• Journal of Preventive Medicine and Public Health
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• v.30 no.3 s.58
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• pp.630-642
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• 1997

The purpose of this study was to examine the mortality risk associated with cognitive impairment among the rural elderly. The subjective of study was 558 of 'A Study on the Depression and Cognitive Impairment in the Rural Elderly' of Jung Ae Rhee and Hyang Gyun Jung's study(1993). Cognitive impairment and other social and health factors were assessed in 558 elderly rural community residents. For this study, a Korean version of the Mini-Mental State Examination(MMSEK) was used as a global indicator of cognitive functioning. And mortality risk factors for each cognitive impairment subgroup were identified by univariate and multivariate Cox regression analysis. At baseline 22.6% of the sample were mildly impaired and 14.2% were severely impaired. As the age increased, the cognitive function was more impaired. Sexual difference was existed in the cognitive function level. Also the variables such as smoking habits, physical disorders had the significant relationship with cognitive function impairment. Across a 3-year observation period the mortality rate was 8.5% for the cognitively unimpaired, 11.1% for the mildly impaired, and 16.5% for the severly impaired respendents. And the survival probability was .92 for the cognitively unimpaired, .90 for the mildly impaired, and .86 for the severly impaired respondents. Compared to survival curve for the cognitively unimpaired group, each survival curve for the mildly and the severely impaired group was not significantly different. When adjustments models were not made for the effects of other health and social covariates, each hazard ratio of death of mildly and severely impaired persons was not significantly different as compared with the cognitively unimpaired. But, as MMSEK score increased, significantly hazard ratio of death decreased. Employing Cox univariate proportional hazards model, statistically other significant variables were age, monthly income, smoking habits, physical disorders. Also when adjustments were made for the effects of other health and social covariates, there was no difference in hazard ratio of death between those with severe or mild impairment and unimpaired persons. And as MMSEK score increased, significantly hazard ratio of death did not decrease. Employing Cox multivariate proportional hazards model, statistically other significant variables were age, monthly income, physical disorders. Employing Cox multivariate proportional hazards model by sex, at men and women statistically significant variable was only age. For both men and women, also cognitive impairment was not a significant risk factor. Other investigators have found that cognitive impairment is a significant predictor of mortality. But we didn't find that it is a significant predictor of mortality. Even though the conclusions of our study were not related to cognitive impairment and mortality, early detection of impaired cognition and attention to associated health problems could improve the quality of life of these older adults and perhaps extend their survival.

• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.1-26
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• 1982

