• Title/Summary/Keyword: Quality of Medical

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Relationship between Physical Function Factors and Discrimination Experiences of the Elderly in Korea: The 2014 and 2017 National Survey on Living Conditions and Welfare Needs of Korean Older Persons (우리나라 노인의 신체기능 요인과 차별경험의 관련성 연구: 노인실태조사(2014, 2017) 자료 분석)

  • Lee, Kyuhee;Yong, Wangshik;You, Changhoon;Lee, Yongjae;Chung, Woojin
    • Health Policy and Management
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    • v.29 no.4
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    • pp.454-468
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    • 2019
  • Background: Supporting the elderly population is presented as a social issue, and it affects age discrimination, which forms a negative perception and avoids the elderly. Since age discrimination lowers the quality of life of the elderly and hinders social unity, it may be important to research related factors. This study examined the physical function as a factor that influences discrimination experiences and aimed to identify the relationship between physical function factors and discrimination experiences. Methods: In this study, we analyzed 20,225 elderly from the 2014 and 2017 survey of living conditions and welfare needs of Korean older persons, conducted nationwide among older than 65 years. Physical function factors are activities of daily living, instrumental activities of daily living, sight discomfort, hearing discomfort, chewing discomfort, and leg strength as factors of interest. We performed multivariable logistic regression that reflected survey characteristics, adjusting for socio-demographic factors, health related factors, and social-support factors. Results: The number of elderly who faced discrimination experiences was 1,175 (5.8%). The results showed that the odds ratio of facing a discrimination experience in the dependent group was significantly higher compared to the independent group when being transferring out of the room (4.05; 95% confidence interval [CI], 1.50-10.88) and difficulty in hearing (1.25; 95% CI, 1.05-1.49). Even with respect to chewing ability, which was significant in models 1 and 2, they face more discrimination experiences (1.30; 95% CI, 1.11-1.53). Conclusion: These research results indicate that an important strategy for preventing age discrimination is to understand the physical function conditions of the elderly and promote the physical functions of the elderly related to transferring, hearing, and chewing; it is necessary to develop a practical intervention plan that considers these aspects.

Characteristics of White Soybean Chungkookjang Fermented by Bacillus subtilis D7 (Bacillus subtilis D7에 의하여 발효된 백태 청국장의 특성)

  • Lee, Na-Ri;Park, Sung-Bo;Lee, Sang-Mee;Go, Tae-Hun;Hwang, Dae-Youn;Kim, Dong-Seob;Jeong, Seong-Yun;Son, Hong-Joo
    • Journal of Life Science
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    • v.23 no.4
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    • pp.529-536
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    • 2013
  • This study was carried out to investigate the characteristics of white soybean Chungkookjang fermented by Bacillus subtilis D7. The highest germination rate was obtained under $25^{\circ}C$ when water was supplied for 4 days at intervals of 2 hr. The total isoflavone content was 971.3 ${\mu}g/g$ before germination and 1023.8 ${\mu}g/g$ after germination. The amino type- and ammonia type-nitrogen contents of Chungkookjang were proportional to the fermentation time. The pH values of all Chungkookjang soybeans increased up to pH 7.8-8.0 during fermentation. The number of viable cells in all Chungkookjang soybeans increased significantly up to 24 hr. The protease activity of all Chungkookjang soybeans increased up to 30-36 hr. The ${\alpha}$- and ${\beta}$-amylase activities of Chungkookjang fermented by B. subtilis D7 were enhanced with increasing fermentation time. Analysis of the effect of Chungkookjang intake on the liver function of mouse showed that the alkaline phosphatase (ALP) activity and the superoxide dismutase (SOD) activity in the Chungkookjang diet group were markedly higher than those in the control group. The asparatate aminotransferase (AST) activity in the germinated soybean Chungkookjang diet group was higher than that in the nongerminated soybean Chungkookjang diet group. Therefore, Chungkookjang soybeans fermented with B. subtilis D7 can be expected to have an increased content of functional components and improved quality characteristics.

Relationship between Percutaneous Transluminal Coronary Anigioplasty Volume and Associated Immediate Outcome (경피적 관동맥 확장술의 시술량과 조기 시술결과의 관련성)

  • Kim, Yong-Ik;Kim, Chang-Yup;Lee, Young-Sung;Kim, Sun-Mean;Lee, Jin-Seok;Oh, Byung-Hee;Khang, Young-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.1
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    • pp.9-20
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    • 2001
  • Objectives : To explore the relationship between Percutaneous Transluminal Coronary Angioplasty(PTCA) volume and the associated immediate outcome. Methods : A total of 1,379 PTCAs were peformed in 25 hospitals in Korea between October 8 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. Results : Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals ($\geq200$ cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. Conclusions : After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.

