• 제목/요약/키워드: early interventions

검색결과 301건 처리시간 0.029초

국내 코로나바이러스감염증-19의 감염재생산수 추정 (Estimation of Reproduction Number for COVID-19 in Korea)

  • 정재웅;권혁무;홍성훈;이민구
    • 품질경영학회지
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    • 제48권3호
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    • pp.493-510
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    • 2020
  • Purpose: As of July 31, there were 14,336 confirmed cases of COVID-19 in South Korea, including 301 deaths. Since the daily confirmed number of cases hit 909 on February 29, the spread of the disease had gradually decreased due to the active implementation of preventive control interventions, and the daily confirmed number had finally recorded a single digit on April 19. Since May, however, the disease has re-emerged and retaining after June. In order to eradicate the disease, it is necessary to suggest suitable forward preventive strategies by predicting future infectivity of the disease based on the cases so far. Therefore, in this study, we aim to evaluate the transmission potential of the disease in early phases by estimating basic reproduction number and assess the preventive control measures through effective reproduction number. Methods: We used publicly available cases and deaths data regarding COVID-19 in South Korea as of July 31. Using ensemble model integrated stochastic linear birth model and deterministic linear growth model, the basic reproduction number and the effective reproduction number were estimated. Results: Estimated basic reproduction number is 3.1 (95% CI: 3.0-3.2). Effective reproduction number was the highest with 7 on February 15, decreased as of April 20. Since then, the value is gradually increased to more than unity. Conclusion: Preventive policy such as wearing a mask and physical distancing campaigns in the early phase of the outbreak was fairly implemented. However, the infection potential increased due to weakening government policy on May 6. Our results suggest that it seems necessary to implement a stronger policy than the current level.

선천성 십이지장 폐쇄증의 임상적 연구 (Clinical Study of Congenital Duodenal Obstruction)

  • 허영수;임명국;박성규
    • Journal of Yeungnam Medical Science
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    • 제15권1호
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    • pp.67-74
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    • 1998
  • Successful management of duodenal obstruction in newborn infant implies not only satisfactory nutrition but also achievement of normal growth. To aid early diagnosis and management, we evaluated the diagnostic methods, operative interventions and clinical characteristics of thirty-nine infants with congenital duodenal obstructions. In the 11-year period from July 1986 through June 1997, thirty-nine patients with congenital duodenal obstruction (23 males and 16 females) were treated and reviewed at the Department of Pediatric Surgery, Yeungnam University Hospital. The ratio of male to female was 1.4:1, and 29 cases(74.1%) among total 39 patients were newborn. There were 5 premature patients and 16 patients of small for gestational age. The most common causes of the congenital duodenal obstruction was malrotation (26 cases, 66.7%) and followed by annular pancreas (9 cases, 23.1 %), type 1 atresia (3 cases, 7.7%) and wind-sock anomaly (1 case, 2.6%). Common symptoms were vomiting, abdominal distention, jaundice. Plain abdominal X-ray study combined with upper gastrointestinal series was the most commonly used diagnostic method. The operative procedures were performed by same pediatric surgeon utilizing Ladd's procedure in 26, duodenoduodenostomy in 8, duodenojejunostomy in 4, excision of wind-sock membrane in 1. A total of 15 associated congenital anomalies were found in 9 patients. Postoperative complications occurred in 13(33.3%). Overall mortality was 2.6%(1/39). Bilious vomiting and plain abdominal radiologic study were most useful for the diagnosis of congenital duodenal obstruction. Early diagnosis and operative intervention were important to prevent complications such as sepsis and peritonitis.

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Mucopolysaccharidoses in Taiwan