The main purpose of this study was to test the effect of the structured information on the sleep amount of the patients undergoing open heart surgery. This study has specifically addressed to the Following two basic research questions: (1) Would the structed in formation influence in the reduction of sleep disturbance related to anxiety and Physical stress before and after the operation? and (2) that would be the effects of the structured information on the level of preoperative state anxiety, the hormonal change, and the degree of behavioral change in the patients undergoing an open heart surgery? A Quasi-experimental research was designed to answer these questions with one experimental group and one control group. Subjects in both groups were matched as closely as possible to avoid the effect of the differences inherent to the group characteristics, Baseline data were also. collected on both groups for 7 days prior to the experiment and found that subjects in both groups had comparable sleep patterns, trait anxiety, hormonal levels and behavioral level. A structured information as an experimental input was given to the subjects in the experimental group only. Data were collected and compared between the experimental group and the control group on the sleep amount of the consecutive pre and post operative days, on preoperative state anxiety level, and on hormonal and behavioral changes. To test the effectiveness of the structured information, two main hypotheses and three sub-hypotheses were formulated as follows; Main hypothesis 1: Experimental group which received structured information will have more sleep amount than control group without structured information in the night before the open heart surgery. Main hypothesis 2: Experimental group with structured information will have more sleep, amount than control group without structured information during the week following the open heart surgery Sub-hypothesis 1: Experimental group with structured information will be lower in the level of State anxiety than control group without structured information in the night before the open heart surgery. Sub-hypothesis 2 : Experimental group with structured information will have lower hormonal level than control group without stuctured information on the 5th day after the open heart surgery Sub-hypothesis 3: Experimental group with structured information will be lower in the behavioral change level than control group without structured information during the week after the open heart surgery. The research was conducted in a national university hospital in Seoul, Korea. The 53 Subjects who participated in the study were systematically divided into experimental group and control group which was decided by random sampling method. Among 53 subjects, 26 were placed in the experimental group and 27 in the control group. Instruments; (1) Structed information: Structured information as an independent variable was constructed by the researcher on the basis of Roy's adaptation model consisting of physiologic needs, self-concept, role function and interdependence needs as related to the sleep and of operational procedures. (2) Sleep amount measure: Sleep amount as main dependent variable was measured by trained nurses through observation on the basis of the established criteria, such as closed or open eyes, regular or irregular respiration, body movement, posture, responses to the light and question, facial expressions and self report after sleep. (3) State anxiety measure: State Anxiety as a sub-dependent variable was measured by Spi-elberger's STAI Anxiety scale, (4) Hormornal change measure: Hormone as a sub-dependent variable was measured by the cortisol level in plasma. (5) Behavior change measure: Behavior as a sub-dependent variable was measured by the Behavior and Mood Rating Scale by Wyatt. The data were collected over a period of four months, from June to October 1981, after the pretest period of two months. For the analysis of the data and test for the hypotheses, the t-test with mean differences and analysis of covariance was used. The result of the test for instruments show as follows: (1) STAI measurement for trait and state anxiety as analyzed by Cronbachs alpha coefficient analysis for item analysis and reliability showed the reliability level at r= .90 r= .91 respectively. (2) Behavior and Mood Rating Scale measurement was analyzed by means of Principal Component Analysis technique. Seven factors retained were anger, anxiety, hyperactivity, depression, bizarre behavior, suspicious behavior and emotional withdrawal. Cumulative percentage of each factor was 71.3%. The result of the test for hypotheses show as follows; (1) Main hypothesis, was not supported. The experimental group has 282 minutes of sleep as compared to the 255 minutes of sleep by the control group. Thus the sleep amount was higher in experimental group than in control group, however, the difference was not statistically significant at .05 level. (2) Main hypothesis 2 was not supported. The mean sleep amount of the experimental group and control group were 297 minutes and 278 minutes respectively Therefore, the experimental group had more sleep amount as compared to the control group, however, the difference was not statistically significant at .05 level. Thus, the main hypothesis 2 was not supported. (3) Sub-hypothesis 1 was not supported. The mean state anxiety of the experimental group and control group were 42.3, 43.9 in scores. Thus, the experimental group had slightly lower state anxiety level than control group, howe-ver, the difference was not statistically significant at .05 level. (4) Sub-hypothesis 2 was not supported. . The mean hormonal level of the experimental group and control group were 338 ㎍ and 440 ㎍ respectively. Thus, the experimental group showed decreased hormonal level than the control group, however, the difference was not statistically significant at .05 level. (5) Sub-hypothesis 3 was supported. The mean behavioral level of the experimental group and control group were 29.60 and 32.00 respectively in score. Thus, the experimental group showed lower behavioral change level than the control group. The difference was statistically significant at .05 level. In summary, the structured information did not influence the sleep amount, state anxiety or hormonal level of the subjects undergoing an open heart surgery at a statistically significant level, however, it showed a definite trends in their relationships, not least to mention its significant effect shown on behavioral change level. It can further be speculated that a great degree of individual differences in the variables such as sleep amount, state anxiety and fluctuation in hormonal level may partly be responsible for the statistical insensitivity to the experimentation.

• Tuberculosis and Respiratory Diseases
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• v.63 no.5
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• pp.423-429
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• 2007

Background: Alveolar recruitment (RM) is one of the primary goals of respiratory care for an acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). The purposes of alveolar recruitment are an improvement in pulmonary gas exchange and the protection of atelectrauma. This study examined the effect and safety of the alveolar RM using pressure control ventilation (PCV) in early ALI and ARDS patients. Methods: Sixteen patients with early ALI and ARDS who underwent alveolar RM using PCV were enrolled in this study. The patients data were recorded at the baseline, and 20 minutes, and 60 minutes after alveolar RM, and on the next day after the maneuver. Alveolar RM was performed with an inspiratory pressure of $30cmH_2O$ and a PEEP of $20cmH_2O$ in a 2-minute PCV mode. The venous $O_2$ saturation, central venous pressure, blood pressure, pulse rate, $PaO_2/FiO_2$ ratio, PEEP, and chest X-ray findings were obtained before and after alveolar RM. Results: Of the 16 patients, 3 had extra-pulmonary ALI/ARDS and the remaining 13 had pulmonary ALI/ARDS. The mean PEEP was 11.3 mmHg, and the mean $PaO_2/FiO_2$ ratio was 130.3 before RM. The $PaO_2/FiO_2$ ratio increased by 45% after alveolar RM. The $PaO_2/FiO_2$ ratio reached a peak 60 minutes after alveolar RM. The Pa$CO_2$ increased by 51.9 mmHg after alveolar RM. The mean blood pressure was not affected by alveolar RM. There were no complications due to pressure injuries such as a pneumothorax, pneumomediastinum, and subcutaneous emphysema. Conclusion: In this study, alveolar RM using PCV improved the level of oxygenation in patients with an acute lung injury and acute respiratory distress syndrome. Moreover, there were no significant complications due to hemodynamic changes and pressure injuries. Therefore, alveolar RM using PCV can be applied easily and safely in clinical practice with lung protective strategy in early ALI and ARDS patients.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.154-161
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• 1997

