• Journal of Radiation Protection and Research
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• v.38 no.4
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• pp.214-227
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• 2013

Computed tomographic scan as a screening procedures in asymptomatic individuals has seen a steady increase with the introduction of multiple-raw detector CT scanners. This report provides a brief review of the current controversy surrounding CT cancer screening, with a focus on the radiation induced cancer risks and clinical efficacy. 1. A large study of patients at high risk of lung cancer(the National Lung Screening Trial[NLST]) showed that CT screening reduced cancer deaths by 20%(1.33% in those screened compared with 1.67% in those not screened). The rate of positive screening tests was 24.2% and 96.4% of the positive screening results in the low-dose CT group were false-positive. Radiation induced lung cancer risk was estimated the most important in screening population because ERR of radiation induced lung cancer does not show the decrease with increasing age and synergistic connection between smoking and radiation risk. Therefore, the radiation risk may be on the same order of magnitude as the benefit observed in the NLST. Optimal screening strategy remain uncertain, CT lung cancer screening is not yet ready for implementation. 2. Computed tomographic colonography is as good as colonoscopy for detecting colon cancer and is almost as good as colonoscopy for detecting advanced adenomas, but significantly less sensitive and specific for smaller lesions and disadvantageous for subsequent therapeutic optical colonoscopy if polyps are detected. The average effective dose from CT colonography was estimated 8-10 $mS{\nu}$, which could be a significant dose if administered routinely within the population over many years. CT colonography should a) achieve at least 90% sensitivity and specificity in the size category from 6 and 10 mm, b) offer non-cathartic bowl preparation and c) be optimized and standardized CT parameters if it is to be used for mass screening. 3. There is little evidence that demonstrates, for whole-body scanning, the benefit outweighs the detriment. This test found large portion of patient(86~90.8%) had at least one abnormal finding, whereas only 2% were estimated to have clinically significant disease. Annual scans from ages 45 to 75 years would accrue an estimated lifetime cancer mortality risk of 1.9%. There is no group within the medical community that recommends whole-body CT. No good studies indicate the accuracy of screening CT, at this time. The benefit/risk balance for any of the commonly suggested CT screening techniques has yet to be established. These areas need further research. Therefore wild screening should be avoided.

• Therapeutic Science for Rehabilitation
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• v.13 no.1
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• pp.35-47
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• 2024

Objective : This study aimed to investigate the association between lifestyle factors and risk of frailty and depressive symptoms among older South Korean adults. Methods : This study included 10,072 individuals aged 65 or older from the 2017 National Survey of Older Koreans, a cohort of community-dwelling older South Koreans. The following lifestyle factors were assessed: physical activity, nutrition management (NM), and leisure/social activity participation (AP). Frailty was measured using the frail scale and depressive symptoms were measured using the Geriatric Depression Scale. Logistic regression analyses were performed to determine the odds ratios. Results : All lifestyle factors were associated with the risk of frailty and depressive symptoms in the study population. Regular exercise (≥3 times/wk, odds ratio [OR] = 0.59, 95% confidence interval [95% CI] = 0.52~0.91; OR = 0.66, 95% CI = 0.59~0.75), active NM (OR = 0.86, 95% CI = 0.80~0.91; OR = 0.81, 95% CI = 0.76~0.86), leisure AP (OR = 0.79, 95% CI = 0.74~0.84; OR = 0.71, 95% CI = 0.66~0.77) and social AP (OR = 0.92, 95% CI = 0.88~0.96; OR = 0.82, 95% CI = 0.78~0.87) were correlated with lower odds ratios of frailty and depressive symptoms. Conclusion : Adopting a healthier lifestyle characterized by regular exercise, balanced nutrition, and active engagement in various activities can effectively reduce the risk of frailty and depressive symptoms among the older population. Ultimately, this study emphasized the essential role of lifestyle choices in promoting the physical and mental well-being of older adults.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.57-68
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• 2019

Purpose: This study aimed to investigate the effects of a short-term group multimodal intervention program that mixes physical activity, cognitive motion, and social interaction, on the cognitive function and depression level of healthy over 75-year-old individuals. Method: This study used a one group pre-test-post-test design, and intervention was made for 70 minutes per session, once a week, for four sessions in total. To compare changes in cognitive function, depression level and physical function before and after intervention, this study used the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Depression Scale-Short Form (GDS-SF), and Berg Balance Scale (BBS). Result: After applying group multimodal interventions to healthy over 75-year-old individuals, there was a statistically significant improvement in their cognitive function (p < 0.01), and there was a statistically significant decrease in their depression level (p < 0.05). Also, there was an increase in the rating score of the degree of balance from $46.83{\pm}9.11$ points before the intervention, to $48.08{\pm}7.00$ points after the intervention; however, it was not statistically significant (p > 0.05). Conclusion: Short-term group multimodal intervention that mixes physical activity, cognitive motion, and social interaction had a significant effect on slowing down the deterioration of cognitive function in healthy over 75 year-old individuals, and decreased their depression level. This study is significant in that it presents a foundation for providing more systematic intervention for the prevention of dementia and depression in the healthy older individuals. Follow-up studies should verify the result through research on the effects of an occupational therapist's professional treatment, and experimental group-control research.

• Therapeutic Science for Rehabilitation
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• v.13 no.1
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• pp.9-21
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• 2024

Objective : The purpose of this study was to confirm the characteristics and quality of a single-subject research that conducted interventions to improve activities of daily living (ADL) in stroke patients. Methods : 'Stroke,' 'activities of daily living,' and 'single-subject studies' were searched as keywords among papers published in the last 15 years between 2009 and 2023 among Research Information Sharing Service, DBpia, and e-articles. A total of nine papers were examined for the characteristics and quality before analysis. Results : The independent variables applied to improve ADL included constraint-induced therapy, mental practice for performing functional activities, virtual reality-based task training, subjective postural vertical training without visual feedback, bilateral upper limb movement, core stability training program, traditional occupational therapy and neurocognitive rehabilitation, smooth pursuit eye movement, neck muscle vibration, and occupation-based community rehabilitation. Assessment of Motor and Process Skills was the most common evaluation tool for measuring dependent variables, with four articles, and Modified Barthel Index and Canadian Occupational Performance Measure were two articles each. As a result of confirming the qualitative level of the analyzed papers, out of a total of nine studies, seven studies were at a high level, two at a moderate level, and none were at a low level. Conclusion : Various types of rehabilitation treatments have been actively applied as intervention methods to improve the daily life activities of stroke patients; the quality level of single-subject studies applying ADL interventions was reliable.