To improve the quality of life, wireless ad-hoc network technologies are considered as one of the key research areas in computer science and healthcare application industries. The ubiquitous healthcare systems also provide alerting mechanisms against ill conditions in real time. This minimizes the need for care-givers and helps the chronically ill and elderly to survive. For the application of the system, supporting the efficient and proper network system is essential. So in this paper, I suggest some hospital network environments including patient mobile nodes continuously sending brainwaves to the server of the hospital area. Finally, the network systems are simulated by OPnet simulator and evaluate the performance among various mobility of the mobile nodes and topologies of the network for the efficient system.
Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2. Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.
Kang, Jeung Yun;Lee, Kyung A;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
Korean Journal of Clinical Pharmacy
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v.28
no.3
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pp.167-173
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2018
Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. Methods: Adult patients aged ${\geq}19years$ who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.
The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.
This study examines factual facilites safety of long-term care facilities for eldery, for improvement of Korean policy. So, This study reviewed policies of facilites safety of long-term care facilities on main OECD countries. We analyzed factual survey of facilites safety of long-term care facilities in Seoul metropolitan area. The results of the study were as follows: First, There were differences of law and rule of facilites safety of long-term care facilities in comparison with those of social welfare facilities, child day-care center, hospital. Second, it was the result of location condition analysis. Long-term care facilities in the Seoul metropolitan area were located on more than six floors of buildings. The location conditions of private facilities are weak compared to those of corporations and local governments. Third, there were the result of internal structure of facilities. Overall, the placement status was insufficient. For instance, there are smokeproof masks/fireproof blankets, smoke windows(fire safety windows), smoke smothering. In addition, there were places where legal essential installation structures were insufficient. Private facilities were generally insufficient in facility structures compared to those of local governments and welfare corporations. Fourth, there were the result of safety management. It was confirmed that private facilities were insufficient compared to local government facilities. For instance, there are safety management analysis, response manuals, fire preparedness training, etc. Finally, implications and future directions policies of facilites safety of long-term care facilities were discussed based on the finding of the study.
The study aims to examine the knowledge and awareness of care workers on oral health knowledge at the geriatric care facilities in order to improve and develop oral health services. For the research method, the study carried out a questionnaire survey to 163 care workers working at the geriatric care facilities (10) in D Metropolitan City from May 1~31, 2015 and then the collected data were statistically analyzed. As a result, the oral health knowledge of care workers was 20.09 points out of total 26 points (77.2%). The highest knowledge was 'proper toothbrushing method' with 93.0% and the lowest one was 'knowledge on the use of oral supplementary goods' with 58.1%. Those with experience of oral health education had higher demand on oral health education (P<0.001), and those with higher experience of oral health education had significantly higher oral health knowledge (P<0.001), demand (P<0.01) and awareness (P<0.05). As for factors influencing care workers' oral health awareness, if they had higher oral health knowledge points (P<0.01), oral health education demand (P<0.01), they had higher oral health awareness level. Accordingly, it is required to provide efficient, sustainable and practical oral health education of care workers considering oral characteristics of the long-term hospitalized patients at the care hospital. And, the role of dental hygienist as the person in charge of oral health education is necessary. Therefore, institutional support from the government is required to assign professional personnel.
Background: Dietary polyunsaturated fatty acids (PUFA) are thought to modify systemic inflammation. The present study aimed to evaluate the relationship between PUFA intake, lung function, and health-related quality of life (HRQoL) in patients with chronic obstructive pulmonary disease (COPD). Methods: In this study, we used the dataset of 6th Korea National Health and Nutrition Examination Survey, in which, a total of 22,948 individuals including 573 participants with a high probability of developing COPD were enrolled. Participants with missing data for the investigated variables were excluded. Linear regression analyses were used to evaluate the association between PUFA intake (omega-3 [N3], omega-6 [N6], and total) with lung function, and HRQoL. HRQoL was determined according to the European Quality of Life-5 Dimensions (EQ-5D). Subgroup analysis of older patients was performed. Age, sex, body mass index, smoking, alcohol, education, residence, total calorie intake, and predicted FEV1% were adjusted in all analyses. Results: Although lung function was not associated with PUFA intake, EQ-5D index was remarkably associated with N3, N6, and total PUFA intake in a dose-dependent manner. This association was more pronounced in elderly COPD patients. Mean levels of N3, N6, and total PUFA intake were significantly higher in patients having better HRQoL with respect to mobility, self-care, and usual activities. Conclusion: Our results suggest that N3, N6, and total PUFA intake are associated with HRQoL in COPD patients. This association may be attributed to mobility, self-care, and usual activities. Further longitudinal study is required to clarify this relationship.
Kim, Hyun Joo;Lee, Jin Yong;Jo, Min-Woo;Eun, Sang Jun
Korea Journal of Hospital Management
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v.21
no.2
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pp.37-49
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2016
The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.
This research is aged 65 or older with chronic pain and social support, are subject to the elderly wanted to know the effect on depression and suicide intention. This research was done through targeting elderly with chronic pain who use welfare center. The data collection period from April 20 in 2014, implemented by May 20. finally 178 kinds of types of data were analyzed. The collected data is Person's correlation coefficient, and multiple regression analysis by using SPSS 18.0, t-test, ANOVA. In this research results chronic pain, depression and suicide was observed a significant correlation between the degree of social support appear also showed a significant negative correlation of depression and suicide. Also, chronic pain can affect the degree of social support, suicide was identified as the most powerful variable impact on depression. The elderly with Chronic pain is more severe the higher the degree of suicide, The results were lower social support is also of increasing depression and suicide. There fore family and social care and social support services need to develop for prevent depression and suicide for the elderly, also needs programs invention for chronic pain as well.
Oh, I Su;Kang, Da Haeng;Lee, Joon Hee;Jeon, Jae Keun
재활복지
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v.20
no.3
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pp.163-178
/
2016
This study was conducted to compare the effects of general and pathological characteristics of elderly with dementia on their cognitive ability, performance of activities of daily living (ADL), and quality of life. Data were collected between July 15 and August 30, 2016 from 136 elderly with dementia who used day care centers. The Korean version of Mini-Mental Status Examination, Korean version of Modified Barthel Index, and Korean version of the WHO Quality of Life Scale Abbreviated Version were used for data collection and values obtained were analyzed accordingly. Significant correlations were found between cognitive ability and performance of ADL, between quality of life and cognitive ability, and between cognitive ability and performance of ADL (p<.001). Moreover, quality of life of elderly with dementia was greatly affected by cognitive ability and performance of ADL (p<.01). Therefore, it is believed that more active therapeutic interventions and studies are needed from sociophysical aspect of elderly with dementia. Therefore, it is believed that more active therapeutic interventions and studies are needed from sociophysical aspect of elderly with dementia.
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