Sleepiness is associated with many different conditions and, as a neglected topic, it can be the cause of serious psychological and social disadvantages. In the aspect of learning, additional problems may arise from poor progress in school caused by the effect of sleepiness on concentration, memory, and other cognitive functions. Narcolepsy is by no means the most common cause of excessive sleepiness. Nonetheless, it is not a rarity, especially in young people. The non-specific nature of early features of narcolepsy, combined with very limited awareness that the condition can start in various ways, leads to many misinterpretations. Misinterpretation of narcolepsy symptoms is not confined to the medical profession. Teachers may well be critical of a student with narcolepsy because of their perception of narcolepsy symptoms as laziness, poor motivation, or difficult behavior and dull learning ability. Inappropriate reactions by parents, teachers, and peers, based on misinterpretation of narcolepsy symptoms or the patient's reactions to them, make a difficult situation worse. Especially in Korea, where schooling is focused on college entrance examinations, the problem is very serious and intensified by inappropriate or delayed diagnosis and treatment. Therefore, psychiatrists should be aware that narcolepsy in young adolescents is not rare and that they need to be familiar with its clinical features in both its classic and less obvious forms. Narcolepsy should be suspected if a adolescent's excessive sleepiness can not be explained in other ways. Therefore, we report on two patients who portray the tendency of dull learning ability and are mistaken as idle students. We diagnosed narcolepsy through polysomnography and multiple sleep latency testing. We treated the students with methylphenidate and pemolin. The students showed improvement in learning ability and were able to adapt better to school.
Objectives: This study aims to contribute to devising systems for family caregivers of dementia patients by examining the state of oral care of dementia patients, and depression and social support among family caregivers of dementia patients. Methods: Family caregivers of dementia patients in the metropolitan area were selected in this study. The inclusion criteria were individuals who have provided care for a dementia patient at home for at least six months and those who come in contact (including phone calls) with the patient at least twice a week. Results: Oral health knowledge of the elderly, caregiving burden, depression, and social support were examined. The mean scores for oral health knowledge of the elderly and caregiving burden were $57.11{\pm}16.94$ out of 100 and $17.33{\pm}8.61$ out of 48, respectively. Further, the mean caregiving behavior score, depression score, and social support score were $8.49{\pm}13.71$ out of 100, $5.11{\pm}3.05$ out of 10, and $72.75{\pm}17.03$ out of 100, respectively. Factors affecting oral health knowledge of the elderly were examined. The results showed that the level of oral health knowledge of the elderly increased with an increasing perception of a need for oral health education (p<0.05), caregiving burden (p<0.01), and social support (p<0.01). Conclusions: These findings suggest that developing and popularizing oral care intervention programs for family caregivers of dementia patients are necessary to ensure systematic oral care for dementia patients.
Objective : The purpose of this study was to investigate the associations between psychosocial factors and the mask-wearing behavior after deregulation of COVID-19 quarantine guidelines among adults in Korea. Methods : We collected data (345 subjects) from online questionnaire survey. The questionnaire included the Korean version of the Patient Health Questionnaire-9, the Korean version of fear of COVID-19 Scale, the Korean version of the Patient Health Questionnaire-15, Korean versions of the Perceived Stress Scale, and measurement tools adapted from previous studies for COVID-19 risk perception, social stigma, and appearance interest of subjects. We analysed data using SPSS version 23.0 for descriptive statistics, chi-square test, and logistic regression analysis. Results : People with cohabitant or mask-wearing tendency before COVID-19 pandemic had a higher rate of mask-wearing than those who were not. Subjects reporting higher level of social stigma (OR=1.154, 95% CI 1.049-1.270) and COVID-19 anxiety (OR=1.072, 95% CI 1.007-1.141) were more likely to report maskwearing behavior. Conclusion : From the results, appropriate intervention to those who fear social stigma and are anxious to the infectious diseases will be needed. Additionally, providing policies and guidelines that consider cohabitants and offering continuous education with information of disease to the public are also expected to helpful for recovery of daily life from infectious diseases.
International Journal of Computer Science & Network Security
/
v.23
no.10
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pp.37-43
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2023
The hospital situation, timing, and patient restrictions have become obstacles to an optimum therapy session. The crowdedness of the hospital might lead to a tight schedule and a shorter period of therapy. This condition might strike a post-stroke patient in a dilemma where they need regular treatment to recover their nervous system. In this work, we propose an in-house and uncomplex serious game system that can be used for physical therapy. The Kinect camera is used to capture the depth image stream of a human skeleton. Afterwards, the user might use their hand gesture to control the game. Voice recognition is deployed to ease them with play. Users must complete the given challenge to obtain a more significant outcome from this therapy system. Subjects will use their upper limb and hands to capture the 3D objects with different speeds and positions. The more substantial challenge, speed, and location will be increased and random. Each delegated entity will raise the scores. Afterwards, the scores will be further evaluated to correlate with therapy progress. Users are delighted with the system and eager to use it as their daily exercise. The experimental studies show a comparison between score and difficulty that represent characteristics of user and game. Users tend to quickly adapt to easy and medium levels, while high level requires better focus and proper synchronization between hand and eye to capture the 3D objects. The statistical analysis with a confidence rate(α:0.05) of the usability test shows that the proposed gaming is accessible, even without specialized training. It is not only for therapy but also for fitness because it can be used for body exercise. The result of the experiment is very satisfying. Most users enjoy and familiarize themselves quickly. The evaluation study demonstrates user satisfaction and perception during testing. Future work of the proposed serious game might involve haptic devices to stimulate their physical sensation.