  • Lin, Hsiang-Yu;Chuang, Chih-Kuang;Lin, Shuan-Pei
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제4권1호
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    • pp.14-20
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    • 2018
  • Mucopolysaccharidoses (MPSs) are a group of rare inherited metabolic disorders caused by specific lysosomal enzyme deficiencies leading to the sequential degradation of glycosaminoglycans, causing substrate accumulation in various cells and tissues and progressive multiple organ dysfunction. The rare disease medical care team at Mackay Memorial Hospital in Taiwan has been dedicated to the study of MPSs for more than 20 years. Since 1999, more than 50 academic papers focusing on MPSs have been published in international medical journals. Topics of research include the following items regarding MPSs: incidence, natural history, clinical manifestations, gene mutation characteristics, cardiac function, bone mineral density, sleep studies, pulmonary function tests, hearing assessments, percutaneous endoscopic gastrostomy, anesthetic experience, imaging analysis, special biochemical tests, laboratory diagnostics, global expert consensus conferences, prenatal diagnosis, new drug clinical trials, newborn screening, and treatment outcomes. Of these published academic research papers, more than half were cross-domain, cross-industry, and international studies with results in cooperation with experts from European, American and other Asian countries. A cross-specialty collaboration platform was established based on high-risk population screening criteria with the acronym "BECARE" (Bone and joints, Eyes, Cardiac and central nervous system, Abdomen and appearance, Respiratory system, and Ear, nose, and throat involvement). Through this platform, orthopedic surgeons, rheumatologists, ophthalmologists, cardiologists, rehabilitation physicians, gastroenterologists, otorhinolaryngologists, and medical geneticists have been educated with regards to awareness of suspected cases of MPSs patients to allow for a further confirmative diagnosis of MPSs. Because of the progressive nature of the disease, an early diagnosis and early multidisciplinary therapeutic interventions including surgery, rehabilitation programs, symptom-based treatments, hematopoietic stem cell transplantation, and enzyme replacement therapy, are very important.

프랑스 혁명 초기의 행정구역 개편을 위한 논의와 지도의 활용 (Debates on the Reorganization of Administration District and Use of Maps in the Early Stage of French Revolution)

  • 정인철
    • 대한지리학회지
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    • 제48권5호
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    • pp.750-767
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    • 2013
  • 이 연구의 목적은 프랑스 혁명 초기의 행정구역 변경에 관한 지리적인 논의를 고찰하고, 이 과정에서 지도가 어떤 목적으로 활용하였는지를 살펴보는 것이다. 이를 위해 먼저 구체제의 행정구역 개편을 주장하는 개혁주의자들의 논거를 살펴보았는데, 일부 중농주의자들은 정교한 지도 활용을 통해 구체적인 행정구역 개편논리를 가지게 되었음을 확인하였다. 둘째, 제헌의회에서의 행정구역관련 논의를 의회회의록을 분석하여 고찰하였는데, 공간을 정각형으로 균등하게 분할하여 유토피아를 구현하려는 혁명가들의 사상의 근저에는 카시니의 기하학 정신에 영향을 받은 에슬른의 지도가 있음을 확인하였다. 셋째, 의원들은 에네킨의 지도를 근거로 데파르트망의 수와 경계를 확정하였다. 지역대표들과의 논의 과정에서 정사각형의 격자는 자연경계의 한계와 지역의 경제적 이익에 봉착하여 불규칙한 형태의 역사적 경계를 그대로 유지하는 불규칙한 다각형의 형태로 변했다. 넷째, 카시니 4세는 새로운 행정구역을 카시니 지도 위에 그려서 의회에 보고하였고 이는 새로운 행정구역으로 확정되었다.

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신생아 어머니와 고위험 신생아 어머니의 신생아에 대한 지각과 신생아 돌보기 활동에 대한 자신감 비교 (A Study on Neonatal Perception and Caring-Confidence of Normal and High-Risk Newborn Mothers)

  • 문영숙;한진숙
    • 부모자녀건강학회지
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    • 제9권2호
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    • pp.116-127
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    • 2006
  • Purpose: Assessment of mothers' neonatal perception is important in understanding early mothering experiences and in planning future care. The purpose of this study was to identify the differences of mothers' perception and caring-confidence between normal and high-risk newborn during the early postpartum period. The ultimate goal was to contribute to healthy mother-infant relationship and development of infants. Method: The data was collected for this study at one university hospital in Daejeon from May 13, 2005 to December 20, 2005. The subjects were 53 of mothers who had normal newborn and 46 of mothers who had high-risk newborn. The instrument was the 'Neonatal Perception Inventory' by revised Ja-Hyung, Lee (1986), and the 'Caring-Confidence Scale' by revised Hyun-Joo, Oh(2000). The data were statistically analyzed by using an SPSS program and include percentage, mean, SD, t-test. Result: There were significant differences in the perception of the newborn between the mothers of normal newborn and the mothers of high-risk newborn (p<.05). There were no significant differences in the perception pattern of the newborn between the mothers of normal newborn and the mothers of high-risk newborn. There were no significant differences in the caring-confidence between the mothers of normal newborn and the mothers of high-risk newborn. Conclusion: The nursing care in the nursery have needed to various interventions for normal and high-risk newborn mothers in order to improve the interaction and caring-confidence between mother and newborn.

