• 제목/요약/키워드: Brain Health Care

검색결과 158건 처리시간 0.026초

뇌병변장애 1급 아동에서 발생한 중증유아기우식증 (SEVERE-EARLY CHILDHOOD CARIES IN CHILDREN WITH GRADE 1 NEUROLOGICAL DISORDER)

  • 이효설;백승호
    • 대한장애인치과학회지
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    • 제7권1호
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    • pp.15-20
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    • 2011
  • 뇌병변장애인은 뇌성마비, 외상성 뇌손상, 뇌졸중 등 뇌의 기질적 병변에 기인한 신체적 장애로 보행 또는 일상생활의 동작 등에 상당한 제한을 받는 사람으로 정의된다. 최근에 뇌병변 장애아동의 DMFT는 비 장애아동과 유사하거나 낮다는 연구가 있었다. 그러나, 본 증례는 중증유아기우식증이 나타난 뇌병변장애 1급 아동들을 치료한 것으로, 아동들의 공통점을 통해 중증유아기우식 우식증의 특별한 원인을 찾고자 하였다. 뇌병변으로 인한 일차적인 운동장애와 이차적인 치과치료를 받기 어려울 정도의 쇠약함, 잦은 입원, 당분이 많은 음식과 약물의 섭취, 구강위생관리 소홀, 늦은 치과 내원, 협조도 저하 등이 우식 유발인자를 높이고, 우식 예방인자를 낮추어 치아우식증을 유발할 수 있는 것으로 사료되었다. 뇌병변 장애아동을 치료할 때, 치과의사는 개인적인 우식 위험도 평가를 통해 철저한 우식 예방프로그램을 만들고, 부모와 의학적 주치의는 구강관리의 중요성을 인식하여 조기 치과 내원 및 홈케어에 신경을 써야 할 것이다.

가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Outcomes and physiologic responses associated with ketamine administration after traumatic brain injury in the United States and Canada: a retrospective analysis

  • Austin J. Peters;Saad A. Khan;Seiji Koike;Susan Rowell;Martin Schreiber
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.354-361
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    • 2023
  • Purpose: Ketamine has historically been contraindicated in traumatic brain injury (TBI) due to concern for raising intracranial pressure. However, it is increasingly being used in TBI due to the favorable respiratory and hemodynamic properties. To date, no studies have evaluated whether ketamine administered in subjects with TBI is associated with patient survival or disability. Methods: We performed a retrospective analysis of data from the multicenter Prehospital Tranexamic Acid Use for Traumatic Brain Injury trial, comparing ketamine-exposed and ketamine-unexposed TBI subjects to determine whether an association exists between ketamine administration and mortality, as well as secondary outcome measures. Results: We analyzed 841 eligible subjects from the original study, of which 131 (15.5%) received ketamine. Ketamine-exposed subjects were younger (37.3±16.9 years vs. 42.0±18.6 years, P=0.037), had a worse initial Glasgow Coma Scale score (7±3 vs. 8±4, P=0.003), and were more likely to be intubated than ketamine-unexposed subjects (88.5% vs. 44.2%, P<0.001). Overall, there was no difference in mortality (12.2% vs. 15.5%, P=0.391) or disability measures between groups. Ketamine-exposed subjects had significantly fewer instances of elevated intracranial pressure (ICP) compared to ketamine-unexposed subjects (56.3% vs. 82.3%, P=0.048). In the very rare outcomes of cardiac events and seizure activity, seizure activity was statistically more likely in ketamine-exposed subjects (3.1% vs. 1.0%, P=0.010). In the intracranial hemorrhage subgroup, cardiac events were more likely in ketamine-exposed subjects (2.3% vs. 0.2%, P=0.025). Ketamine exposure was associated with a smaller increase in TBI protein biomarker concentrations. Conclusions: Ketamine administration was not associated with worse survival or disability despite being administered to more severely injured subjects. Ketamine exposure was associated with reduced elevations of ICP, more instances of seizure activity, and lower concentrations of TBI protein biomarkers.

Physicians' Understanding of Nutritional Factors Determining Brain Development and Cognition in the Middle East and Africa

