• 제목/요약/키워드: early interventions

검색결과 301건 처리시간 0.028초

Endoscopic management of postoperative bleeding

  • Sung Hyeok Ryou;Ki Bae Bang
    • Clinical Endoscopy
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    • 제56권6호
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    • pp.706-715
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    • 2023
  • Postoperative gastrointestinal bleeding is a rare but serious complication that can lead to prolonged hospitalization and significant morbidity and mortality. It can be managed by reoperation, endoscopy, or radiological intervention. Although reoperation carries risks, particularly in critically ill postoperative patients, minimally invasive interventions, such as endoscopy or radiological intervention, confer advantages. Endoscopy allows localization of the bleeding focus and hemostatic management at the same time. Although there have been concerns regarding the potential risk of creating an anastomotic disruption or perforation during early postoperative endoscopy, endoscopic management has become more popular over time. However, there is currently no consensus on the best endoscopic management for postoperative gastrointestinal bleeding because most practices are based on retrospective case series. Furthermore, there is a wide range of individual complexities in anatomical and clinical settings after surgery. This review focused on the safety and effectiveness of endoscopic management in various surgical settings.

뇌경막 정맥동 혈전증 - 증례보고 - (Cerebral Dural Sinus Thrombosis - Case Report -)

  • 한영민;이종필;황형식;임대철;송준호;안명수
    • Journal of Korean Neurosurgical Society
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    • 제30권3호
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    • pp.389-394
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    • 2001
  • 경막정맥동 혈전증은 다양한 원인을 가진 비교적 드문 질환으로 알려져왔으며 임상양상 및 발현형태가 매우 다양하여 임상적 진단이 쉽지 않았다. 그러나 최근에는 여러 영상진단 방법, 특히 자기공명영상 혈관 촬영등을 통해 조기 진단이 가능하게되었다. 치료 방법을 결정할 때, 환자의 임상증상과 정맥순환계의 개인간 차이가 매우 중요한 인자중 하나이다. 저자들은 보존적 치료로 좋은 결과를 얻은 2례의 경막정맥동 환자의 특성을 문헌고찰과 함께 보고하는 바이다.

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Social Distancing and Public Health Guidelines at Workplaces in Korea: Responses to Coronavirus Disease-19

  • Kim, Eun-A
    • Safety and Health at Work
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    • 제11권3호
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    • pp.275-283
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    • 2020
  • Background: In the absence of a vaccine or treatment, the most pragmatic strategies against an infectious disease pandemic are extensive early detection testing and social distancing. This study aimed to summarize public and workplace responses to Coronavirus Disease-19 (COVID-19) and show how the Korean system has operated during the COVID-19 pandemic. Method: Daily briefings from the Korean Center for Disease Control and the Central Disaster Management Headquarters were assembled from January 20 to May 15, 2020. Results: By May 15, 2020, 11,018 COVID-19 cases were identified, of which 15.7% occurred in workplaces such as health-care facilities, call centers, sports clubs, coin karaoke, and nightlife destinations. When the first confirmed case was diagnosed, the Korean Center for Disease Control and Central Disaster Management Headquarters responded quickly, emphasizing early detection with numerous tests and a social distancing policy. This slowed the spread of infection without intensive containment, shut down, or mitigation interventions. After entering the public health blue alert level, a business continuity plan was distributed. After entering the orange level, the Ministry of Employment and Labor developed workplace guidelines for COVID-19 consisting of social distancing, flexible working schedules, early identification of workers with suspected infections, and disinfection of workplaces. Owing to the intensive workplace social distancing policy, workplaces remained safe with only small sporadic group infections. Conclusion: The workplace social distancing policy with timely implementation of specific guidelines was a key to preventing a large outbreak of COVID-19 in Korean workplaces. However, sporadic incidents of COVID-19 are still ongoing, and risk assessment in vulnerable workplaces should be continued.

Oral Cancer Early Detection - a Pressing Need for Continuing Education in Jordan

  • Hassona, Y;Sawair, F;Baqain, Z;Maayta, W;Shahin, A;Scully, C
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7727-7730
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    • 2015
  • Aims: To identify deficiencies in the knowledge of general medical (GMPs) and dental practitioners (GDPs) regarding early detection of oral cancer, to compare differences between subgroups, and to identify educational needs for continuing education courses on this subject. Materials and Methods: 165 GDPs and 165 GMPs were directly interviewed to assess their knowledge about oral cancer using a pre-tested survey. Knowledge scores were generated from correct responses of participants to factual questions about oral cancer. Results: Few participants (15.2% of GDPs and 12.8% of GMPs) reported that they attended any continuing education courses on oral cancer during their professional career. Most participants (81.6% of GDPs and 86.3% of GMPs) admitted that their knowledge about oral cancer was not up to date and that they would need to attend continuing education courses on oral cancer if available. A few significant differences were identified between groups regarding knowledge about risk factors, clinical presentations and diagnostic techniques but the overall knowledge scores showed no significant difference between GMPs and GDPs. Conclusions: The present study identified several deficiencies in the knowledge of GMPs and GDPs regarding risk factors, clinical presentations, and diagnostic techniques of oral cancer. Interventions to correct these defects through properly designed continuing education courses are required.