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코로나19 감염병 대응모델의 국제표준화 요건 (Requirements for Reusable Infection Prevention and Control Measures for COVID-19 Response)

  • 안선주
    • 보건행정학회지
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    • 제31권3호
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    • pp.244-254
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    • 2021
  • The management of emerging infectious diseases cannot help but completely depend on non-pharmaceutical interventions in the early stages of the outbreak. Consequently, South Korea has developed and implemented the 3T (test-trace-treat) models, non-pharmaceutical infection prevention and control (IPC) measures, in response to the coronavirus disease 2019 (COVID-19) pandemic. The IPC measures have gained global attention, rendering them to be essential in the development of a shareable, reusable, and applicable protocol for future pandemics. This study was conducted to identify the requirements necessary for standardizing the IPC measures. Three new work items of the 18 3T models were proposed to ISO/TC 304 (International Organization for Standardization/Technical Committee 304; healthcare organization management). Requirements for each IPC measure, identified by participating members (P-members) countries during the ISO ballots, were analyzed in this study. The three new work items were approved by the P-members countries after a 3-month ballot. There was a consensus that the three IPC measure models should be International Standards (IS). Other comments include (1) the models should include not only COVID-19 but also any respiratory pandemic; and (2) keep donning of level D protection at screening sites as an optional protocol, in consideration for the lack of personal protective equipment. Standardization is a systematic process of developing internationally agreed-upon wisdom and knowledge that consider and respect the diversity and universality of each country. It is expected that such standardized applicable IPC measure models contribute to global efforts to rapidly respond to a public health emergency of international concern during its early stages.

자살 위험성 및 자살 시도 방지에 대한 전기경련치료의 역할 (The Electroconvulsive Therapy in the Prevention of Suicide Risks and Attempts)

  • 김희철;정성훈;안용민;박승현;김용식;정인원
    • 생물정신의학
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    • 제27권2호
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    • pp.64-73
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    • 2020
  • Suicidality is the most serious complication of mood disorders and psychosis; effective treatment should reduce suicide rates. The Organization for Economic Cooperation and Development age-standardized suicide rate in Korea was 22.6 in 2018, much higher compared to other countries worldwide. As mental and psychiatric problems are the main reasons for suicide attempts, accounting for 31.6% in 2018, targeting such problems should be the focus of efforts to reduce suicide rates. However, the ability of current pharmacotherapeutic and psychotherapeutic interventions to reduce suicide rates is limited due to their delayed effects. Therefore, electroconvulsive therapy (ECT) has been proposed as an alternative treatment. This approach is effective for treating most mental disorders associated with high suicide rates, including severe depression, bipolar disorder, and intractable psychotic disorders; ECT is also effective for Parkinson's disease, which has the highest suicide rate among all disorders in Korea. The acute, long-term, and prophylactic effects of ECT on suicidality have been reported in the literature, and treatment guidelines outside of Korea recommend that ECT be used at an early stage for rapid reduction of suicide rates, as opposed to being applied as a treatment of last resort. However, only ~0.092 of every 10000 members of the Korean general population received ECT in 2018; this is much lower than the average rate worldwide, of 2.2 per 10000. Elimination of obstacles to the use of ECT, early crisis intervention involving administration of ECT for rapid stabilization, and maintenance ECT to prevent recurrence should reduce suicide rates.

Clinical Manifestations and Outcomes of Older Patients with COVID-19: A Comprehensive Review

