• Research in Community and Public Health Nursing
• /
• v.32 no.3
• /
• pp.312-324
• /
• 2021

Purpose: Tuberculosis is an infectious condition with a high disease burden, and the stigma in patients with tuberculosis causes negative health outcomes. The purpose of this study was to define and clarify the concept of self-stigma among patients with tuberculosis. Methods: The analysis was conducted using Walker and Avant's conceptual approach. Twenty-seven studies met the selection criteria. Results: Self-stigma in patients with tuberculosis can be defined by the following attributes: 1) self-esteem decrement; 2) fear; 3) negative emotions to oneself; 4) social withdrawal; and 5) discrimination. The antecedents identified were 1) inappropriate knowledge of tuberculosis, 2) spread of improper health information through media and social communications, 3) stereotypes and prejudices, 4) visibility due to symptoms appearing, 5) recognizing the risk of infection, and 6) low financial status. The consequences were 1) concealing the disease, 2) treatment delay, 3) poor treatment adherence, 4) poor quality of life, and 5) deterioration in or lack of social activities. Conclusion: The definition and attributes of self-stigma identified by this study can be applied to enhance the understanding of stigma in tuberculosis patients and to improve communications between healthcare providers and researchers. It can also be used to develop theories and measurements related to stigma in patients with tuberculosis.

• Journal of Digital Convergence
• /
• v.16 no.12
• /
• pp.123-135
• /
• 2018

The objective of this paper is to investigate the issues related to the supply chain management in plant engineering industry, and propose the framework to improve the project efficiency. The preliminary case study shows that EPC's fragmented nature, lack of coordination and information sharing, and lack of proper risk and change management contribute to project delay and cost overrun. To examine the level of informatization and information sharing in supply chain, survey responses from the suppliers and subcontractors have been collected. The statistical results show that information sharing, early involvement in design process and awareness in SCM have influenced the level of collaboration, but supplier assessment and informatization have no impact on the collaboration. A conceptual model is proposed in order to facilitate the integration of design, procurement and construction functions. Implications from the study are also provided.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.22 no.2
• /
• pp.142-151
• /
• 2019

Purpose: The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods: The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed. Results: Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction (<48 vs. ${\geq}48$ hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p<0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence. Conclusion: Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ${\geq}48$ hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.

• Safety and Health at Work
• /
• v.10 no.3
• /
• pp.260-264
• /
• 2019

Background: Professional dance is a physically demanding career path with a high injury prevalence, yet an ingrained culture of hiding or pushing through injuries. Developing better knowledge surrounding the cultural beliefs and behaviors related to injury reporting is critical to understand their incidence and burden. Therefore, the aim of this study was to investigate injury fear and injury reporting behaviors in professional dancers in Australia. Methods: This study utilized data collected in a cross-sectional survey of professional dancers in Australia. Descriptive analysis of injury fear and reporting stigma are presented with comparisons between subgroups (full-time versus part-time dancers; men versus women) conducted using two-sided Fisher's exact tests. Results: A total of 146 professional dancers were included. Over half (63%) of the respondents reported that they fear sustaining a dance-related injury, that they believe there is still a stigma surrounding injuries in dance (62%), and that this stigma has led to a delay in reporting or seeking care for an injury (51%). A lower proportion of part-time than full-time dancers reported that they would usually tell someone within their dance employment about an injury (35.1% vs. 59.6%, p = 0.006). Conclusion: Professional dancers are at risk of losing contracts or roles if they are injured, and therefore, it is common to dance through their occurrence. Many dancers, particularly those dancing part-time, are unwilling to tell their employers about their injuries. Action is required to improve this culture regarding injury reporting and help seeking for more effective injury understanding, prevention, and management in dance.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.7
• /
• pp.102-110
• /
• 2019

This study is for the elderly with mental and physical dysfunction, developing resistance exercise program using tube elasticity, and analysing the effects of this movement on the improvement of gait ability, balance ability and muscle strength of the elderly. After a 12-week program for 58 participants of the daycare center, dependent t-test was performed. As a result, the total participants showed average improvement in gait, balancing and hand grip strength. This means a lot in terms of improving one's ability of ADL(Activities of daily living) and reducing the risk of falling. Therefore, if the program expands and activates the target as an entire elderly, it is expected to be a preventative way to prevent healthy elderly people from moving to the frailty who need treatment and to delay the deterioration of the frailty with disabilities.

• The Korean Journal of Emergency Medical Services
• /
• v.25 no.2
• /
• pp.19-38
• /
• 2021

Purpose: This study aimed to investigate the relationship between emergency medical service accessibility in different regions and the sudden death rate in elderly patients with ischemic heart disease using data analysis techniques and suggest improvements in regional emergency medical services. Methods: The study collected data from the NEDIS database and Statistics Korea. Data on a total of 75,867 patients aged ≥65 years were reviewed among patients with ischemic heart disease who visited emergency medical institutions in 2018. Frequency analysis, chi-square test, multiple logistic regression analysis, and simple logistic regression analysis were performed using SPSS PC Window 25.0. Results: With an emergency medical resource per 100km², there was a concomitant reduction in the risk of death. There was a decrease in the death rate by 0.967, 0.970, 0.997, and 0.391 times with the increase in the presence of a fire department, an ambulance, a paramedic, and a regional medical center, respectively. Furthermore, a decrement in the death rate was witnessed 0.844, 0.825, and 0.975 times with the initiation of a local emergency medical center, a local emergency medical institution, and an angiography device, respectively(p <.001). Conclusion: To improve the accessibility of emergency medical services, the population and geometric area of the region should be considered essential factors when deploying emergency medical resources.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.2
• /
• pp.129-143
• /
• 2022