Background : Although the long term adverse effects of cigarette smoking on health are well known, the acute possible detrimental effects of smoking on pulmonary or cardiovascular function, especially when these systems are stressed by the metabolic demands of exercise, have not been well studied The purpose of this study is to determine the acute action of cigarette smoking on cardiopulmonary function under stress. Method : Twenty -one healthy smoking subjects were studied. Before exrecise testing, history taking, physical examination and baseline studies, including CBC, chest PA, PFT and EKG, were done. The subjects performed an incremental bicycle exercise test to exhaustion on two occasions, one without smoking and the other after smoking 5 cigarettes/h for 2 hours. All indices of P.F.T. and bicycle ergometry were compared between before and after smoking. Results : 1. $VO_2$max and $O_2$ pulse showed significant decrease in smoking day. 2. Although there were no significant differences, anaerobic threshold showed a tendency of decrease and HRmax showed that of increase in smoking day. 3. P.F.T. and respiratory indices showed no significant change io smoking day. Conclusion : Cigarette smoking has immediate adverse effect, especially on the cardiovascular system rather than the respiratory system. These results would be due to the effect of elevated HbCO and/or impaired blood flow in response to the exercise stimulus.

• Tuberculosis and Respiratory Diseases
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• v.58 no.2
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• pp.160-166
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• 2005

Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.

• The korean journal of orthodontics
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• v.35 no.4 s.111
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• pp.286-294
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• 2005

The purpose of this study was to evaluate the efficacy of an electric toothbrush, with a specially designed orthodontic brush head, compared to a manual toothbrush on the periodontal health of patients with fixed orthodontic appliances Forty patients were randomly divided into two groups. the electric and the manual toothbrush groups, 1 month after attachment of fixed orthodontic appliances. Periodontal status was measured using a plaque index, a gingival index. a bleeding index, a pocket depth and a relative attachment loss, at baseline and after 3 months. 6 months, 9 mouths. and 12 mouths. The Braun Oral-B Plak Control with Ortho OD 15-1 brush head was used as the electric toothbrush while the Butler G.U.M 124 was given as the manual toothbrush. In the manual toothbrush group, the giugival and bleeding indices showed no statistically significant differences, but the plaque index was significantly decreased (P<0.001) and pocket depth as well as relative attachment loss were significantly increased (p<0.01). In the electric toothbrush group. the bleeding index, pocket depth and relative attachment loss showed no statistically significant differences. but the plaque and gingival indices were significantly decreased (p<0.001). In the case of the plaque. giugival and bleeding indices, there were no statistically significant differences between the electric and the manual toothbrush groups. On the contrary, in the case of pocket depth and relative attachment loss, there were statistically significant differences between the electric and the manual toothbrush groups: an increase in the manual toothbrush groups unlike the electric toothbrush group which kept the same state (P<0.05) These findings suggest that an electric toothbrush is useful for orthodontic patients with fixed appliances.

• The Journal of Korean Academy of Sensory Integration
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• v.9 no.2
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• pp.1-13
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• 2011

Objective : Purpose of this study is to discuss benefits and implications of the clinical reasoning process and re-evaluation in the OTIPM by introducing a single case that occupational therapy intervention is provided based on the OTIPM. Methods : The case subject is a boy aged 5 years and 10 month who had diagnosed as attachment disorder and anxiety disorder from a pediatric psychiatrist before. The boy is referred to sensory integration therapy clinic and underwent occupational therapy intervention service twice a week for four month. Therapeutic activities for the intervention were consisted of sensory integration activities for restorative model, care-giver education for educational model, and performance skill training for acquisitional model. Measurements used in the initial evaluation are JSI-R, DDST-2, Social Maturity Test, KPPS-R, and observation-based performance task analysis. For the performance task analysis, performance skill items were constructed based on the Occupational Therapy Process Framework (OTPF), and those were assessed by the evaluation system of Assessment of Motor and Process Skill (AMPS) and Evaluation of Social Participation (ESI). Results : The detail process of implementing of the OTIPM in this study is reported by following four phases; 1) establish client-centered performance context; 2) establish baseline and interpret cause (initial evaluation); 3) intervention planning and implementing; and 4) recognize intervention outcome (reevaluation). Conclusion : In this case, occupational therapist could provide the client an occupation-based intervention within comprehensive performance context based on the OTIPM. Therapist could clearly identify the cause of problematic performance skills and behaviors and so provide effective intervention to improve client's occupational performance. Additionally, it was found that client's satisfaction of the intervention can be raised when the concept of 'who is the client' is expanded based on the OTIPM. From this study, it is proposed that OTIPM may be a model educible 'comprehensive' enhancement of 'specific' occupational engagement, as it considers both improvement of occupational performance and satisfaction.