노인생애주기에 따른 낙상요인 (Risk Factors for Falls in the Elderly by Life-cycle)

  • 김종민;서혜경
    • 보건교육건강증진학회지
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    • 제27권1호
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    • pp.21-34
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    • 2010
  • Objectives: The objective of this study was to investigate risk factors for falls in the elderly by life-cycle. Methods: This study used the data on 435 male and female elderly generated from a survey taken at 21 Welfare Centers for the Elderly in Seoul. The incidence of demographic characteristics, physical changes brought about with ageing, health-related behavior, chronic diseases, and environmental characteristics on falls in the elderly was analyzed. Hierarchical Logistic Regression analysis was also conducted to investigate the incidence by life-cycle (early-mid-late stage) and the results were used for predicting falls. Results: The incidence of risk factors on falls varied across life-cycle. Among the elderly in the early (ages from 65 through 74), marital status, the existence of a companion, the quality of sleep, the chronic diseases, and the condition of the bathroom floor were found to be related to falls. Among those in the mid-stage (ages from 75 through 84), sex, marital status, the existence of a companion, hearing capacity, sense of balancing, chronic diseases, the exclusive use of rooms, and the side bar with bath tub were found to affect falls. Finally, for the elderly in their late stage (85 years of age and older), drinking and vision were found to be related to falls. Conclusion: The incidence of risk factors on falls was found to vary according the stage in the elderly. A key implication of this finding is that falls prevention programs and interventions must be catered to specific age sub-groups.

Impact of a Clinical Pathway on Hospital Costs, Length of Stay and Early Outcomes after Hepatectomy for Hepatocellular Carcinoma

  • Zhu, Liang;Li, Jun;Li, Xiao-Kang;Feng, Jun-Qiang;Gao, Jian-Min
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권13호
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    • pp.5389-5393
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    • 2014
  • Background: A clinical pathway (CP) can standardize and improve perioperative care for a number of interventions. In hepatic surgery, however, pertinent evidence is very limited. This study was conducted to implement a CP for hepatocellular carcinoma (HCC) patients undergoing hepatectomy, and to evaluate its effects on hospital costs, length of hospital stay (LOHS) and early clinical outcomes. Materials and Methods: Medical records for HCC patients undergoing hepatectomy were retrospectively reviewed before implementation of a CP (the non-CP group) from March 2012 to August 2012. This information was compared with the data collected prospectively from patients after implementation of the CP (the CP group) between September 2012 and April 2013. Hospital costs, LOHS and early clinical outcomes were evaluated and compared between groups. Results: There were no significant differences in terms of patient clinical characteristics between the two groups. For clinical outcome measures, no significant differences were found in postoperative complications, mortality and readmission rate. The hospital costs were significantly reduced from 24,844 RMB in the non-CP group to 19,761 RMB in the CP group (p<0.01). In addition, patients of the CP group also had shorter LOHS compared with the non-CP group (8.3 versus 12.3 days, p<0.001). Conclusions: The CP proved to be an effective approach to minimize hospital costs and LOHS with hepatectomy for HCC without compromising patient care.

북한이탈 어머니의 영유아 자녀 양육 경험 (The Early Childhood Caring Experience of North Korean Refugee Mothers)

  • 김예영
    • Child Health Nursing Research
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    • 제19권2호
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    • pp.102-110
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    • 2013
  • 목적 본 연구의 목적은 북한이탈 어머니의 영유아 자녀 양육 경험이 무엇인지 그 경험 과정을 확인하고, 양육과정을 통해 심리사회적 문제를 어떻게 해결하는가에 대한 실체이론을 개발하는 것이다. 방법 연구참여자는 이론적 표본추출을 통하여 선정하였고 연구 자료는 심층면담과 참여관찰 및 참여자의 의무기록 등을 사용하여 수집한 후 Strauss와 Corbin (1998)의 근거이론방법을 적용하여 분석하였다. 결과 연구 결과 개방코딩 과정에서 62개의 개념과 23개의 하위범주, 11개의 범주가 도출되었으며 북한이탈 어머니의 영유아 자녀 양육 과정의 핵심범주는 '희망을 가지고 키워가기'로 밝혀졌다. 시간 흐름에 따른 양육 과정은 '양육 환경 변화 인식기', '양육 방법 조정기', '자신감 형성기'의 3단계로 나타났으며 양육 과정의 유형은 기대하기형, 지켜보기형, 걱정하기형의 세 가지 유형으로 구분되었다. 결론 본 연구의 결과는 영유아 자녀를 돌보는 북한이탈 어머니들의 양육경험을 이해하고 개별적인 간호를 제공하는데 기초가 될 이론적 기틀로 활용할 수 있을 것이며 북한이탈주민이 급증하고 이에 따라 동반 입국하는 아동의 수도 함께 증가하고 있는 현 시점에서 이 아동들의 건강 유지 및 증진을 위한 간호 실무에 매우 중요한 초석이 될 것이다.