  • Jeong Eun Lee;Da Hyun Kang;So-Yun Kim;Duk Ki Kim;Song I Lee
    • Tuberculosis and Respiratory Diseases
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    • 제87권2호
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    • pp.145-154
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    • 2024
  • The consequences of coronavirus disease 2019 (COVID-19) are particularly severe in older adults with a disproportionate number of severe and fatal outcomes. Therefore, this integrative review aimed to provide a comprehensive overview of the clinical characteristics, management approaches, and prognosis of older patients diagnosed with COVID-19. Common clinical presentations in older patients include fever, cough, and dyspnea. Additionally, preexisting comorbidities, especially diabetes and pulmonary and cardiovascular diseases, were frequently observed and associated with adverse outcomes. Management strategies varied, however, early diagnosis, vigilant monitoring, and multidisciplinary care were identified as key factors for enhancing patient outcomes. Nonetheless, the prognosis remains guarded for older patients, with increased rates of hospitalization, mechanical ventilation, and mortality. However, timely therapeutic interventions, especially antiviral and supportive treatments, have demonstrated some efficacy in mitigating the severe consequences in this age group. In conclusion, while older adults remain highly susceptible to severe outcomes from COVID-19, early intervention, rigorous monitoring, and comprehensive care can play a pivotal role in improving their clinical outcomes.

알츠하이머성 치매에서 혈액 진단을 위한 바이오마커 (Blood Biomarkers for Alzheimer's Dementia Diagnosis)

  • 박창은
    • 대한임상검사과학회지
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    • 제54권4호
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    • pp.249-255
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    • 2022
  • 알츠하이머병은 주요한 공중보건 문제로 나타나며 연구분야에서도 최우선적인 과제이다. 알츠하이머병(AD)에서 뇌척수액(CSF)을 활용한 바이오마커인 아밀로이드-β(Aβ42), 총 타우(T-tau) 및 인산화 타우(P-tau)가 알츠하이머병 병태생리학의 핵심 요소를 반영한다. 임상 연구 및 새로운 측정법을 통한 임상적으로 활용되는 진단은 전임상 알츠하이머병에 대해 민감적이고 특이적이며 신뢰할 수 있는 바이오마커의 발굴, 뿐만 아니라 치매의 조기 발견 및 감별 진단과 질병 진행 모니터링에 도움이 되는 검사법의 개발에도 중요할 것이다. 증상 전 단계에서 AD의 조기 발견은 시냅스 손상 및 신경 손실이 확장되기 전에 개입이 수행되기 때문에 치료 개입을 조기에 가능하게 하고 치료 성공을 위한 가능성이 더 큰 좋은 기회로 이어진다. 따라서 새롭고 접근하기 쉽고 비용이 적게 드는 바이오마커를 임상 진단에 활용하는 것이 매우 유익할 것이다. 치매의 초기단계에 일어나는 병리학적 변화나, 질병의 진행정도를 추적할 수 있는 다양한 바이오마커들의 진단방법을 찾는 일은 치료제 개발처럼 중요한 연구 분야이다. 조기진단을 위해 임상증상을 대변하거나(surrogate marker), 증상이 나타나기 이전 상태를 측정할 수 있는 새로운 진단마커가 필요한 상황이다. 이러한 이유로 인지기능 저하정도를 측정하여 정상, 경도인지장애(mild cognition impairment, MCI) 및 전임상(preclinical) 상태의 사람을 판별할 수 있는 바이오마커(biomarker)를 활용한 조기진단법 개발의 중요성이 강조되고 있다.

산후우울 예측모형 개발: 산전우울의 매개효과 검증을 중심으로 (Development of a Prediction Model for Postpartum Depression: Based on the Mediation Effect of Antepartum Depression)

  • 이은주;박정숙
    • 대한간호학회지
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    • 제45권2호
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    • pp.211-220
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    • 2015
  • Purpose: This study was done to develop a prediction model for postpartum depression by verifying the mediation effect of antepartum depression. A hypothesized model was developed based on literature reviews and predictors of postpartum depression by Beck. Methods: Data were collected from 186 pregnant women who had a gestation period of more than 32 weeks and were patients at a maternity hospital, two obstetrics and gynecology specialized hospitals, or the outpatient clinic of K medical center. Data were analysed with descriptive statistics, correlation and exploratory factor analysis using the SPSS/WIN 18.0 and AMOS 18.0 programs. Results: The final modified model had good fit indices. Parenting stress, antepartum depression and postpartum family support had statistically significant effects on postpartum depression, and defined 74.7% of total explained variance of postpartum depression. Antepartum depression had significant mediation effects on postpartum depression from stress in pregnancy and self-esteem. Conclusion: The results of this study suggest that it is important to develop nursing interventions including strategies to reduce parenting stress and improve postpartum family support in order to prevent postpartum depression. Especially, it is necessary to detect and treat antepartum depression early to prevent postpartum depression as antepartum depression can affect postpartum depression by mediating antepartum factors.