Objectives: This study was conducted as descriptive correlation research in order to survey healthcare personnel(HCP)'s awareness of patient safety culture and their recognition of standard precautions, and to examine the correlation between the two factors. Methods: The subjects were 400 HCPs including 80 doctors, 240 nurses, and 80 medical technicians from two general hospitals. The questionnaire used in the survey consisted of 9 questions on general characteristics, 44 on the perception of patient safety culture, and 21 on the recognition of standard precautions. Results: According to the subjects' general characteristics, the score was significantly higher in those aged over 40 than in those aged 30-39. In addition, it was significantly higher in managers than in practitioners, in those with work experience of less than a year than in those with 5-9 years. The score was also significantly higher in those working 8 hours a day than in those working over 10 hour a day. The number of medical accident reports according to the subjects' general characteristics was significantly larger in nurses than in doctors, in managers than in practitioners, and in those with 10 years' or longer experiences than in those with less than a year. In the awareness of standard precautions according to the subjects' general characteristics, the score was significantly higher in female workers than in male workers, and in managers than in practitioners. As a whole, the subjects' awareness of patient safety culture and their recognition of standard precautions showed a significant correlation with each other. Conclusion: From the result of this study, sufficient work force and the promotion of organizational culture for safety is needed in order to guarantee patient safety. Likewise, these results suggest that experience, job skill, and adequate working hours have a positive effect on the awareness of patient safety culture and the recognition of standard precautions.
In order to study the changes of pregnancy rates according to the factors, age, season, repeated utilization, synchrony, of recipients (29 holstein heifers, one Korean native heifer and 3 holstein cows) were transfered one embryo (from morulae stage to advanced blastocyst) to each, and the results are as follows ; 1. The effect of age of recipient on pregnancy rate in cows and 18-24months of aged group are 100% and 78%, respectively. Under 14months of aged group recorded the worst, 67%. 2. In winter (Nov.-Jan.) and spring (Feb.-Apr.), the pregnancy rate were better than others 100%, 83%, respectively. In the autumn (Aug.-Oct.), it was only 50%, the worst. 3. Among 31 recipients which were utilized at the first, 25 were pregnanted (80.7%), but in the second utilization after the failure of the first transfering, 2 heifers, none of pregnancy was obtained. 4. Pregnancy rates related to synchronization of estrus between donor and recipients are;-(before donor)12hrs. (100%), -6hrs. (86%), +( after donor)6hrs. (67%), + 12hrs. (79%), and +over 12hrs. (50%), respectively. 5. Differences in the pregnancy rate of the recipients +over 12hrs. were significantly large, so in order to ger good pregnancy rate in embryo transfer, the differences of the synchronization must be reduced inner ${\pm}12hrs$. In general, recipients estrus before donor showed better pregnancy rate than estrus after donor.
Bello, Marcelo Adeodato;de Menezes, Raquel Ferreira;de Sousa Silva, Brunna;da Silva, Rafael de Carvalho;Cavalcanti, Rousiane Silva;da Costa Moraes, Thayane de Fatima;Tonellotto, Fabiana;de Aguiar, Suzana Sales;Martucci, Renata Brum;Bergmann, Anke;Thuler, Luiz Claudio Santos
Asian Pacific Journal of Cancer Prevention
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v.17
no.10
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pp.4769-4774
/
2016
Objective: To analyze the survival of elderly patients with breast cancer according to the type of treatment used. Methods: A cohort study of women aged 80 or over with breast cancer registered with the Brazilian National Cancer Institute (Instituto Nacional do $C{\hat{a}}ncer$ - INCA) between 2008 and 2009 was conducted. Prognosis was analyzed according to the cancer treatment performed: surgery, radiotherapy, or hormone therapy. Analysis of the overall 5-year survival rate was performed using the Kaplan - Meier method, and comparisons of curves were undertaken using the log-rank test. For multiple regression analysis, Cox regression was used, adjusting for age and clinical stage, considering values of p < 0.05 as significant. Data were all analyzed using the statistical package