• Journal of Hospice and Palliative Care
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• v.16 no.4
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• pp.205-215
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• 2013

Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

• The Journal of Korean Academy of Sensory Integration
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• v.11 no.1
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• pp.11-27
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• 2013

Objective : This is a descriptive study using a program review collaborative group program by special educator and occupational therapist for supporting children's school tasks, and it is designed to explore how changed school performance skills and to analyze how applied intervention methods including sensory integrative approach. Methods : Participants were 6 male elementary students(5 = 1st grade, 1 = 2nd grade). Pilot program had reviewed and its results used as base for planning main program. Main program was implemented by collaborative process with teacher and occupational therapist for 1 year. School AMPS was used to assess school task participants, and informal motor and process skill observation was used to assess self-help activities. Description of records by professions about intervention strategies through assessments was described as qualitative way. Japanese sensory inventory was used by parents. Results : Through the collaborative process, assessing children, planning and modifying program, establishing intervention strategies were implemented. Self-help abilities in group program were increased much more independently. School task abilities were increased slightly but skills changed irregularly and unexpectedly and their reasons became considered more complex from sensory processing reasons to social and emotional reasons. Conclusion : Sensory integration had benefits for primary group program and more complex intervention strategies became to emerge demands for person- environment-task challenges. Collaborative practice with teacher and occupational therapist was supplement and synergic effect for children and group dynamics. More objective and comprehensive methods for measure collaboration and group effect would be needed in further study.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.1
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• pp.141-150
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• 2014

This study was carried out to investigate the effects of nutrition education on blood glucose in type 2 diabetic patients with low income. There were 50 (27 male and 23 female) study subjects with type 2 diabetes under national medical support, and the monthly income in most of them was less than 500,000 won. Anthropometric measurement, biochemical blood indices, food intake, dietary habits, and nutrition knowledge of the subjects were investigated before nutrition education. Nutrition education was conducted 6 times within 12 weeks. After nutrition education, the glycosylated hemoglobin was significantly decreased (male: $8.4{\pm}1.6%$ to $8.0{\pm}1.7%$, female: $8.3{\pm}1.6%$ to $8.0{\pm}1.3%$) and the total cholesterol was also significantly decreased in both groups. The group of female resulted in a significant decrease in fasting blood glucose ($169.7{\pm}28.2$ mg/dL to $152.8{\pm}22.0$ mg/dL) and triglyceride ($177.8{\pm}56.3$ mg/dL to $162.3{\pm}36.1$ mg/dL), but the group of male did not show a significant decrease in fasting blood glucose and triglyceride. Nutritional knowledge and dietary habit scores of the subjects were significantly improved after nutrition education. The results demonstrate that nutrition education for type 2 diabetic patients with low income are effective in improving their blood glucose.

• Tuberculosis and Respiratory Diseases
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• v.47 no.3
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• pp.365-373
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• 1999

Background: Despite widespread use of tracheostomy in intensive care unit, it is still controversial to define the best timing from endotracheal intubation to tracheostomy under prolonged mechanical ventilation. Early tracheostomy has an advantage of easy airway maintenance and enhanced patient mobility whereas a disadvantage in view of nosocomial infection and tracheal stenosis. However, there is a controversy about the proper timing of tracheostomy. Methods: We conducted a retrospective study of the 35 medical and 15 surgical ICU patients who had admitted to Ewha Womans University Mokdong Hospital from January 1996 to August 1998 with the observation of APACHE III score, occurrence of nosocomial infections, and clinical outcomes during 28 days from tracheostomy in terms of early (n=25) vs. late (n=25) tracheostomy. We defined the reference day of early and late tracheostomy as 7th day from intubation. Results: The number of patients were 25 each in early and late tracheostomy group. The mean age were $48{\pm}18$ years in early tracheostomy group and $63{\pm}17$ years in late tracheostomy group, showing younger in early tracheostomy group. The median duration of intubation prior to tracheostomy was 3 days and 13 days in early and late tracheostomy groups. Organs that caused primary problem were nervous system in 27 cases(54%), pulmonary 14(28%), cardiovascular 4(8%), gastrointestinal 4(8%) and genitourinary 1(2%) in the decreasing order. Prolonged ventilation was the most common reason for the purpose of tracheostomy in both groups. APACHE m scores at each time of intubation and tracheostomy were slightly higher in late tracheostomy group but not significant statistically. Day to day APACHE III scores were not different between two groups with observation upto 7th day after tracheostomy, Occurrence of nosocomial infections, weaning from mechanical ventilation, and mortality showed no significant difference between two groups with observation of 28 days from tracheostomy. The mortality was increased as the APACHE m score upto 7 days after tracheostomy increased, but there were no increment for the mortality in terms of the time of tracheostomy and the days of ventilator use before tracheostomy, Conclusion: The early tracheostomy seems to have no benefit with respect to severity of illness, nosocomial infection, duration of ventilatory support, and mortality. It suggests that the time of tracheostomy is better to be decided on clinical judgement in each case. And in near future, prospective, randomized case-control study is required to confirm these results.

