Trauma remains a significant healthcare burden, causing over five million yearly fatalities. Notably, the liver is a frequently injured solid organ in abdominal trauma, especially in patients under 40 years. It becomes even more critical given that uncontrolled hemorrhage linked to liver trauma can have mortality rates ranging from 10% to 50%. Liver injuries, mainly resulting from blunt trauma such as motor vehicle accidents, are traditionally classified using the American Association for the Surgery of Trauma grading scale. However, recent developments have introduced the World Society of Emergency Surgery classification, which considers the patient's physiological status. The diagnostic approach often involves multiphase computed tomography (CT). Still, newer methods like split-bolus single-pass CT and contrast-enhanced ultrasound (CEUS) aim to reduce radiation exposure. Concerning management, nonoperative strategies have emerged as the gold standard, especially for hemodynamically stable patients. Incorporating angiography with embolization has also been beneficial, with success rates reported between 80% and 97%. However, it is essential to identify the specific source of bleeding for effective embolization. Given the severity of liver trauma and its potential complications, innovations in diagnostic and therapeutic approaches have been pivotal. While CT remains a primary diagnostic tool, methods like CEUS offer safer alternatives. Moreover, nonoperative management, especially when combined with angiography and embolization, has demonstrated notable success. Still, the healthcare community must remain vigilant to complications and continuously seek improvements in trauma care.
In recent years the progress of nuclear medicine advanced dramatically in imaging and targeted radionuclide therapy is able to open op exciting perspectives as standard diagnostic and therapeutic modalities, complementing conventional modalities. Positron emission tomography/computed tomography (PET/CT) technology with FDG has been developed clinically in less than 10 years as a routine standard in oncological imaging, including a number of other fluorinated radiopharmaceuticals being evaluated for their ability to complement FDG. However, the limitation of FDG-PET such as non-specific uptake and its short half-life is not compatible with the time necessary for optimal tumour targeting. Therefore, a development of innovative positron-emitting radionuclides with half-lives longer than 10 h is needed. For therapeutic applications, the injection of higher activities is required to reach efficient adsorbed doses in radioresistant solid tumours, while limiting the irradiation of vital organs. In this application, the longer half-life of radiolsotopes are more fit well for radionuclide therapy. To achieve this, researches have to be carried in a largor spectrum of radionuclides for diagnosis and therapy. In the context of rapidly growing nuclear medicine and strong demanding innovative radionuclides, a high-energy (100 MeV), high-intensity (-mA) accelerator with proton (PEFF at KAFRI). will be operating in 2011. The priorities of PEFP will include supporting the nuclear medicine research community by providing those radionuclides with current limited availability by means of a high-energy, high-intensity accelerator.
Purpose: This study was conducted in order to explore self-perceived objectives, effects, determinant factors of satisfaction and demands on home-based rehabilitation service (HBRS) based on a community-based rehabilitation (CBR) model in community-dwelling disabilities. Methods: This research was conducted through in-depth interview. HBRS was conducted by four physical therapists for one hour a day, once a week, for eight weeks. After an eight-week intervention period, in-depth interviews were conducted using a semi-structured questionnaire for five recipients of HBRS and six care givers. Results: For the physical effect, some participants experienced positive effects, whereas others did not due to the short-term intervention period. For the social and emotional effects, 'occurrence of motivation for exercise', 'change of surroundings' and 'sorriness for the therapist' emerged as keywords. For the determinant factors of satisfaction, 'movement-inducing therapy', 'therapy from the specialist', 'development of friendship & social network', and 'learning the way of self-rehabilitation' emerged as keywords. For further demands on HBRS, participants stated that 'sufficient time for therapy', 'user opinion-reflected therapy', 'additional instructions for therapeutic exercise & activities of daily living', and 'active promotion for HBRS' were necessary. Conclusion: Participants were satisfied with the physical, social, emotional, and educational aspects of HBRS. In particular, the participants regarded educational aspects as the significant factor throughout self-perceived objectives, determinant factors of satisfaction and the demands. This result suggests that when providing HBRS to community-dwelling persons with disabilities, therapists should recognize the necessity and significance not only of the physical, but also the educational aspect of HBRS.