즐거운 부부활동과 협력적 부부대처가 성적 친밀감을 매개로 결혼만족도에 미치는 영향: 결혼초기 중국 도시 여성을 중심으로 (The Effects of Enjoyable Couple Activity and Common Dyadic Coping on Marital Satisfaction through Mediation of Sexual Intimacy: Focusing on Urban Chinese Women in the Early Years of Marriage)

  • 김득성;권윤아;신사원
    • Human Ecology Research
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    • 제59권1호
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    • pp.45-58
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    • 2021
  • The present study examined whether enjoyable couple activity and common dyadic coping as daily positive couple interactions have direct or indirect effects on marital satisfaction through the mediation of sexual intimacy among urban Chinese women in the early years of marriage. The subjects were 182 urban women born under the one-child policy, who live in Heilongjiang, Anhui and Beijing provinces of China, and have been married up to six years. Data were collected using a self-administered questionnaire. We conducted a hierarchical multiple regression analysis in SPSS software and tested the significance of the mediation effects using bootstrapping method in Mplus software. The results of the study are as follows. First, both enjoyable couple activity and common dyadic coping had positive direct impacts on urban Chinese women's marital satisfaction and positive indirect impacts on marital satisfaction via sexual intimacy. Second, enjoyable couple activity was the strongest predictor of marital satisfaction, followed by common dyadic coping and sexual intimacy. The path model explained 48% of the variance in marital satisfaction. The results suggest that enjoyable couple activity, common dyadic coping, and sexual intimacy should be considered in the design of interventions to enhance urban Chinese women's marital satisfaction in the early years of marriage.

Gender Inequalities in Mental Health During the COVID-19 Pandemic: A Population-based Study in Korea

  • Minku Kang;Sarah Yu;Seung-Ah Choe;Daseul Moon;Myung Ki;Byung Chul Chun
    • Journal of Preventive Medicine and Public Health
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    • 제56권5호
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    • pp.413-421
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    • 2023
  • Objectives: This study explored the effect of the coronavirus disease 2019 (COVID-19) pandemic on psychosocial stress in prime working-age individuals in Korea, focusing on gender inequalities. We hypothesized that the impact of COVID-19 on mental health would differ by age and gender, with younger women potentially demonstrating heightened vulnerability relative to men. Methods: The study involved data from the Korea Community Health Survey and included 319 592 adults aged 30 years to 49 years. We employed log-binomial regression analysis, controlling for variables including age, education, employment status, marital status, and the presence of children. The study period included 3 phases: the period prior to the COVID-19 outbreak (pre-COVID-19), the early pandemic, and the period following the introduction of vaccinations (post-vaccination). Results: The findings indicated that women were at a heightened risk of psychosocial stress during the early pandemic (relative risk [RR], 1.01; 95% confidence interval [CI], 0.98 to 1.05) and post-vaccination period (RR, 1.07; 95% CI, 1.04 to 1.10) compared to men. This pattern was prominent in urban women aged 30-34 years (pre-COVID-19: RR, 1.06; 95% CI, 1.02 to 1.10; early pandemic: RR, 1.16; 95% CI, 1.08 to 1.25; post-vaccination period, RR, 1.22; 95% CI, 1.14 to 1.31). Conclusions: The COVID-19 pandemic has exerted unequal impacts on psychosocial stress among prime working-age individuals in Korea, with women, particularly those in urban areas, experiencing a heightened risk. The findings highlight the importance of addressing gender-specific needs and implementing appropriate interventions to mitigate the psychosocial consequences of the pandemic.

경증 및 아임상 우울증의 중의학 임상연구 동향 분석 - China National Knowledge Infrastructure를 중심으로 - (The Analysis of Clinical Trial Research Trend on Mild and Sub-clinical Depression in Traditional Chinese Medicine - using China National Knowledge Infrastructure Database -)

  • 고유미;이시우;김상혁
    • 대한예방한의학회지
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    • 제19권1호
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    • pp.47-59
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    • 2015
  • Objective : The purpose of this study was to analyze the trend of clinical research on 'mild and sub-clinical depressions' in China. Method : The journal search was performed using China National Knowledge Infrastructure(CNKI). Our inclusion criteria were as follows: TCM clinical trials for mild, sub-clinical, early stage of depression. Exclusion criteria were the following: non-TCM clinical trials, disease-associated depression related clinical trials. Results : We included 16 papers in this study. 1. In this study, we realized there have been several mild and sub-clinical depressions related clinical trials conducted in the field of TCM. 2. The result of 10 Journals used the Hamilton Depression Rating Scale for diagnosis and assessment criteria of mild and sub-clinical depressions. 3. The selected journals categorized by various interventions, such as, herbal medicine(7), acupuncture(4), miscellaneous(5). 4. Also, 7 Journals showed the significant improvements in patients with mild and sub-clinical depressions by TCM interventions, and 5 studies of TCM patent prescription reported that herbal medicine therapy has less side effect than the western medicine. Conclusion : Through this study, we found out that several researchers in China performed clinical trials on mild and sub-clinical depressions constantly. From the result of this study, we need to concern about the necessity of research on the mild and sub-clinical depression in Korea. Therefore, this result could be used as a meaningful reference for the design of future clinical trials.