SPSS version 20. Results: 70 women with a mean age of $84.0{\pm}3.7years$ at diagnosis participated in the study. The median follow-up time was 37.1 months (range 0.5-75.5), and 31 deaths (44.3%) occurred during this time. The median survival time was 51.2 months (95% CI, 44.9-57.4), higher in those who underwent surgery (p = 0.012) and those who had hormone therapy (p=0.001). Treatment with surgery reduced the risk of death by 61.7% (HR 0.3; 95% CI, 0.1-0.6; p = 0.001) when adjusted for clinical stage and age at diagnosis. However, there was no significant benefit from radiotherapy (HR 1.2; 95% CI, 0.5-2.5; p = 0.694). Conclusion: Treatment with surgery and hormone therapy increased the survival of our Brazilian patients with breast cancer aged 80 or over.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.4
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pp.303-310
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2019
The purpose of this study was to compare the oralmyofunctions (occlusal force, tongue pressure, lip force) of adults and elderly people. And analyzed the factors affecting oral health related quality of life and dysphagia. The study was conducted on 73(over 20 years of age) Residing in Daejeon and Nonsan From December 2017 to May 2018. The data was analyzed using one-way ANOVA, pearson's correlation and multiple regression. The masticatory strength of each age group evaluated the right and left posterior occlusal forces. the elderys group (8.93, 10.80) were lower than adults group(12.51, 14.61) and middle age group(11.63, 14.75)(p>0.05). The tongue pressure was statistically significant lower in eldery group(37.43) than the adult group(60.55), middle-aged group(50.61) (p=0.000). In addition lip force was significantly lower in eldery group(8.57) than adult(12.01), middle-aged(11.37)(p= 0.000). The tongue pressure was positively correlated with the number of natural teeth(r=.566, p<.05), and the lip force (r=.497, p<.05). The quality of life quality related to oral health and dysphagia was tongue strength(p<0.05). It is necessary to recognize the risk of declining oral muscle function caused by aging. especially tongue strength is associated with quality of life and dysphagia. In order to improve the quality of life related to oral health in the aged society, the necessity of regular oral administration and oral muscle training was proposed.
This study investigated the relation between frailty, social support, and health-related quality of life to provide basic data to improve the health-related quality of life of old-old elderly who are a high risk group for frailty. For this descriptive study, one-on-one interviews with structured questionnaires were conducted for elderly aged 75 years or older at elderly welfare facilities in K county from March 01 to 31 in 2016, and a total of 211 elderly were interviewed. The collected data were analyzed by t-test, Pearson's correlation coefficient, and path analysis using SPSS/WIN and AMOS 18.0 program. For the differences between the age groups, those aged over 80 years had a significantly higher frailty (t=-2.51, p=.013) and a lower health-related quality of life than those aged below 80 years (t=3.29, p=.001); however, there was no significant difference in social support (t=1.28, p=.201). The correlation between frailty, social support and health-related quality of life showed that as frailty became higher, social support (r=-.21, p=.003) and health-related quality of life (r=-.65, p<.001) were significantly lower, and health-related quality of life was significantly higher with a higher social support (r=.18, p=.010). As a result of investigating the mediating effects of frailty between social support and health-related quality of life, social support had a significant direct effect on frailty (${\beta}=-.21$, p=.016) and frailty had a significant direct effect on health-related quality of life (${\beta}=-.06$, p=.004); however, social support had no significant direct effect on health-related quality of life (${\beta}=.00$, p=.562). Social support had a significant indirect effect on health-related quality of life and a mediating effect on frailty (${\beta}=.01$, p=.012); therefore, the full mediation effect of frailty between social support and health-related quality of life was verified. Social support prevents frailty, and improving frailty enhances health-related quality of life. Therefore, it is necessary to develop a multifactorial frailty prevention program that includes age-specific social support strategies to improve the health-related quality of life in old-old elderly.
