• Journal of Korean Orthopaedic Sports Medicine
• /
• v.3 no.2
• /
• pp.93-97
• /
• 2004

Continued research needs to be devoted to understanding the natural history of rotator cuff tears. Recent studies have shown progression of tear, symptomatic flare-ups and irreversible change in rotator cuffs managed nonsurgically. These data allow the grouping of patients with rotator cuff tears into three categories based on risk-benefit ratios. Nonsurgical care should be maximized for patients with impingement symptoms only, with partial-thickness tears, with chronic tears, and for the elderly patients. The proper selection of candidates for nonsurgical management should lead to the high success rate quoted by multiple authors. Even though conservative treatment is necessary, early surgery should be considered for tears that are acute, small or medium, associated with shoulder loss of function, or occur in a younger patient. Prolonged nonsurgical care in these patients risks tear propagation and irreversible changes to the cuff, which may complicate rotator cuff repair.

• Journal of Korean Academy of Rural Health Nursing
• /
• v.16 no.1
• /
• pp.18-28
• /
• 2021

Purpose: This study attempted to confirm whether the suicide prevention effect could be achieved by managing the frailty of the elderly in rural areas. Methods: This study is a single-group pre-post study design. The frailty management program was applied twice a week for 12 weeks for the vulnerable elderly in the rural area from 16th April to 31st May in 2020. The program consisted of physical exercise, health education on nutrition management and disease control, cognitive training, and protein drink provision. Results: The average age of the participants was 77.1 years, and they lived alone (88.6%). As a result of providing the program, there were positive results such as increase in body strength (pre 12.27: post 13.27) and weight (pre 58.51: post 59.13), and decrease in depression (pre 4.66: post 1.20), and there was no statistically significant change in quality of life, Time Up & Go, and BMI. Conclusion: Frailty should be managed to prevent suicide in the elderly. It is necessary to expand and apply various programs that combine physical functions and emotional interventions such as health education, and exercise to maintain muscle strength.

• Journal of Hospice and Palliative Care
• /
• v.26 no.1
• /
• pp.18-21
• /
• 2023

The combination of oxycodone and naloxone is useful for cancer pain management. Naloxone, as a pure opioid antagonist, cannot be used simultaneously with opioids. However, owing to its low bioavailability, it can be used in an oral composite formulation. We present the case of a 55-year-old man with gastric cancer who experienced severe opioid withdrawal syndrome (OWS) triggered by oxycodone/naloxone that was successfully managed with dexmedetomidine. He had been in a stable condition on intravenous morphine to alleviate cancer pain. Intravenous morphine was switched to oral oxycodone/naloxone for discharge from the hospital. The patient suddenly developed restlessness, heartburn, and violent behavior 30 minutes after taking oxycodone/naloxone. We attempted sedation with midazolam and propofol, but paradoxical agitation and desaturation occurred. Next, we tried dexmedetomidine and the patient showed a decreased heart rate and reduced agitation. The patient was eventually stabilized by increasing the dose of dexmedetomidine. This report informs clinicians of the possibility of OWS when switching from opioids to oxycodone/naloxone, which can be overcome with the appropriate use of sedatives and dexmedetomidine depending on the patient's condition.

• Journal of Digital Convergence
• /
• v.11 no.10
• /
• pp.619-627
• /
• 2013

This study reviews the time while the homeless patients Length of Stay emergency medical institution according to their medical treatment when they visit a hospital and characteristics of pathogenesis to understand the related factors affecting the case. Such review aims at providing basic data and information on how to improve medical care services of our society. 691 homeless patients visited an emergency medical care institution in Chungnam-si for one year from January 1, 2012 until December 31, of the same year were surveyed. Methods adopted were the analysis of frequency, ANOVA, correlation analysis and multiple regression analysis was conducted by making an independent variable as a dummy. This study came to a conclusion that first of all a medical care institution is required to avoid negative awareness and it should provide the homeless patients with medical care of better quality, having emergency care support system. Second, as most of the homeless patients are in their 40 or 50's, they are still in the age of high productivity of our society. Therefore, proper policy should be established and managed by the government on the program for their returning to the society as well as providing them with better medical care and support.

