The Journal of Korea Assosiation for Disability and Oral Health
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v.3
no.1
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pp.17-21
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2007
Alagille syndrome is an autosomal dominant genetic disorder and occurs in approximately 1 in 100,000 live births. Diagnostic criteria was established by Alagille. It is mainly caused by a mutation in the Jagged1 gene. Major clinical features of this syndrome are paucity of intrahepatic bile duct with cholestasis, characteristic facies, cardiac murmur, defects of vertebrae, and embryotoxon. And minor clinical features are mental retardation, renal involvement, growth retardation, other skeletal abnormalities, a high-pitched voice. The surviving prognosis of Alagille syndrome patients depends on the severity of cardiovescular malformation in the early ages of infant. However, with the increasing years, it depends on the severity of the liver disease. Cholestasis causes congenital jaundice, malnutrition and growth retardation. Also, the increase of serum cholesterol level cause xanthoma and pruritus. Even though the severity of these problems are reduce with age, there is cases where there is no way but liver transplantation. For oral features of Alagille syndrome patients, green discoloration of entire dentition, induced by bilirubin infiltration into dentinal tubules, is especially. Also, xanthoma on gingiva and partial hypodontia have been reported. This report is on the oral features of an Alagille syndrome patient who visited to Kyung-Pook University Hospital.
Purpose: This study examined the injury and rehabilitation of athletes with disabilities in racket sports projects (i.e., badminton, table tennis, and wheelchair tennis). In addition, the characteristics of each project and the differences among those projects are discussed. Methods: Business team athletes with disabilities in racket sport were enrolled as subjects (i.e., 19 badminton athletes, 19 table tennis athletes, and 19 wheelchair tennis athletes). The real conditions of the injury, injury severity, injury site, symptoms, and rehabilitation methods after injury were analyzed. Results: No significant differences were observed among the actual condition, injury severity, symptoms and the methods of rehabilitation on racket sport for athletes (i.e., badminton, table tennis, and wheelchair tennis athletes) with disability. The differences were focused mainly on the injury sites due to the characteristics of the different projects, and specific technical actions. Conclusion: This study examined the real condition of the injury, injury severity, injury site, symptoms and rehabilitation methods after the injury on the rackets (i.e., badminton, table tennis, and wheelchair tennis) athletes with disabilities. The data can be used to eliminate the incidence of injury and minimize the injury severity for racket athletes with disabilities. In addition, it can also be used for the disabled, who like racket projects, as the fundamental material to prevent injury and assist in recovery.
Background: This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. Methods: This study used the 2017-2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. Results: Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (𝛽=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. Conclusion: This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.
Background; In the event of an industrial accident, the appropriate choice of hospital is important for worker health and prognosis. This study investigates whether the choice of hospital by the employer in the case of industrial accidents affects the prognosis of injured employees. Methods; Data from the 2018 Panel Study of Workers' Compensation Insurance in Korea were used in an unmatched case-controlled study. The exposure variable is "hospital selection by an employer," and the outcome variable is 'worker's disability." Odds ratios (ORs) were estimated by modified Poisson regression and adjusted for age, gender, underlying disease, injury severity, and workplace size and stratified by industrial classification. The group at increased risk was analyzed and stratified by age, gender, and area. Results; In the construction industry, hospital selection by the employer was significantly associated with increased risk of disability (adjusted OR 1.26; 95% confidence interval [CI]; 1.20-1.32) and severe disability (adjusted OR 1.38; 95% CI; 1.08-1.76) among the injured. Female and younger workers not living in the Seoul capital area were more at risk of disability and severe disability than those living in the Seoul capital area. Conclusions; Hospital selection by employers affects the prognosis of workers injured in an industrial accident. For protecting workers' health and safety, workplace emergency medical systems should be improved, and the selection of appropriate hospitals to supply treatment should be reviewed.