The purpose of this study was to find out any difference and correlation between the cardiac structure and its function according to the level of obesity as evaluated by waist measurement and BMI (body mass index) in healthy adults. For research subjects, the study selected a final 519 subjects excluding 198 subjects aged 55 or over out of 717 subjects who received echocardiography through a medical checkup at J General Hospital. For the criteria for obesity, men were defined as being obese in case their waist measurement was over 90 cm, whereas women were defined as being obese in case their waist measurement was over 80 cm. Also, regarding the BMI criteria, in case a person's BMI was 30 kg/$m^2$, the subject was classified as belonging to an obese group, and in case a person's BMI was between 25 kg/$m^2$ and 30 kg/$m^2$, the subject was classified as belonging to an overweight group. Concerning the evaluation of cardiac structure and function, they were evaluated using two-dimensional, M-mode, doppler echocardiography. According to the stage of obesity in accordance with waist measurement and BMI, the cardiac structure showed both eccentric and centripetal changes, and the cardiac function was also discovered to show differences according to the stage of obesity. In addition, also in the overweight group, which is a prior stage to obesity, out of the criteria for obesity classification according to BMI, there were differences in the cardiac structure and function. Also, both the waist measurement and BMI were found to have a correlation with cardiac structure and diastolic function. Consequently, cardiac structure and function are correlated with BMI and waist measurement, which are anthropometrical variables, and obesity is assumed to induce not only structural change but also functional change of the heart.
This study was carried out to investigate the cadmium level in blood by age, gender, and smoking status among 162 elderly subjects in Gyeongnam Province from September 2006 to February 2007. The cadmium level in blood was analyzed by atomic absorption spectrophotometer. Subjects were classified according to smoking status and divided into smokers and non-smokers, smoking duration, daily smoking habits, age, and gender. Mean blood cadmium levels in male and female were $0.70{\pm}0.41{\mu}g/dL$ and $0.57{\pm}0.32{\mu}g/dL$ respectively, with no significant differences between the two groups. Cadmium levels in the blood of smokers and non-smokers were $0.57{\pm}0.32{\mu}g/dL$, $0.90{\pm}0.44{\mu}g/dL$ respectively, with the cadmium level of smokers being significantly higher than that of non-smokers. In comparison by age, cadmium levels in the blood of subjects over the age 70 years and over the age 80 years were $0.91{\pm}0.44{\mu}g/dL$, $1.02{\pm}0.39{\mu}g/dL$ respectively, showing a significantly higher blood cadmium level than that of non-smokers. when compared by the amount of daily cigarette consumption, there were no significant differences in the blood cadmium level between groups. However when compared by smoking duration, the blood cadmium level for the group of smoking duration of over 10 years was $1.15{\pm}0.38{\mu}g/dL$, significantly higher than $0.67{\pm}0.31{\mu}g/dL$ for the group of smoking duration of less than 10 years. In conclusion, longer smoking duration and older aged group showed higher cadmium level in blood. For more reliable results, further study of the elements that elevate the cadmium level in blood with more subjects and study variables will be needed.
Tae Woo Kim;Junhyuk Chang;Eunjung Choo;Rae Woong Park;Sukhyang Lee
Korean Journal of Clinical Pharmacy
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v.33
no.4
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pp.242-253
/
2023
Background: Arrhythmia due to QT prolongation is one of the most serious adverse events with drug interactions in the elderly. This study aimed to examine the incidence of arrhythmia in Korean elderly patients who administered both cytochrome P450 3A4 (CYP3A4) substrates and inhibitors. Methods: Patients using CYP3A4 substrate and inhibitor were selected from the 2017 elderly patient dataset (the Korean Health Insurance Review and Assessment Service - Aged Population Sample). Selection criteria were patients with a medication possession ratio over 80%, medication duration of at least 7 days, and a follow-up period of 3 months or more. The patient's basic information is age, gender, health insurance type, and comorbidities. The top 50 drug pairs and comorbidity with high-incidence arrhythmia were presented. Results: In patients with drug combinations for over 7 days, there were 981 incidences of arrhythmia, and 351 incidences in those with combinations for over 30 days. The comorbidities of congestive heart failure and myocardial infarction had a significant association with incidence of arrhythmia. Among patients with 7 days or longer, the drug pairs [substrates-inhibitors] with significant adjusted odds ratio (aOR) were [propranolol-cimetidine] (aOR, 2.25; 95% confidence interval [CI], 1.66-3.04). Among patients with 30 days or longer, the drug pairs with significant aOR were [tramadol-amiodarone] (aOR, 2.87; 95% CI, 1.97-4.19). Conclusions: In elderly patients, the incidence of arrhythmia was high with drug interactions of CYP3A4 substrates and inhibitors. The comorbidity of congestive heart failure was the risk factor.
Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.
Objective : Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods : The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS. Results : The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant. Conclusion : To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.
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