• The Journal of Korean society of community based occupational therapy
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• v.10 no.1
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• pp.51-61
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• 2020

Objectives : The purpose of this study is to investigate the effect of object size and reaching distance on kinematic factors of the upper limb while performing arm reaching for normal subjects. Methods : The subjects of this study were 30 university students who were in D university in Busan, and the measuring tool was CMS-70P(Zebris Medizintechnik Gmbh, Germany), a three-dimensional motion analyzer. The task had six conditions. The average velocity of motion, average acceleration, maximum velocity, and the velocity definite number of movements were measured according to changes in object size(2cm, 10cm) and reaching distance(15%, 37.5%, 60%) when they performed arm reaching. The general characteristics of the subject were technical statistics. One-way ANOVA measurement was used to compare variables when the arm reaching task was performed from two object sizes to three reaching distance, and the post-test was conducted with Tukey test. In addition, an independent t-test was used to analyze the kinematic differences according to the two object sizes at three reaching distances. A two-way ANOVA measurement (3×2 Two-way ANOVA measurement) was performed to identify the interaction of the reaching distance(15%, 37.5%, 60%) and the object size(2cm, 10cm). The statistical significance level α was set to .05. Results : When the size of the object increased, the velocity and maximum velocity also increased, but the definite number of velocity decreased. When the reaching distance increased, the velocity and maximum velocity increased, whereas the definite number of velocity decreased. Conclusion : The clinical significance of this study could be utilized as the baseline data for grading object size and reaching distances when the reaching training is implemented for patients whose central nervous system was damaged.

• Journal of Korean Society of Forest Science
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• v.105 no.4
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• pp.401-413
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• 2016

Forest resources utilization and variable disturbance history have been affected the rarity and conservation value of forest relict trees, which served as habitat for forest biodiversity, important carbon stock and cultural role include human and natural history in South Korea. This study was conducted to establish the baseline data for forest resources conservation by clarifying species diversity, spatial distribution and ecological characteristics (individual and habitat) of forest relict trees (DBH > 300 cm) based on the data getting from mountain trail, high resolution aerial photos and field professionals and field survey. As results, 54 taxa (18 family 32 genus 48 species 1 subspecies 3 variety and 2 form) as about 22% of tree species in Korea was identified in the field. 837 individuals of forest relict trees were observed and the majority of the trees was in Pinaceae, deciduous Fagaceae and Rosaceae, which families are abundant in population diversity. High elevation area was important to relict trees as mean altitudinal distribution was 1,200 m a.s.l as likely affected by human activity gradients and mid-steep slope and North aspect was important environment for the trees remain. Many individuals exhibited 'damage larger branch' (55.6%) and consequent relatively lower mean canopy coverages (below 80%). Synthetically, present diversity and abundance of relict forest trees in South Korea were the result of complex process among climate variation, local weather and biological factors and the trees of big and old were estimated to important forest biodiversity elements. In the future, clarifying the role and function of relict trees in forest ecosystem, in- and ex- situ programmes for important trees and habitat, and activities for building the background of conservation policy such as "Guideline for identifying and measurement of forest relict trees".

• Journal of agricultural medicine and community health
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• v.35 no.3
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• pp.287-300
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• 2010

Objectives: We identified factors associated with any participation and with "good participation" (as assessed by frequency of attendance) in health promotion programs at a public health center in Korea. Methods: The subjects included 199 women who attended a baseline examination of health promotion programs during the first half of 2009. We collected data by structured interviews and physical examinations. Participation status was quantified by the frequency of attendance to the program. We classified the subjects as non-participants (0) and participants (1+ times), and as poor participants (0-29 times) and good participants (30+ times). Results: Of the 199 subjects, there were 57 (28.6%) non-participants, while 56 (28.1%) were classified as good participants. The factors that significantly affected participation status, as identified by univariate analysis, were personal factors (age, educational level, marital status, religion, living with someone, monthly income), environmental factors (method of access, accessibility of other facilities), body mass index, hypertension, perceived barriers to health, emotional salience, affectionate domain of social support, and depression. Multiple logistic regression analyses indicated that method of access was the most significant factor affecting participation in the health promotion program, and that the factors most highly associated with good participation were emotional salience, hypertension and body mass index. Conclusions: Our findings suggest that specific factors determine and enhance participation in health promotion programs offered by public health centers. These factors should be considered during the design and evaluation of health promotion programs that are offered by public health centers.