• Journal of Korean Public Health Nursing
• /
• v.18 no.2
• /
• pp.312-329
• /
• 2004

This study was examined 718 workers who had consistent blood pressure results in 2001 and 2002 general health examinations that were held at a work places managed by a health care agency in Seoul. Significant results are found as follows by analysing SPSS 11.0 on the result of self-recorded questionnaires investigated from Mar 1, 2003 to April 30, 2003. 1. A sampled healthy group and a sampled unhealthy group had significant differences in four variables out of possible nineteens that are sex, age, marriage and occupation. The unhealthy group had more males than females, more aged (over 50 years old) than youngers (under 50 years old), more married than singles, more manufacturing workers than non-manufacturing workers. In the case of systolic blood pressure, as the healthy group had 16.52mmHg while that of the other group had 149. 58mmHg, 33.06mmHg of difference between those groups were detected. In the case of diastolic blood pressure, 74.93mmHg of the healthy group and 96.53mmHg of the unhealthy group yielded 21.60mmHg of difference between them. This result implies that a guidance of health care is required to be aware of 20-30mmHg volatility in blood pressure rate or to understand and treat properly own blood pressure. as it is difficult to detect hypertension in early stage due to no initial symptom. According to the result. an establishment of management system of workers, companies and health care agencies is required for consist health care. 2. In terms of risky habits to health, the unhealthy group had more proportion of past smokers, over-twice-a-week drinkers, people with higher obesity rate. However, in terms of excercise, the proportion of regularly exercising people is higher in the unhealthy group while that of non-exercising people is higher in the healthy group. On the other hand. the average grade of health practicing behaviour in two groups are not significantly different as the health group had 3.00 out of possible 6.00 while the other had 3.10. This result means that as workers are not interested in health practicing behaviour. health promoting programmes must be developed in such a way of various method of motivations and incentives. Particularly this implies that distortional objectives of exercises should be readjusted through health guidance. 3. Systolic blood pressure in the healthy group can be explained by sex and the obesity rate while that in the unhealthy group can be explained by subjective health awareness and the obesity. Diastolic blood pressure in the healthy group can be explained by sex and the obesity rate like the former. The obesity rate was significant variable affecting the blood pressure of both groups, and particularly the effect to the unhealthy group was remarkably higher than that to the healthy group. Therefore, this research identified that the health care on the blood pressure of workers is not only limited to hypertension patients, but also extended to all workers. In order for consistent care, an establishment of management system of workers, companies and health care agencies is required.

• The Journal of the Korea Contents Association
• /
• v.18 no.12
• /
• pp.140-149
• /
• 2018

Along with the recent increase in national income, social phenomena such as aging due to a decrease in population and an increase in single households are observed. There are also an increasing number of households raising pets in proportion to aging households and the increase in the number of single households, most of which use animal companions to overcome loneliness and boost domestic vitality. As more and more people consider pets as family members, the size of the domestic pet market is also growing. The growing number of pets in older households and single households is not properly managed by care such as food meals and exercise management for pets. It is necessary to research and develop robots that can monitor animal companions remotely, feed a certain amount of food at regular intervals, and manage their health through exercise. Among pet companions, dog selection is the highest. Therefore, this study identified robot research on driving methods, examples of existing pet care systems, and researched pet care robots using obstacle avoidance algorithms. In order to use the snack pay behavior and obstacle avoidance algorithm of the pet animals by applying IoT and we .oPI technology, it is able to use ultrasonic sensors on the front and has four infrared sensors on the back. However, this study does not reflect the characteristics of other pet animals as a study on pet care robots, and it requires continuous observation and testing.