  • Vandenplas, Yvan;Rakhecha, Aditya;Edris, Amira;Shaaban, Bassel;Tawfik, Eslam;Bashiri, Fahad A.;AlAql, Fahd;Alsabea, Hassan;Haddad, Joseph;Barbary, Mohammed El;Salah, Mohamed;Abouelyazid, Mohamed;Kumar, Mudit;Alsaad, Sulaiman
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권6호
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    • pp.536-544
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    • 2019
  • Purpose: Proper nutrition is essential for brain development during infancy, contributing to the continued development of cognitive, motor, and socio-emotional skills throughout life. Considering the insufficient published data in the Middle East and North Africa, experts drafted a questionnaire to assess the opinions and knowledge of physicians on the impact of nutrition on brain development and cognition in early life. Methods: The questionnaire consisted of two parts: The first focused on the responders' demographic and professional characteristics and the second questioned the role of nutrition in brain development and cognition. Descriptive statistics were used to summarize respondents' characteristics and their responses to questions. Results: A total of 1,500 questionnaires were distributed; 994 physicians responded. The majority of the surveyed physicians (64.4%) felt that nutrition impacts brain development in early childhood (0-4 years), with almost 90% of physicians agreeing/strongly agreeing that preventing iron, zinc, and iodine deficiency would improve global intelligence quotient. The majority of physicians (83%) agreed that head circumference was the most important measure of brain development. The majority of physicians (68.9%) responded that the period from the last trimester until 18 months postdelivery was crucial for brain growth and neurodevelopment, with 76.8% believing that infants breast-fed by vegan mothers have an increased risk of impaired brain development. Conclusion: The results of this study show that practicing physicians significantly agree that nutrition plays an important role in brain and cognitive development and function in early childhood, particularly during the last trimester until 18 months postdelivery.

인삼산사복합방(人蔘山査複合方)이 Alzheimer성 치매 병태(病態) 생쥐의 뇌조직 손상에 미치는 효과 (Effects of Ginseng Radix plus Crataegi Fructus on the injury of brain tissue in the mice with Alzheimer's disease induced by ${\beta}$ amyloid peptide(${\beta}A$).)

  • 한신희;길기정
    • 대한본초학회지
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    • 제21권4호
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    • pp.123-131
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    • 2006
  • Objectives : This research was investigated the effect of the Ginseng Radix plus Crataegi Fructus on the injury of brain tissue in the mice with Alzheimer's disease induced by ${\beta}A$. Methods : Observed a change of the injury of brain tissue and reduced the infarction area of hippocampus in the mice with Alzheimer's disease induced by ${\beta}A$. Results : 1. The Gin-CF extract reduced the infarction area of hippocampus, and controlled the injury of brain tissue in the mice with Alzheimer's disease induced by ${\beta}A$. 2. The Gin-CF extract reduced the Tau protein, GFAP protein, and presenilin1/presenilin2 protein (immunohistochemistry) of hippocampus in the mice with Alzheimer's disease induced by ${\beta}A$. Conclusion : These results suggest that the Ginseng Radix plus Crataegi Fructus extract may be effective for the prevention and treatment of Alzheimer's disease. Investigation into the clinical use of the Ginseng Radix plus Crataegi Fructus extract for Alzheimer's disease is suggested for future research.

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Brain Stimulation of Elderly with Dementia Using Virtual Reality Home

  • Park, Sung-jun
    • Journal of Information Technology Applications and Management
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    • 제26권4호
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    • pp.1-18
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    • 2019
  • The virtual reality (VR) is an immerging technology used in the serious games industry to treat psychological disorders like dementia. We created a system named as Virtual Reality Home (VRH) for the elderly who lived with Alzheimer's disease (or other form of dementia) and cognitive impairment using virtual reality technology. The purpose of our study is to measure the long-time immersion and retention of VRH on the moods and apathy, enhancement in physical and brain stimulation as well as a decision making with peoples of dementia and explore the experience of aged care home staff's member. The VRH shows a positive impact on the elderly participants and staff members. During the VRH experience, excitement and a great level of alertness were observed among the participants but few of them were feeling anxiety. Furthermore, we observed the improvement in physical, memory and brain stimulation, but the participants have a low focus on decision making because they wanted to explore all interactable objects in the VRH. This study suggests that the VR may have the potential to improve the quality of life, and these results can assist to expand the future development in the enhancement of efficiency of people with dementia.

퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로 (A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal-)

  • 최연순;김대현;서미혜;김조자;강규숙
    • 대한간호
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    • 제31권4호
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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Cancer Risks among Welders and Occasional Welders in a National Population-Based Cohort Study: Canadian Census Health and Environmental Cohort