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A Study on the Development of Urine Analysis System using Strip and Evaluation of Experimental Result by means of Fuzzy Inference (스트립을 이용한 요분석시스템의 개발과 퍼지추론에 의한 검사결과 평가에 관한 연구)

  • Jun, K. R.;Lee, S. J.;Choi, B. C.;An, S. H.;Ha, K.;Kim, J. Y.;Kim, J. H.
    • Journal of Biomedical Engineering Research
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    • v.19 no.5
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    • pp.477-486
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    • 1998
  • In this paper, we implemented the urine analysis system capable of measuring a qualitative and semi-quantitative and assay using strip. The analysis algorithm of urine analysis was adopted a fuzzy logic-based classifiers that was robust to external error factors such as temperature and electric power noises. The spectroscopic properties of 9 pads In a strip were studied to developing the urine analysis system was designed for robustnesss and stability. The urine analysis system was consisted of hardware and software. The hardware of the urine analysis system was based on one-chip microprocessor, and Its peripherals which composed of optic modulo, tray control, preamplifier, communication with PC, thermal printer and operating status indicator. The software of the urine analysis system was composed of system program and classification program. The system program did duty fort system control, data acquisition and data analysis. The classification program was composed of fuzzy inference engine and membership function generator. The membership function generator made triangular membership functions by statical method for quality control. Resulted data was transferred through serial cable to PC. The transferred data was arranged and saved be data acquisition program coded by C+ + language. The precision of urine analysis system and the stability of fuzzy classifier were evaluated by testing the standard urine samples. Experimental results showed a good stability states and a exact classification.

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Nutritional Evaluation and Its Relation to the Risk of Metabolic Syndrome according to the Consumption of Cooked Rice and Cooked Rice with Multi-grains in Korean Adults: Based on 2007-2008 Korean National Health and Nutrition Examination Survey (한국 성인의 밥 섭취 정도와 잡곡밥 섭취 유무에 따른 영양섭취실태 및 대사증후군 위험수준 평가 - 2007-2008년 국민건강영양조사 자료를 이용하여 -)

  • Son, Soo-Hyun;Lee, Hwa-Jung;Park, Kyong;Ha, Tae-Youl;Seo, Jung-Sook
    • Korean Journal of Community Nutrition
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    • v.18 no.1
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    • pp.77-87
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    • 2013
  • This study was conducted to investigate the nutrient intakes of subjects by quartile of percent energy intake from cooked rice, consumption of cooked rice mixed with multi-grains and to evaluate rice consumption in relation to the risk of metabolic syndrome. The subjects were 5,830 males and females aged between 20~64 years based on 2007-2008 KNHNES data. Levels of percent energy intake from cooked rice were classified into 4 groups (Q1, Q2, Q3, Q4 groups: 25% of each) using data of 24-hour recall method from KNHNES. Using medical examination and questionnaire, subjects were classified according to diagnostic criteria of metabolic syndrome. The subjects with higher age, being married, lower education, lower economic level were more likely to take higher percent energy intake from cooked rice. Quartile Q3 of percent energy intake from cooked rice tended to show higher Index of Nutritional Quality (INQ) for fiber, calcium, iron, potassium and vitamin A. INQ of protein, dietary fiber, calcium, thiamin, phosphorus, potassium, riboflavin, niacin and vitamin C by consumption of cooked rice mixed with multi-grains was higher than that by consumption of cooked white rice when adjusted for age. No association with a risk for metabolic syndrome was found for quartile of percent energy intake from cooked rice or cooked rice mixed with multi-grains compared to cooked white rice after adjusting for energy, gender, age, BMI, alcohol, smoking, income and physical activity. In conclusion, consumption of over 54% energy intake from cooked rice or only cooked white rice showed relatively low INQs, but was not associated with a higher risk for metabolic syndrome.