Purpose: to investigate nursing service needs of dementia caregivers in the community, and, also to provide basic data that is helpful in developing nursing intervention for them. Method: MMSE-K exam was administered on 15,216 men more than 65years old who live in Gu, Seoul city, and the subject of this study were caregivers of 792 demented elderly who were below 20 points in the MMSE-K exam. Result: Total score of nursing service needs of family appeared lower than average. By specific area, information nursing needs was the highest(M=3.29), and therapeutic nursing needs (M=3.31), welfare service nursing needs(M=3.32), emotional support nursing needs (M=3.34) followed in order. The factors which increased the total score of nursing service needs of dementia caregivers as general and physical characteristics were man (p=.04), lower ADL (p=.00) and IADL(p=.00), longer length of sick days(p=.01), having diseases(p=.03), decline of cognition(p=.00), existence of dementia symptom(p=.00). And. high economic status(p=.03), good caring attitude(p=.00) were family characteristics which increased the nursing service needs of caregivers. As predicting variables dementia symptom (10.4%), caring attitude(1.9%), existence of economic activity (1.5%), and length of sick days(1.2%) exhibited explanation power in order. Conclusion: In future, active intervention methods that correspond to family nursing service needs have to be developed, and it is also needed to develop nursing intervention strategy on specific problem with dementia problematic behavior, exercise etc.. Also, it is needed to do research on the caring attitude of dementia family because active caring attitude of family was significant influencing factor on nursing service needs of family.
Objective: The aim of this randomized controlled clinical trial was to compare oral health-related quality of life (OHRQoL) of patients treated with conventional, active self-ligating (ASL), and passive self-ligating (PSL) brackets in different therapeutic phases. Methods: Sixty patients (mean age 18.3 years; 29 males and 31 females) requiring orthodontic treatment were randomly and equally assigned to receive conventional (Victory Series), ASL (In-Ovation R), or PSL (Damon 3MX) brackets. OHRQoL was measured with a self-administered modified 16-item Malaysian version of the Oral Health Impact Profile for immediate (soon after the visit) and late (just before the subsequent visit) assessments of the bonding and activation phases. Data were analyzed with the Kruskal-Wallis and chi-square tests. Results: The PSL and ASL groups showed more immediate and late impacts in the bonding phase, respectively; the conventional group was affected in both the assessments. The first activation phase had similar impacts in the groups. After the second activation, the conventional group showed more immediate impacts, whereas the PSL and ASL groups had more late impacts. The commonly affected domains were "physical disability," "functional limitation," "physical pain," and "psychological discomfort." No significant differences in the prevalence and severity of immediate and late impacts on OHRQoL of the patients were noted in any therapeutic phase. Conclusions: No bracket system seems to ensure superior OHRQoL. This information could be useful for explaining the therapeutic phases, especially the initial one, and selecting the optimal bracket system based on the patient's preference.
Objectives : This study examined the possibility of therapeutic application of natural pigments in the Joseon Period other than aesthetic purposes. Methods : The medicinal properties of natural pigments as written in the texts Sangayorok, Gyuhapchongseo, Imwongyeongjeji were searched and analyzed in the texts Bencaogangmu, Encyclopedia of Eastern Medicine, and the Encyclopedia of Chinese Medicinals focusing on their Qi, flavor, effects and application. Of the conditions they treated, we examined whether they treated skin conditions using external application. The Korean Medical effects of these pigments were examined based on the content of the skin chapter of the Donguibogam. Results : We were able to extract 47 kinds of natural pigments, most of which had cold nature and bitter tasting properties. In addition, most of the pigments had the effect of treating skin conditions, illnesses due to micro-organisms, and of detoxifying. Conclusions : After consideration of medicinal properties and effects of the herbs that were used as pigments in the Joseon period, it could be concluded that as these herbs not only function as pigments but also hold properties that prevent skin conditions, their therapeutic functions could have been considered when using them as pigments.