This study was carried out to investigate the post stroke depression (PSD) occurrence in acute stroke patients and to identify the factors that influence PSD. The study subjects were 104 adults in their 20s or older who were scheduled to be discharged due to inpatient treatment for ischemic stroke in two hospitals. Data were collected using Post Stroke Depression Scale for PSD, Multidimensional Scale of Perceived Social Support for social support, National Institutes of Health Stroke Scale for stroke severity, and Modified Rankin Scale for disability. The average length of stay after stroke onset of the study subjects was 5.9±2.1 days, and 79.8% were within 7 days. Stroke severity score was an average of 2.4±2.5 out of 42 points, and disability score was an average of 1.6±1.1 out of 6 points. Among the subjects, 32.7% had mild or more severe depression after stroke. The subjects with no religion, severe disability, high stroke severity, and less family support had a higher likelihood of experiencing PSD. These results show that depression can appear in the early stages of stroke onset. Therefore, it is necessary to develop nursing guidelines for depression intervention after acute stroke, including continuous early assessment of depression from the acute phase of stroke and religion or family support.
Journal of the Korean Operations Research and Management Science Society
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v.13
no.2
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pp.72-77
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1988
Subjective scoring by different groups on different status of morbidity are compared to objective data obtained from legal awards. A power law is tested between subjective and objective scores. Regression analysis by means of a power function provides a measure of consistency in its regression coefficient. Power functions fitting also leads to a justified use of geometric averaging of individual scores into group scores.
Objectives : As the disabled have higher prevalence rates and earlier onsets of chronic diseases than the non-disabled, their participation in mass screening is important for the early detection and intervention of chronic diseases. Nevertheless, in Korea, the disabled have lower participation rates in mass screening services than the non-disabled. The purpose of the study was to find determinants for the participation in the National Health Insurance (NHI) mass screening program among the disabled. Methods : In this study, the NHI mass screening data of 423,076 disabled people, which were identified using the National Disability Registry (2003), were analyzed. Of the factors affecting the participation rates in mass screenings, the following variables were included for the analysis: socioeconomic stati, such as sex, age, category of health insurance program, region and income, disability characteristics, such as disability type, and severity. A multiple logistic regression analysis was used to evaluate the association between the participation rates, disability characteristics variables and demographic variables. Results : The participation rate in mass screening of the disabled was 41.3%, but was lower in females, an age of more than 70 years, self-employed and for those with an average monthly insurance premium over 133,500 Won and in metropolitan legions. The participation rate was 1.31 times lower in females than males (95% CI=1.29-1.33); 3.50 times lower in the elderly (more than 70 years) than the younger (95% CI=3.33-3.67); 1.43 times lower in those who live in metropolitan areas (95% CI=1.40-1.46); 2.59 times lower for those in a health Insurance program for the self-employed than for employees (95% CI=2.56-2.63), 1.19 times lower for the higher income (more than 133,500) than the lower income group (4,400-22,000) for the average monthly insurance premium (95% CI=1.15-1.23): 2.04 times lower for those with brain palsy and stroke disabilities than with auditory impairments (95% CI: 1.97-2.11) and 3.27 times for those with severe compared to mild disabilities (95% CI=3.15-3.40). Conclusions : The disabled with high severity, and locomotive and communication disabilities have lower participation rates in mass screening services in Korea.
Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.
Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.
Although linkages between poverty and disability are often noted, until recently they have not been systematically examined in Korea. Many people with disabilities tend to become poorer because they lack access to jobs. And income support programs are not sufficient. But more severe is people with disabilities in labor market tend to be poor. The purposes of this study were to explore the characteristics of working poor with disabilities and to identify the major determinants of poverty. For this, '2005 Survey on the Workers With Disabilities' was used. The data was analyzed by descriptive statistics, t-test, logistic regression. The results showed that gender, age, education level, marital status, region where they live, the number of the household member, the severity of disability, the onset of disability are significant predictors in determining their poverty status. Also employment status, occupation type, industry type, numbers of years in current job are major determinants of their poverty status. Finally, based on these results several policy implications were presented.
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