  • MacLeod, Jill S.;Harris, M. Anne;Tjepkema, Michael;Peters, Paul A.;Demers, Paul A.
    • Safety and Health at Work
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    • 제8권3호
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    • pp.258-266
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    • 2017
  • Background: Welders are exposed to many known and suspected carcinogens. An excess lung cancer risk among welders is well established, but whether this is attributable to welding fumes is unclear. Excess risks of other cancers have been suggested, but not established. We investigated welding cancer risks in the population-based Canadian Census Health and Environmental Cohort. Methods: Among 1.1 million male workers, 12,845 welders were identified using Standard Occupational Classification codes and followed through retrospective linkage of 1991 Canadian Long Form Census and Canadian Cancer Registry (1992-2010) records. Hazard ratios (HRs) were calculated using Cox proportional hazards models based on estimated risks of lung cancer, mesothelioma, and nasal, brain, stomach, kidney, and bladder cancers, and ocular melanoma. Lung cancer histological subtypes and risks by industry group and for occasional welders were examined. Some analyses restricted comparisons to blue-collar workers to minimize effects of potential confounders. Results: Among welders, elevated risks were observed for lung cancer [HR: 1.16, 95% confidence interval (CI): 1.03-1.31], mesothelioma (HR: 1.78, 95% CI: 1.01-3.18), bladder cancer (HR: 1.40, 95% CI: 1.15-1.70), and kidney cancer (HR: 1.30, 95% CI: 1.01-1.67). When restricted to blue-collar workers, lung cancer and mesothelioma risks were attenuated, while bladder and kidney cancer risks increased. Conclusion: Excess risks of lung cancer and mesothelioma may be partly attributable to factors including smoking and asbestos. Welding-specific exposures may increase bladder and kidney cancer risks, and particular sources of exposure should be investigated. Studies that are able to disentangle welding effects from smoking and asbestos exposure are needed.

뇌사와 장기기증 및 장기이식에 대한 간호학생의 지식과 태도 연구 (A Study on Nursing College Students' Knowledge and Attitudes toward Brain Death, Organ Donation and Organ Transplantation)

  • 강희영
    • 한국간호교육학회지
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    • 제5권1호
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    • pp.7-19
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    • 1999
  • The purpose of this study was to examine nursing college students' knowledge of and attitudes toward brain death, organ donation and organ transplantation. The research design utilized in this study was a descriptive research design. The data were collected from September 7 to 14, 1998, by means of strutted questionnaire. To measure students' knowledge of brain death, organ donation and organ transplantation, Joo's(1995) instrument was used. The questionnaire was composed of 22 items. To measure students' attitudes toward organ donation and organ transplantation, s(1995) Instrument was used. The questionnaire was composed of 22 items. The data were analyzed by frequency, t-test, ANOVA, and Pearson's Correlation Coefficient using the SAS program. The results were as follows : 1. Students' knowledge of brain death, organ donation and organ transplantation was 9-20. The mean score was 15.36, with 22, the highest possible score. There was statistically significant difference between students' knowledge and approval on the brain death recognition group(t=9.75, p=0.002). 2. Students' altitudes toward organ do nation and organ transplantation showed is mean score of 3.61 on a 5 attitudes points Liken scale. More than 80% of respondents agreed that organ transplantation can offer a high quality of life to the recipient and is an acceptable form of medical treatment. The health care costs associated with organ transplantation are worth itif another's life can be saved. Students felt it important to help others who are very ill. Also, by donating organs, students felt a part of their own body would continue to live by making it possible for someone else to live. Only 2.9% of students objected to organ donation for religious reasons. There was statistically significant difference among students' attitudes, experienced blood donor group(t=17.04, p=0.000), approval on the brain death recognition group (t=21.06, p=0.000), organ donation agreement group(t=46.13, p=0.000).

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정신 질병의 탄생: 고대 그리스 의학적 시선의 철학적 기원 플라톤의 정신 질병 개념을 중심으로 (The Concept of Mental Disease in Plato)

  • 장미성
    • 철학연구
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    • 제121호
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    • pp.1-24
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    • 2018
  • 본 논문의 목적은 영혼의 질병과 치유와 관련된 고대 논변들을 통해 플라톤이 말하는 정신의 질병과 건강은 무엇인지 알아보는 것이다. 고대 그리스에서 의학은 몸의 건강을 돌보는 것이었다면, 철학은 영혼의 건강을 돌보며 삶을 변화시키는 것이었다. 따라서 정신적 질병의 개념을 규정하는 것은 의학의 영역이기보다 철학의 영역이며, 철학의 실천적 기능은 우리의 영혼을 돌보는 삶이다. 그리고 영혼을 돌보기 위해서는 영혼의 질병은 무엇이며 어디서부터 오는지에 관한 진단이 우선시 된다. 플라톤은 정신적 질병을 (1) 국부적인 뇌의 문제가 아니라 인격의 총체적 문제이며, (2) 이는 불균형과 부조화에 기이하는 것으로, (3) 무지 또한 정신적 질병이라 할 수 있다고 말한다. (4) 더 나아가 그는 부정의와 악덕 역시 정신적 질병이라고 진단하며, 정신적 질병의 문제를 개인을 넘어서 국가의 문제로 확대시킨다. 결과적으로 플라톤은 철학의 목적을 영혼의 건강을 유지하기 위해 덕을 가지고 공동체 속에서 정치적 정의를 이루어 나가는 것이라고 주장한다.