• Title/Summary/Keyword: the Elderly

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Current status of dental geriatric education in Korea (한국의 노인치과학 교육 현황)

  • Kim, Ha-Young;Lee, Jeong-Yol;Huh, Jung-Bo;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.49 no.3
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    • pp.229-235
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    • 2011
  • Purpose: The aim of this study was to evaluate the current status of dental geriatric education in Korea. Materials and methods: One of the faculty members related in geriatric education was selected in each Korean dental school and the questionnaire on geriatric dental education was sent to them by e-mail. The questionnaire consists of the topics about undergraduate geriatric education and administration of the geriatric education. The information obtained from the questionnaire was compared with that of other countries in the aspects of curriculum, teaching methods, subjects, and existence of specific clinics, etc. Results: Seven schools have geriatric dentistry in undergraduate education curriculum. Among those, only two schools had it taught by theoretical lecture as well as clinical lecture. Two dental schools had specific geriatric clinic among seven dental schools. Compared with the USA and western European countries, the geriatric dental education in Korea is at a developing stage and was perfunctory without diverse clinical experience. Conclusion: In Korean dental schools, geriatric education was mostly conducted by lectures, and clinical teaching programs were not well organized compared with developed countries. It seems that the status of geriatric dental education in Korea has not been well established academically or administratively yet.

Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients (심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가)

  • Lee, Hye-Jin;Lee, Jung-Jeung;Hwang, Tae-Yoon;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.167-180
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    • 2012
  • Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

Compliance of Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 환자의 지속적 상기도 양압술 순응도)

  • Choi, Jong-Bae;Lee, Seung-Hee;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.13 no.1
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    • pp.27-32
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    • 2006
  • Objectives: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. Methods: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. Results: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. Conclusions: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.

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Investigation of the Correlation between Seoul Neuropsychological Screening Battery Scores and the Gray Matter Volume after Correction of Covariates of the Age, Gender, and Genotypes in Patients with AD and MCI (알츠하이머 치매 및 경도인지기능장애 환자에서 나이, 성별, 유전자형을 고려한 뇌 회백질 부피와 표준신경심리검사와의 상관관계 연구)

  • Lee, Seung-Yeon;Yoon, Soo-Young;Kim, Min-Ji;Rhee, Hak Young;Ryu, Chang-Woo;Jahng, Geon-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.4
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    • pp.294-307
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    • 2013
  • Purpose : To investigate the correlations between Seoul Neuropsychological Screening Battery (SNSB) scores and the gray matter volumes (GMV) in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) and cognitively normal (CN) elderly subjects with correcting the genotypes. Materials and Methods: Total 75 subjects were enrolled with 25 subjects for each group. The apolipoprotein E (APOE) epsilon genotypes, SNSB scores, and the 3D T1-weighted images were obtained from all subjects. Correlations between SNSB scores and GMV were investigated with the multiple regression method for each subject group using both voxel-based and region-of-interest-based analyses with covariates of age, gender, and the genotype. Results: In the AD group, Rey Complex Figure Test (RCFT) delayed recall scores were positively correlated with GMV. In the MCI group, Seoul Verbal Learning Test (SVLT) scores were positively correlated with GMV. In the CN group, GMV negatively correlated with Boston Naming Test (K-BNT) scores and Mini-Mental State Examimation (K-MMSE) scores, but positively correlated with RCFT scores. Conclusion: When we used covariates of age, gender, and the genotype, we found statistically significant correlations between some SNSB scores and GMV at some brain regions. It may be necessary to further investigate a longitudinal study to understand the correlation.

Does the Gut Microbiota Regulate a Cognitive Function? (장내미생물과 인지기능은 서로 연관되어 있는가?)

  • Choi, Jeonghyun;Jin, Yunho;Kim, Joo-Heon;Hong, Yonggeun
    • Journal of Life Science
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    • v.29 no.6
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    • pp.747-753
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    • 2019
  • Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.

Psychological, relational and financial resources: How do they influence happiness among Koreans (심리적, 관계적, 경제적 자원: 한국인의 행복에 어떠한 영향을 미치는가?)

  • Youngshin Park ;Uichol Kim
    • Korean Journal of Culture and Social Issue
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    • v.15 no.1
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    • pp.95-132
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    • 2009
  • Can money buy happiness? If not, what are the factors that influence happiness? What makes people happy? What are the factors that influence happiness among Korean adults? How can we better explain factors that influence happiness? These are the research questions that led to the analyses of psychological, relational, financial resources that influence happiness. To examine differences in socio-economic status, adults and elderly from three different districts that vary wealth and income were interviewed in their own home. A total of 313 respondents (male=133, female=180) between the ages of 20 through 80 completed a questionnaire that contained background information, emotional support scale and happiness scale developed by the present researcher and resiliency of efficacy developed by Bandura(1995). The results are as follows. First, monthly income influence happiness to some extent, but when the variable was excluded from the path analysis, the goodness-of-fit did not change significantly. Although those who have more money can be happier, those without much money can also be happy. These results indicate that financial resource has limited influence on happiness. In addition, monthly income did influence self-efficacy of respondents indicating that those with more money were not necessarily more confident about themselves. Second, an important factor influencing happiness is the relational resource. Emotional support was the most powerful predictor of happiness, four to five times more important than monthly income. Third, self-efficacy influenced happiness. Those respondents with higher resiliency of efficacy had higher happiness scores and the influence was two times greater than monthly income. Moreover, self-efficacy played a mediating role between emotional support and happiness. Fourth, those respondents with higher occupational achievement reported higher happiness score and the influence was two times greater than monthly income. Fifth, success of children influenced happiness score and the influence was 1.5 times greater than monthly income. Sixth, education did not directly influence happiness, but had an indirect influence through self-efficacy and occupational achievement. Seventh, age was not related to self-efficacy and happiness.