Park, Young-Sook;Kim, Keum-Soon;Song, Kyung-Ja;Kang, Ji-Yeon
Journal of Korean Academy of Nursing
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v.36
no.7
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pp.1183-1192
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2006
Purpose: The purpose of this survey was to investigate clinical nurses' understanding of delirium and their educational need of delirious patient care. Method: A survey questionnaire regarding nurses' general perception and understanding of delirium, experience with delirious patients and educational need was developed and conducted with 179 clinical nurses in a university hospital in Seoul. Data was analyzed using descriptive statistics. Results: Nurses thought that delirium was one of the most important nursing problems and they considered it to be more treatable than to be preventable. However, the majority of nurses were ilot confident in caring for delirious patients. Nurses reported that delirium happened most often after surgery, and that possible contributing factors could be changes in physical environment and anxiety/stress, as well as medication and long-term isolation. Thirteen nursing interventions were identified but half of the nurses utilized only one or two of the thirteen. The most frequently used intervention was reorienting the patient followed by medication and emotional support, presenting family, and close observation. 99.5% of nurses addressed the importance of professional education on delirium care, especially in the area of intervention and management. Conclusion: The results support the strong need for development of a multi-component educational program on delirium care.
Background Temporal hollowing is inevitable after decompressive craniectomy. This complication affects self-perception and quality of life, and various techniques and materials have therefore been used to restore patients' confidence. Autologous fat grafting in postoperative scar tissue has been considered challenging because of the hostile tissue environment. However, in this study, we demonstrate that autologous fat grafting can be a simple and safe treatment of choice, even for postoperative depressed temporal scar tissue. Methods Autologous fat grafting was performed in 13 patients from 2011 to 2016. Fat was harvested according to Coleman's strategy, using a tumescent technique. Patient-reported outcomes were collected preoperatively and at 1-month and 1-year follow-ups. Photographs were taken at each visit. Results The thighs were the donor site in all cases for the first procedure. The median final volume of harvested fat was 29.4 mL (interquartile range [IQR], 24.0-32.8 mL). The median final volume of fat transferred into the temporal area was 4.9 mL on the right side (IQR, 2.5-7.1 mL) and 4.6 mL on the left side (IQR, 3.7-5.9 mL). There were no major complications. The patient-reported outcomes showed significantly improved self-perceptions at 1 month and at 1 year. Conclusions Despite concerns about the survival of grafted fat in scar tissue, we advise autologous fat grafting for patients with temporal hollowing resulting from a previous craniectomy.
Journal of Korea Entertainment Industry Association
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v.14
no.7
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pp.559-570
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2020
The purpose of this study was to classify the internal members of nursing hospitals and Western hospitals that received the certification system of medical institutions, and to examine the effect of certification on member satisfaction, job stress, hospital operation effect, and improvement of medical services. In nursing hospitals, the certification system was higher in member satisfaction, hospital operation effect, and medical service effect than in Western hospitals, and members of Western hospitals were higher in job stress. In both nursing hospitals and Western hospitals, the satisfaction of members, hospital operation effect, and medical service effect according to certification showed positive (+) results. It is believed that the effect of the certification system has been empirically high in nursing hospitals as mandatory certification from 2013. Therefore, this study aims to contribute to the efficiency of hospital management and improvement of patient satisfaction through continuous quality management of medical care by analyzing the effect of certification system on medical service improvement.
Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.
Journal of Clinical Otolaryngology Head and Neck Surgery
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v.29
no.2
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pp.229-234
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2018
Background and Objectives : Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods : We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results : Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions : Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.13
no.2
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pp.1-11
/
2007
Purpose: The purpose of this study was to determine the effect of continuous wave ultrasound and pulsed wave ultrasound that influence changes in pain and range of motion when applied to patients with temporomandibular joint disability. Methods: The subjects of the study were 40 selected patients who had been diagnosed with temporomandibular joint movement restriction and had endured pain for more than two weeks. These patients had visited K orthopedic surgery in Deagu measured from October 1, 2004 to March 31, 2005. The subjects were divided into two groups with 20 patients each. The one group was applied to continuous wave ultrasound and the other group was applied to pulsed wave ultrasound at a dosage of 1.5 W/$cm^2$ for a duration of 5 minutes and eight times for two weeks. The pain perception degree were measured by using Visual Analogue Scale(VAS) and the range of motion was measured by using a rule for each group. Results: The results obtained were as follows The change in the pain perception degree were statistically significant in both group(p<0.05) ; however, the continuous wave ultrasound group showed more difference in the average decrease in the pain perception degree than did the pulsed wave ultrasound group. Both groups showed significant results regarding changed in the range of motion(p<0.05) ; Comparing the difference in the average of the range of motion between the two groups, came back from normal the range of motion of temporomandibular joint at the both groups. Conclusion : Based on the results of this study, we found that both groups showed decreased pain and increased the range of motion, but the continuous wave ultrasound method had a higher therapy effect pain and the range of motion than the pulsed wave ultrasound method to patients with temporomandibular joint disability. With such finding, we expect that according to ultrasound therapy applicant method can be helped usable accurately to patients with variety symptoms temporomandibular joint disability.
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