A Study on the Informal Cost Burden of the Patients Admitted to the Hospital (입원환자의 비공식적 의료비용 부담에 관한 연구)

  • Han, Mi-Hyun
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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Information Needs and Satisfaction among Family Members of Terminal Cancer Patients through Phone Cancer Information Services (말기 암 환자 가족의 전화상담을 통한 정보요구와 만족도 조사)

  • Kwon, Kyeung-Eun;Kim, Boon-Han;Chang, Yoon-Jung;Kim, Hee-Jung;Jung, Yun
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.5-13
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    • 2009
  • Purpose: This exploratory study was undertaken to analyze the information needs of family members of terminal cancer patients, collected through the telephone counselling service by National Cancer Information Center. Methods: The study included 113 family members of terminal cancer patients who had enrolled at the National Cancer Information Center for the period from June, 2007 through March, 2008 and had agreed to the survey. Results: The subjects (n=113) consisted of grown-up children (n=82) and spouses (n=8) of patients'. Those in their 40's (n=40) and 30's (n=36) accounted for the majority of the sample. The questions raised most were about the information on treatment methods (n=117), management of terminal cancer patients (n=46), terminal cancer patients' life (n=27), deathbed and prediction of remaining life (n=18), hospitalization (n=16), and financial support (n=15). Most of the subjects were satisfied with the telephone counseling services, and 69% of the subjects had come to know about the telephone counseling service via Internet, and 10.6% of them stated that the PR for the service was poor. Conclusion: It is deemed essential for the government to use the mass media for PR of the hospice services, since family members of terminal cancer patients' are less aware of the hospice conducive to enhancement of patients' remaining quality of life, being involued too deeply in their treatment.

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Design of the control Algorithm for Improvement of the Convenience the Active-type Walking Aid (전동 보행보조기의 편의성 향상을 위한 제어기 설계)

  • Lee, D.K.;Kong, J.S.;Goh, M.S.;Kang, S.J.;Lee, S.M.;Lee, E.H.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.5 no.1
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    • pp.17-25
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    • 2011
  • This paper aims to find the optimal control gain for enhancing the convenience of electric walking frames and design a control algorithm. With the recent advances in medical technology, there has been a rapid increase in the aging population and a variety of mobile walking frames have been developed for improvement of the quality of life. However, the manual walking frames of such mobile aids don't have any electric motor which helps facilitate elderly users' walking and thus are not efficient enough for the old people of weak strength to use especially when moving on uneven surfaces such as slopes or thresholds. The types of electric walking frames have been developed to overcome such inefficiency. Electric walking frames require users' control operations for motor driving unlike manual frames. Therefore, when they are not properly handled, it causes considerable inconvenience to their users. The present study compared the electric walking frames with manual ones in terms of operational convenience and attempted to improve the user convenience of walking frames varying the control value for user convenience based on certain standards. This paper presented a haptic sensor designed to recognize the will to walk and measure the degree of convenience and proposed a control algorithm for improvement of convenience. For user convenience, this paper evaluated the relative convenience of walking frames in view of changing differences between the center of vehicle (COV) and the center of position (COP). With the employment of an electric walking frame and a new measuring method, all the processes were experimentally tested and validated.

Significance of Tissue Expression and Serum Levels of Angiopoietin-like Protein 4 in Breast Cancer Progression: Link to NF-κB /P65 Activity and Pro-Inflammatory Cytokines