• Journal of dental hygiene science
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• v.17 no.2
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• pp.142-149
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• 2017

This study targeted 123 dental hygienists working at the university and dental hospital as well as the dental clinic in Busan. The study ran for 5 months beginning July 23, 2016. The purpose of the study was to understand the relationship between core competencies and job performance for dental hygienists. The major core competencies of dental hygienists were interpersonal relation competency (3.61) was the highest, followed by management and educational competency (3.59), organizational relation competency (3.57), and basic dental hygiene management competency (3.56). Regarding the subjects' job performance, 'the task requested by a boss could be finished by the deadline' (3.93) was the highest, followed by 'there has been no case where others were harmed owing to carelessness' (3.76). 'The performance exceeding the targets set by the boss' (3.11) was relatively low. The group working for dental hospitals showed higher job performance than the group working for dental clinics (p=0.009) while there were high correlations between core competencies and job performance (p=0.733). Also, analysis for understanding relevant variables of core competencies that affected job performance revealed that the interpersonal relation competency (p=0.25), self-control competency (p=0.32), and basic dental hygiene competency (p=0.15) were significant. In summary, reinforcement of the dental hygienists' core competencies has a positive effect on job performance. Improved job performance in turn should improve patient care as well as the performance of the healthcare organization overall which will be eventually helpful to the provision of high-quality medical service to patients, and helpful for the hospital organization Helpful in making their performance better. Therefore, it would be necessary to establish administrative/educational support to facilitate dental hygiene education to develop major competencies and vocational basic abilities, as well as reinforce diverse competency educational programs for the current dental hygienists.

• Journal of dental hygiene science
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• v.4 no.3
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• pp.133-140
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• 2004

It examines closely the occupation characteristic primary factor which the dentistry hygienic company field which is working to presence at a sickbed is undergoing the degree and from the research which it sees and it grasps the adaptation method against it gropes bitterly with development of the dentistry hygienic company individual to join in, it contributed in dentistry medical treatment service quality improvement and the research which tries to sleep it attempted. Currently the dentistry hygiene which works from Seoul and the condition area subject matter dentist unit, the dentistry hospital and the general hospital dentistry back it did in the object which it will burn. 116 issues which become frequency in question 120 it used SPSS 10.0 and it analyzed. Result of this study is as following. (1) Was expose that stress degree by factor feels about commonness on the whole, and angle prospects and support connection stress at company were the biggest item by item, and appeared as on the other hand relation connection stress with patient is the smallest. (2) Stress that stress degree by each receives in case of there are a lot of other businesses to characteristic businesses except appeared highest. On the other hand, was expose that feel the lowest stress degree an item that other a type of occupation and discord are. (3) 'Do action of that throw goods or closes the door bump' appeared article highest by short term adaptation method about stress, and 'Think and gives up by fate' appeared highest by special skill adaptation method. Short term adaptation method appeared high than special skill adaptation method on the whole but the difference appeared as is very small. (4) Stress degree comparison by general special quality was shown difference that stress by only dental hygiene administration of justice selection motive keeps in mind. (5) All of the result that compare short term, long term adaptation method about stress that feel new dental higienist apple career dental higienist same difference be, but displayed high result in same munhang. (6) Was expose that difference that keep in mind from all arguments in comparison of short term adaptation method by general special quality does not exist, on the other hand, comparison of long-term adaptation method displayed result that religion among only variable keeps in mind statistically.

• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.1-13
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• 2013

Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

• Journal of agricultural medicine and community health
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• v.38 no.1
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• pp.14-24
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• 2013

Objectives: Pregnant women in rural areas do not have access to sufficient obstetric services in their own communities due to the shortage of obstetricians. Therefore, most of these women must seek obstetrician outside of their communities. The purpose of this study was to investigate the relationship between obstetric complications and accessibility to local obstetric care in Korea. Methods: This study was an ecological study in which the unit of analysis was an administrative district. Using Korea National Health Insurance Corporation data, the total number of deliveries and the delivery proportion within and outside of the community from 2001 to 2008 were calculated for 232 administrative districts nationwide. Three outflow levels were categorized based on each district's out-of-community delivery proportion: high outflow (upper one third), moderate outflow (middle one third), and low outflow (lower one third). In addition, three obstetric complication rates (the rate of complications following abortion, ectopic and molar pregnancy, the abortion rate, and the eclampsia rate) were calculated for the 232 districts. One-way ANOVA and multivariate linear regression were used to evaluate obstetric complications among the three outflow levels. Results: The high outflow districts had higher rates of eclampsia and complications following abortion, ectopic, and molar pregnancy compared to the other districts (ANOVA, p<0.05). However, there was no significant difference in the abortion rate among the three groups. Multiple linear regression analysis showed that high outflow districts were statistically significant in the rate of complications following abortion, ectopic and molar pregnancy and eclampsia rate after adjusting for local tax per capita (p<0.01). Conclusion: These results indicate that poor access to local obstetric care correlate with poor obstetric outcomes (delayed or excessive bleeding, embolism, genital tract or pelvic infection, shock or other complications following abortion and ectopic or molar pregnancy, or eclampsia).

• Journal of Biomedical Engineering Research
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• v.32 no.2
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• pp.165-176
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• 2011

The femoral nerve innervates the quadriceps muscles and its dermatome supplies anteromedial thigh and medial foot. Paralysis of the quadriceps muscles due to the injury of the femoral nerve results in disability of the knee joint extension and loss of sensory of the thigh. A child could walk independently even though he had injured his femoral nerve severely due to the penetrating wound in the medial thigh. We measured and analyzed his gait performance in order to find the mechanisms that enabled him to walk independently. The child was eleven-year-old boy and he could not extend his knee voluntarily at all during a month after the injury. His gait analysis was performed five times (GA1~GA5) for sixteen months. His temporal-spatial parameters were not significantly different after the GA2 or GA3 test, and significant asymmetry was not observed except the single support time in GA1 results. The Lower limb joint angles in affected side had large differences in GA1 compared with the normal normative patterns. There were little knee joint flexion and extension motion during the stance phase in GA1 The maximum ankle plantar/dorsi flexion angles and the maximum knee extension angles were different from the normal values in the sound side. Asymmetries of the joint angles were analyzed by using the peak values. Significant asymmetries were found in GA1with seven parameters (ankle: peak planter flexion angle in stance phase, range of motion; ROM, knee: peak flexion angles during both stance and swing phase, ROM, hip: peak extension angle, ROM) while only two parameters (maximum hip extension angle and ROM of hip joint) had significant differences in GA5. The mid-stance valleys were not observed in both right and left sides of vertical ground reaction force (GRF) in the GA1, GA2. The loading response peak was far larger than the terminal stance peak of vertical ground reaction curve in the affected side of the GA3, GA4, GA5. The measured joint moment curves of the GA1, GA2, GA3 had large deviations and all of kinetic results had differences with the normal patterns. EMG signals described an absence of the rectus femoris muscle activity in the GA1 and GA2 (affected side). The EMG signals were detected in the GA3 and GA4 but their patterns were not normal yet, then their normal patterns were detected in the GA5. Through these following gait analysis of a child who had selective injuries on the knee extensor muscles, we could verify the actual functions of the knee extensor muscles during gait, and we also could observe his recovery and asymmetry with quantitative data during his rehabilitation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.9
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• pp.6089-6098
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• 2015

This study purposes to identify the effects of performance of public health services (PHS) and personal characteristics on community image to public hospitals. The subjects of this study were 33 public hospitals and 1,789 community residents. The data of '2011 Public hospital evaluation programme' were utilized in this study. The personal characteristics consisted of nine items which were gender, age, education, occupation, monthly incomes, medical security, use experience, health state, and location type. The PHS performance consisted of five items which were number of doctors, number of nurses, total number of staff, budget per 1,000 community residents, and amount of activities per 1,000 community residents. The cronbach's alpha of community image instrument was 0.916. As the results of logistic regression, the significant variables of community image, were age (OR=0.34, 95% CI=0.19-0.60), education (OR=3.03, 95% CI=1.60-5.76), use experience (OR=0.57, 95% CI=0.40-0.81), health state (OR=0.69 95% CI=0.49-0.96), location type (OR=2.10, 95% CI=1.11-3.99), and amount of activities per 1,000 community residents (OR=0.58, 95% CI=0.35-0.96). Community image is very important to public hospitals. The workforce and budget related PHS were significantly demanded to improve community image. The Central and Local government should support to public hospitals to perform PHS effectively.