinforced boldly in the exposed area. In the middle ring(security sector), first, the control plan needs to be devised by considering particularity of the main site. Second, there is necessity for adopting the efficient security badge operation plan that is included RFID function within security badge. In the outer ring(aid protective sector), first, there is necessity of preparing for several VIP terrorisms, of collecting information and intelligence, and of reinforcing the information collection system against terrorism under the cooperation with the overseas information agency. Second, the urgent measure training in time of emergency needs to be carried out toward security agent event manpower. Third, to maintain the certain pace in VIP motorcade, the efficient traffic control system needs to be operated. Finally, as for what will need to be reflected in light of policy for VIP security measures, first, there is necessity for allowing VIP residence to be efficiently dispersed to be distributed and controlled. Second, there is necessity for allowing impure element to misjudge or attack to be failed by utilizing diverse deception operations. Third, according to the reorganization in North Korea's Organization of the South Directed Operations, the powerful 'military-support measure' needs to be driven from this G20 Summit Meeting. For this, the necessity was proposed for further reinforcing the front back defense posture under the supervision of the Ministry of National Defense and for positively coping even with detecting and removing poison in preparation for CBR (chemical, biological, and radio-logical) terrorism.

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