To survey the recognition of Community Based Rehabilitation(CBR) by Public Health Center(PHC) Physical Therapists in Seoul Province. This study analysed general characteristic of Physical Therapists and cognition, participation, education, problems and requirements for CBR. The subjects of this study were 31 therapists who work at PHC in Seoul Province and Seoul City Childerns Municipal Hospital. Data was collected for 18 days from April 13 to 31, 1998 and results computed from 25 responses. First, Female therapists outnumber males. The age category 30 to 35 old represented 44.0% of the total number studied. 48.0% of therapists had worked more than 7 years and therapists usually 84.0% worked from 3 to 4 years at the PHC. Junior colleage graduates were 72.0%, and respondents with family responsibility were 52.0%. Second, Recently pain control and therapeutic exercises has become the major requirement of patients at PHC(56.0%). If the offered expanded services, a rehabilitation programe at PHC(36.0%) was highly. When asked about a working guide book, nobody had one. Third, 64.0% of therapists were aware of the present level of CBR, 28.0% of them had gotten an information from newspaper and mass media. Fourth, For CBR, 72.0% had positive ideas in which they could participate. 56.0% wished to compose a team of various rehabilitation specialists. 52.0% wished for the meeting day to be flexible and 64.0% desired to meet once or twice a week. Fifth, Almost all(92.0%) desired more educational opportunity about CBR. Example, once or twice a year(48.0%) and training period of 4 to 7 day(44.0%). They wanted to learn theory and parctice together(88.0%) and 48.0% wanted national mutirehabilitation center as a educational managing organization. Sixth, The most important requirement for accomplishing CBR by Physical Therapists was job security and adequate number of therapists(48.0%). Required number of physical therapists in the PHC was 3(52.0%). The cooperative agency should be the distict govement(32.0%) and community welfare center of the disabled persons(32.0%). Factors inhibiting the execution of CBR were lack of physical therapists(56.0%), and equipments for pain control and for therapeutic exercises(68.0%).
Journal of The Korea Institute of Healthcare Architecture
/
v.3
no.4
/
pp.35-49
/
1997
The percentage of postnatal disabled people and elderly population is rapidly increased by the industrialization, and the improvement of medical technology. The disparity between the city and rural area is in the way to disabled people who need rehabilitation. To solve these problems, Community Based Rehabilitation(CBR) is suggested by WHO. In this study, at first, the CBR model considering the specific characteristics of AnSan City are presented. Secondly, the first, the second, and the third rehabilitation facilities in AnSan City are classified by the CBR model. Thirdly, the estimation of optimum space for physical therapy and occupational therapy at rehabilitation center and public health center are sugested, which are the second level rehabilitation facilities. There are some differences in the distribution of population between new and old area in AnSan City. In other words, the subject population of CBR program in old area is relatively higher than that of new area. So, the CBR program for AnSan City must reflect their regional characteristics. In this study, the therapeutic boundaries of second level rehabilitation facilities is decided through the survey of physical therapists and occupational therapists in general hospitals and nursing homes.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.10
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pp.119-130
/
2016
This study was conducted to investigate the effects of individual patient behavior regarding health and medical care level on doctor's diagnoses of hypertension. A X2-test was used to compare therapeutic compliance in individual characteristics and two-stage multilevel logistic regression to identify community variance of the related index of high blood pressure therapeutic compliance using data from 229,229 adults over the age of 19 in a community health survey conducted in 2010. The experience rate of doctors' diagnoses of hypertension was higher for people of older age, higher level of education, higher BMI, and among heavy drinkers (no recipients of basic living). Furthermore, there was a higher rate for those visiting health and medical institutions, having more frequent checks of blood pressure in a month, having a higher stress level, and having depression. Among paid workers, the ratio was lower for employers and owner/operators with more daily exercise (such as walking), infrequent smokers, and private health insurance holders. Doctor's diagnoses of hypertension was affected by individual health behavior and health and medical care level. Further studies employing multilevel analyses considering regional level data should be conducted in the future.
Minority populations in the United States have a higher prevalence of non-insulin-dependent diabetes mellitus (NIDDM) and more persons die of the disease than white persons. This study was to review and compare risk factors and prevalence rates of NIDDM in African Americans, Hispanic s, Korean Americans and Native Americans in the United States. The risk factors of NIDDM, including family history of diabetes, obesity, physical inactivity, diet and age, were reviewed in the minority populations. Risk factors such as obesity, physical inactivity and family history of diabetes occurred to a greater extent in some minority populations than in the white population. Diabetes should be treated as a public health problem for minority populations. Due to the increase of older populations and the increased prevalence of obesity and sedentariness, NIDDM in minorities is nearing epidemic proportions. Good diet and regular exercise can reduce the incidence of NIDDM but an understanding of the cultural aspects of diabetes is imperative in order to provide adequate community health education programs because those programs involve diet and behavior changes, characteristics that are often culturally determined. In summary, it is important to plan a community health education program targeted on NIDDM in a culturally adapted manner that will be received with both comprehension and acceptability. In particular, the program for high-risk populations should be stressed so to prevent diabetes. Preventive approaches to diabetes should be considered because they can be both therapeutic and cost effective.
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