  • Shafik, Noha M;Mohamed, Dareen A;Bedder, Asmaa E;El-Gendy, Ahmed M
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8579-8587
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    • 2016
  • Background: The molecular mechanisms linking breast cancer progression and inflammation still remain obscure. The aim of the present study was to investigate the possible association of angiopoeitin like protein 4 (ANGPTL4) and its regulatory factor, hypoxia inducible factor-$1{\alpha}$ (HIF-$1{\alpha}$), with the inflammatory markers nuclear factor kappa B/p65 (NF-${\kappa}B$/P65) and interleukin-1 beta (IL-$1{\beta}$) in order to evaluate their role in inflammation associated breast cancer progression. Materials and Methods: Angiopoietin-like protein 4 (ANGPTL4) mRNA expressions were evaluated using quantitative real time PCR and its protein expression by immunohistochemistry. DNA binding activity of NF-${\kappa}B$/P65 was evaluated by transcription factor binding immunoassay. Serum levels of ANGPTL4, HIF-$1{\alpha}$ and IL-$1{\beta}$ were immunoassayed. Tumor clinico-pathological features were investigated. Results: ANGPTL4 mRNA expressions and serum levels were significantly higher in high grade breast carcinoma ($1.47{\pm}0.31$ and $184.98{\pm}18.18$, respectively) compared to low grade carcinoma ($1.21{\pm}0.32$ and $171.76{\pm}7.58$, respectively) and controls ($0.70{\pm}0.02$ and $65.34{\pm}6.41$, respectively), (p<0.05). Also, ANGPTL4 high/moderate protein expression was positively correlated with tumor clinico-pathological features. In addition, serum levels of HIF-$1{\alpha}$ and IL-$1{\beta}$ as well as NF-${\kappa}B$/P65 DNA binding activity were significantly higher in high grade breast carcinoma ($148.54{\pm}14.20$, $0.79{\pm}0.03$ and $247.13{\pm}44.35$ respectively) than their values in low grade carcinoma ( $139.14{\pm}5.83$, $0.34{\pm}0.02$ and $184.23{\pm}37.75$, respectively) and controls ($33.95{\pm}3.11$, $0.11{\pm}0.02$ and $7.83{\pm}0.92$, respectively), (p<0.001). Conclusion: ANGPTL4 high serum levels and tissue expressions in advanced grade breast cancer, in addition to its positive correlation with tumor clinico-pathological features and HIF-$1{\alpha}$ could highlight its role as one of the signaling factors involved in breast cancer progression. Moreover, novel correlations were found between ANGPTL4 and the inflammatory markers, IL-$1{\beta}$ and NF-${\kappa}B$/p65, in breast cancer, which may emphasize the utility of these markers as potential tools for understanding interactions for axes of carcinogenesis and inflammation contributed for cancer progression. It is thus hoped that the findings reported here would assist in the development of new breast cancer management strategies that would promote patients' quality of life and ultimately improve clinical outcomes. However, large-scale studies are needed to verify these results.

The Effect of Nutrition Plus Program among 0~5 Year Children in the Yeojoo Area - The Improvement in Nutritional Status of Children after Nutrition Supplement of Children and Nutrition Education in Parents/Guardians - (여주지역 영유아 대상 영양플러스 사업 효과 - 영유아 영양보충 및 보호자 영양교육 실시에 따른 영유아의 영양개선효과를 중심으로 -)

  • Park, Ok-Jin;Lee, Min-June;Kim, Ji-Hyang;Min, Sung-Hee;Lee, Hyun-Sook
    • Korean Journal of Community Nutrition
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    • v.14 no.6
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    • pp.767-776
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    • 2009
  • This study evaluated the effect of nutritional improvement of 0~5 year children of financially poor families after nutrition supplement of children and nutrition education in parents/guardians. The subject selected among applicants for low-income family financing of the government included 198 children (0~12 months:92, 1~5 years:106), and the average ages were 5.3 months and 2.4 years respectively. Food that includes each nutrient factor was provided to the subject for six months. Nutrition education was performed in two ways, through class and private education, once a month for both. Nutritional improvement was evaluated by body measurement and anemia prevalence rate. As to the survey on breast-feeding, complete breast-feeding accounted for 58.7%, weaning food 27.3%, and combined feeding 14.1% respectively, which shows that breast-feeding accounted for the largest percentage. The education program improved knowledge and attitude of the parents/guardians, which brings in positive effects on growth of children as well. The nutrition knowledge score was improved after nutrition education in 0~12 month children $(8.5\pm1.75\;to\;8.9\pm1.69)$ and 1~5 year children $(7.3\pm1.39\;to\;7.8\pm1.30)$. The nutrition attitude score was significantly improved in 0~12month children $(52.0\pm6.99$ to $53.5\pm5.21$, p < 0.001) and 1~5year children ($45.1\pm7.30$ to $49.0\pm5.96$, p < 0.001). In evaluation on nutritional improvement based on body measurements, it turned out that the wasting was reduced as for children in consideration of the height and weight according to the subject's age. The concentration of hemoglobin after the nutrient treatment for six months was significantly improved, and the anemia prevalence rate as well was reduced from 40.6% to 13.5%, which indicates the significant improvement. Based on the findings above, it turned out that providing quality food to children and nutrition education to the parents/guardians poorly fed in low-income families improved knowledge and attitude of the guardians and prevents anemia and improves growth, which brings in positive effects on growth of children. In the results regarding attitude and knowledge on nutrient/dietary life; however, the improvement level was relatively low when the extent before the education was too small, which indicates the need to revise and complement the contents and methods. In addition, as shown in the result of body measurement, long-term and consistent investigation is necessary since it is difficult to judge the effect on growth only based on short-term nutrient supplement.