• Korean Journal of Occupational Health Nursing
• /
• v.4
• /
• pp.5-29
• /
• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.3
• /
• pp.159-163
• /
• 2013

Objective : Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid endarterectomy (CEA). However, the prevalence of CHS has decreased as techniques have improved. This study evaluates the role of strict blood pressure (BP) control for the prevention of CHS. Methods : All 18 patients who received CEA from February 2009 through November 2012 were retrospectively reviewed. All patients were routinely managed in an intensive care unit by a same protocol. The cerebral perfusion state was evaluated on the basis of the regional cerebral blood flow (rCBF) study by perfusion computed tomography (pCT) and mean velocity by transcranial doppler (TCD). BP was strictly controlled (<140/90 mm Hg) for 7 days. When either post-CEA hyperperfusion (>100% increase in the rCBF by pCT or in the mean velocity by TCD compared with preoperative values) or CHS was detected, BP was maintained below 120/80 mm Hg. Results : TCD and pCT data on the patients were analyzed. Ipsilateral rCBF was significantly increased after CEA in the pCT (p=0.049). Post-CEA hyperperfusion was observed in 3 patients (18.7%) in the pCT and 2 patients (12.5%) in the TCD study. No patients developed clinical CHS for one month after CEA. Furthermore, no patients developed additional neurological deficits related to postoperative cerebrovascular complications. Conclusion : Intensive care with strict BP control (<140/90 mm Hg) achieved a low prevalence of post-CEA hyperperfusion and prevented CHS. This study suggests that intensive care with strict BP control can prevent the prevalence of post-CEA CHS.

• The Journal of the Korea Contents Association
• /
• v.13 no.6
• /
• pp.380-389
• /
• 2013

The nurse staffing level in the acute care hospitals affects patient safety and performance, and the nurse staffing legislation can be an important tool to guarantee the minimum nurse staffing. In Korea, although the medical law suggests the nurse staffing standards, it is necessary to revise the medical law for quality of nursing care and patient safety. Firstly, the nurse staffing standards in the current medical law enacted in 1962 needs to be revised to reflect changes in health care environment. Secondly, legal nurse staffing standards in the medical law are the minimum nurse staffing that medical institutions should comply with and thus must be managed so that all medical institutions should abide by them. Thirdly, the nurse staffing standards should apply on the basis of RN-to-patient ratios per shift in order to help patients understanding and ensure the easy management. Fourthly, the information of nursing staff level by the nursing unit and nursing shift in hospitals shall be released.

• Korea Journal of Hospital Management
• /
• v.8 no.4
• /
• pp.1-25
• /
• 2003

The wave of globalisation initiated by marketisation has increasingly penetrated into all sectors across the world, accordingly, the health & hospital service sector could not be made no escapes, and it currently faces the order of more marketised competition more than ever. Traditionally, the characteristic of the hospital services in the UK has considered as a model of social provision by government. However, contrary to our knowledge, the sphere of the hospital service in the UK has already been immersed in by the marketisation, in which the private actors have been embedded in order to tweak the activities of the hospital service with in the European Union. As the methodology of this research, the qualitative analysis, namely the interview with some doctors in Surgery, NHS Trusts staffs and relevant specialists in has been performed on April to May, 2003. And on the other hand, the various documents related to its service have been analysed. Thus, this paper will review the characteristics of the health service sector in the UK. In doing so, it will illuminate what would be the structural factors derived from its existing system, as a result, it will shed light on how the UK government makes an effort to resolve the problematic situation by reviewing the policy direction of Foundation Hospital proposed recently. In the next stage, it will analyse how all elements consist of the hospital management in the UK has been adjusted and be likely to be changed within Europe. More specifically focuses on how the private hospital service has been managed and related with the activities of its public hospital service-NHS Trusts. Also, under the circumstance, what private health insurance companies function will be studied. In conclusion, it will be concluded that what will be the implication of Korean hospital service market so as to correspond to globally open market by WTO. Now the UK health service system has faced a turning point of becoming more health care market internally and externally pressed by global and regional factors. Thus it is meaningful to scrutinize how a key part of social provision in the health care market system tends to adjust to globally marketised regulation.