Background: Patient-controlled analgesia (PCA) has been widely used as an effective medical treatment for pain and for postoperative analgesia. However, improper dose errors in intravenous (IV) administration of narcotic analgesics from a PCA infusion pump can cause patient harm. Furthermore, opioid overdose is considered one of the highest risk factors for patients receiving pain medications. Therefore, accurate delivery of opioid analgesics is a critical function of PCA infusion pumps. Methods: We designed a microbalance method that consisted of a closed acrylic chamber containing a layer and an oil layer with an electronic balance. A commercially available infusion analyzer (IDA-5, Fluke Co., Everett, WA, USA) was used to measure the accuracy of the infusion flow rate from a commercially available smart PCA infusion pump (PS-1000, UNIMEDICS, Co., Ltd., Seoul, Korea) and compared with the results of the microbalance method. We evaluated the uncertainty of the flow rate measurement using the ISO guide (GUM:1995 part3). The battery life, delay time of the occlusion alarm, and bolus function of the PCA pump were also tested. Results: The microbalance method was good in the short-term 2 h measurement, and IDA-5 was good in the long-term 24 h measurement. The two measurement systems can complement each other in the case of the measurement time. Regarding battery performance, PS-1000 lasted approximately 5 days in a 1 ml/hr flow rate condition without recharging the battery. The occlusion pressure alarm delays of PS-1000 satisfied the conventional alarm threshold of occlusion pressure (300-800 mmHg). Average accuracy bolus volume was measured as 63%, 95%, and 98.5% with 0.1 ml, 1 ml, and 2 ml bolus volume presets, respectively. A 1 ml/hr flow rate measurement was evaluated as 2.08% of expanded uncertainty, with a 95% confidence level. Conclusion: PS-1000 showed a flow accuracy to be within the infusion pump standard, which is ± 5% of flow accuracy. Occlusion alarm of PS-1000 was quickly transmitted, resulting in better safety for patients receiving IV infusion of opioids. PS-1000 is sufficient for a portable smart PCA infusion pump.

• CELLMED
• /
• v.11 no.4
• /
• pp.17.1-17.4
• /
• 2021

Episiotomy is the commonest obstetrics intervention in the world to reduce severe perineal injuries. Its prevalence is 43% to 100% in primiparous women in Asia. Further, worldwide approximately 10-95% of pregnant women undergo episiotomy incision during birth. Delay in wound healing probably increases the risk of wound infection, changes the muscular structure, and ultimately causes muscle tone loss. So, wound care is of specific significance to postnatal maternal outcomes. Hence, this case study aimed to evaluate the effect of Marham-i-Raal in episiotomy wound healing and pain relief. The study was conducted in eleven postpartum primi or multipara pregnant women aged between group 19 and 35 years with term gestational age, singleton pregnancy in a cephalic presentation who had a normal vaginal delivery with mediolateral episiotomy, without a perineal tear, and perineal hematoma. Externally, application of Marham-i-Raal 2g on episiotomy incisional wound, twice a day for 10 days was advised. Wound healing of episiotomy and pain intensity was assessed with REEDA ["redness, oedema, ecchymosis, discharge and approximation of the edges"] scoring and VAS scoring for pain intensity respectively. At one hour (baseline), the REEDA mean score of eleven patients was 3.90±1.04 whereas on day 7-10 it was 0.18±0.40 with statistically significant difference (p<0.001). The VAS mean score at one hour was 6.90±1.22 whereas on day 7-10 it was 0.72±0.78 with a statistically significant difference (p<0.001). Marham-i-Raal would be effective in episiotomy wound healing and reducing pain intensity. Further, randomized double-blind controlled trials in large sample size are recommended.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.4
• /
• pp.349-357
• /
• 2022

Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.

• Environmental Mutagens and Carcinogens
• /
• v.23 no.2
• /
• pp.56-62
• /
• 2003

The liver progenitor cells could form a potential target cell population fore both tumor-initiating and -promoting chemicals. Induction of drug-metabolizing and antioxidant enzymes, including AhR-dependent CYP1A1, NQO-1 and AKR1C9, was detected in the rat liver epithelial WB-F344 "stem-like" cells. Additionally, WB-F344 cells express a functional, wild-type form of p53 protein, a biomarker of genotoxic events, and connexin 43, a basic structural unit of gap junctions forming an important type of intercellular communication. In this cellular model, two complementary assays have been established for detection of the modes of action associated with tumor promotion: inhibition of gap junctional intercellular communication (GJIC) and proliferative activity in confluent cells. We found that the PAHs and PCBs, which are AhR agonists, released WB-F344 cells from contact inhibition, increasing both DNA synthesis and cell numbers. Genotoxic effects of some PAHs that lead to apoptosis and cell cycle delay might interfere with the proliferative activity of PAHs. Contrary to that, the nongenotoxic low-molecular-weight PAHs and non-dioxin-like PCB congeners, abundant in the environment, did not significantly affect cell cycle and cell proliferation; however both groups of compounds inhibited GJIC in WB-F344 cells. The release from contact inhibiton by a mechanism that possibly involves the AhR activation, inhibition of GJIC and genotoxic events induced by environmental contaminants are three important modes of action that could play an important role in carcinogenic effects of toxic compounds. The relative potencies to inhibit GJIC, to induce AhR-mediated activity, and to release cells from contact inhibition were determined for a large series of PAHs and PCBs and their metabolites. In vitro bioassays based on detection of events on cellular level (deregulation of GJIC and/or proliferation) or determination of receptor-mediated activities in both ?$stem-like^{\circ}{\times}$ and hepatocyte-like liver cellular models are valuable tools for detection of modes of action of polyaromatic hydrocarbons. They may serve, together with concentration data, as a first step in their risk assessment.