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Needs of Patients and their Families in Hospice Care Unit (일 호스피스 병동 입원 환자와 가족의 요구도)

  • Kim, Hyung-Chul;Kim, Eun-Sook;Park, Kwang-He
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.137-144
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    • 2007
  • Purpose: The purpose of this study is to identify and assess the needs of the cancer patients and their families and provide basic data to meet with their needs. Methods: This is a descriptive study using questionnaire method. Questionnaire were collected by mail from 76 discharged patients from a hospice ward from May until the end of October, 2004, and data were analyzed by SPSS 10.0. Results: Admitted patients had needs of pain control (85.5%), non-pain symptoms (63.2%) such as vomiting, dyspnea, ascites, etc, and emotional and spiritual problem solving (28.9%, 14.5%). Interests of patients were health care of himself/herself (65.8%), concern for their spouses left alone (32.9%), and future of their children (15.8%). In families' needs of care of 5 areas, "information on patient's status and treatment/nursing care" was shown most high score ($3.48{\pm}0.62$). In detailed questions, they request most 'to inform the prognosis of patients' and the next is 'to inform the reasons that nursing care was required'. The next highest score was to 'inform family roles' ($3.39{\pm}0.64$), and next was spiritual support ($3.11{\pm}0.79$), and emotional support ($3.08{\pm}0.72$). Expectations of family on the treatment were comfortable dying (73.4%) scored the highest. Patients' families were satisfied with volunteer service most in service area (97.4%). The next was pain control (89.5%) and nursing service (77.6%). Conclusion: Health care staff should identify the actual needs of families caring cancer patients and they should operate realistic programme which can give continuous and assistance by reflecting individual needs and characteristics. With these srategies, the quality of life of patients and families can be improved. And then the intervention programme should be developed to measure subjective nursing care needs of terminally ill cancer patients and their families.

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Cytotoxicity of COX-2 Inhibitor (Nimesulide) in Non-small Cell Lung Cancer Cell Line (비소세포폐암 세포주에서 COX-2억제제(Nimesulide)의 세포독성)

  • Park Chan Beom;Jeon Hyun Woo;Jin Ung;Cho Kyu Do;Kim Chi Kyung;Wang Young-Pil
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.263-270
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    • 2005
  • In recent years, a combination of two demographic phenomena, an increased number of older people in the population and an increase in the incidence of lung cancer with age, has made it mandatory to develop therapeutic modalities with less toxicity for the treatment of inoperable elderly patients with lung cancer. Therefore, we investigated the correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Material and Method: Immunohistochemical staining of COX-2 was performed. After exposure of Nimesulide, XTT analysis, FACS analysis and Hoechst staining were carried out. Result: COX-2 protein was expressed in non-treated A549 cells strongly, but not in H1299. Cytotoxicity of Nimesulide against A549 cell and H1299 cell were similar and $IC_{50}$ of Nimesulide in both cell lines were $70.9{\mu}M$ in A549 cell line and $56.5{\mu}M$ in H1299 cell line respectively. FACS analysis showed $G_0/G_1$ arrest in both cell lines and the S phase cell fraction was decreased. Morphologic assessment of apoptosis by Hoechst 33258 staining, many apoptotic cells were detected in both cell lines. Conclusion: Selective COX-2 inhibitor, Nimesulide, can inhibit the proliferation of non-small cell lung cancer cell lines in vitro. Inhibitory effect of Nimesulide are induction of apoptosis and $G_0/G_1$ arrest. There is no correlation between COX-2 expression and cytotoxicity of Nimesulide, a specific COX-2 inhibitor. Therefore, highly selective COX-2 inhibitors such as Nimesulide can be expected to lead to even greater efficacy of their use as adjuncts to various anticancer angents and radiation therapy for the treatment of high-risk patients.

Differences in Patients' and Family Caregivers' Ratings of Cancer Pain (암환자와 그 가족간호자가 지각하는 환자의 통증강도 차이)

  • Kim, Hyun-Sook;Yu, Su-Jeong;Kwon, Shin-Young;Park, Yeon-Hee
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.42-50
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    • 2008
  • Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.

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The Influence of Urinary Incontinence and Depression in Elderly on the Quality of the Life (노인의 요실금과 우울증이 삶의 질에 미치는 영향)

  • Kim, Jihyun;Lee, Joongsuk;Nam, Beomwoo;Choi, Jin-Yong;Yang, Sang-Kuk;Yim, Hyeon Woo;Jo, Sun-jin;Jeong, Hyunsuk
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.129-135
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    • 2017
  • Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.