• Title/Summary/Keyword: intervention of state

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Successful Treatment with Partial Splenic Embolization in a Case of Post-transplantations Lymphoproliferative Disease with Persistent Hypersplenism (림프세포증식성 질환에서 효과를 보인 부분적 비동맥 색전술 1례)

  • Kim, Mi Jin;Rho, Young Il;Yang, Eun Seok;Moon, Kyung Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.92-97
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    • 2004
  • Posttranplantations lymphoproliferative disease (PTLD) is a common and life-threatening complication for soid organ transplantation associated with the use of chronic immunosuppression and Epstein-Barr virus. There is no standardized treatment algorithm, but numerous management strategies are vaiable. Partial splenic embolization (PSE) had been demonstrated to be an effetive alternatie to splenectomy for patients hypersplenism and portal hypertension. PSE has the advantages of non-invasive intervention and resolution of the complications of hypersplenism. We report the effect of the PSE in a 6-year old male liver transplantation recepient with PTLD who has undergone persistent hypersplenism post-transplant. We reduced immunosuppression agent, started antiviral agent. We started with interferon and IV globulin one month after admission. Hepatosplenomegaly and cervical lymphadenopathy were improved. But fever was not subside. We selectively embolized the lower pole of the spleen to achieve a 50~60% reduction in flow as determined by angiography. After embolization, fever subside and peripheral blood findings were improved. Follow up abdominal CT revealed reduced volume of spleen due to ischemic change and there was no multiple enlarged mesenteric lymphnode compared to preembolization state. We thick that PSE is a safe an effetive treatment modality of PTLD with persistent hypersplenism in patients twho failed to medical treatment.

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Effect of Informational Support by Hospice Team on Family Caregivers of Terminally III Cancer Patient (말기암 환자 가족에 대한 호스피스 팀의 정보적 지지 제공 효과)

  • Lee, Hye-Won;Kim, Chung-Nam;Park, Myung-Hwa
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.175-186
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    • 2001
  • To evaluate the effect of informational support by hospice team on family caregivers of terminally ill cancer patients. 22 family caregivers of D University Hospital in Daegu city were participated. The research was conducted from Aug. 16th to Oct. 28th 2000 by using self-reported questionnaires. The instruments used in this study were the Weinert's scale of perceived social support. Spielberger's state anxiety inventory. CES-D. and Ellison and Paloutzian's spiritual well-being scale. The intervention was designed to give educational and counselling program up to 7 times within 4 weeks. Educational and counselling booklets which made by the researcher were used step by step by hospice team, he data were analysed frequency. percentage. Wilcoxon Singed Ranks Test with SPSS Win l0.0/PC. The results obtained from this study were as follows; 1. The perceived social support of family caregivers was significantly increased after ready planned informational support was applied by hospice team(z=-3.045. p=0.002). 2. The anxiety of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z =-3:348. p=0.001). 3. The depression of family caregivers was significantly reduced after ready planned informational support was applied by hospice team(z=-3.641. p=0.000). 4. The spiritual well-being score of family caregivers was not significantly improved after ready planned informational support was applied by hospice team(z=-0.422. p=0.673). In conclusion. the results of this study clearly suggests that the informational support provided by hospice team not only increased the family caregivers' who are caring for terminally ill cancer patients. Therefor the informational support program designed by researcher for family caregivers who are caring for terminally ill cancer patients should be utilized and expended.

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Development of Context Awareness and Service Reasoning Technique for Handicapped People (장애인을 위한 상황인식 및 서비스 추론기술 개발)

  • Ko, Kwang-Eun;Shin, Dong-Jun;Sim, Kwee-Bo
    • Journal of the Korean Institute of Intelligent Systems
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    • v.18 no.4
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    • pp.512-517
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    • 2008
  • It is show that increasing of aged and handicapped people requires development of Ubiquitous computing technique to offer the specialized service for handicapped-people. For this, we need a development of Context Awareness and Service Reasoning Technique that the technique is supplied interaction between user and U-environment instead of the old unilateral relation. The old research of context awareness needed probabilistic presentation model like a Bayesian Network based on expert Systems for recognize given circumstance by a domain of uncertain real world. In this article, we define a domain of disorder activity assistant service application and context model based on ontology in diversified environment and minimized intervention of user and developer. By use this context model, we apply the structure learning of Bayesian Network and decide the service and activity to development of application service for handicapped people. Finally, we define the proper Conditional Probability Table of the structured Bayesian Network and if random situation is given to user, then present state variable of Activity and Service by given Causal relation of Bayesian Network based on Conditional Probability Table and it can be result of context awareness.

Development of multi-dimensional body image scale for malaysian female adolescents

  • Chin, Yit Siew;Taib, Mohd Nasir Mohd;Shariff, Zalilah Mohd;Khor, Geok Lin
    • Nutrition Research and Practice
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    • v.2 no.2
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    • pp.85-92
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    • 2008
  • The present study was conducted to develop a Multi-dimensional Body Image Scale for Malaysian female adolescents. Data were collected among 328 female adolescents from a secondary school in Kuantan district, state of Pahang, Malaysia by using a self-administered questionnaire and anthropometric measurements. The self-administered questionnaire comprised multiple measures of body image, Eating Attitude Test (EAT-26; Gamer & Garfinkel, 1979) and Rosenberg Self-esteem Inventory (Rosenberg, 1965). The 152 items from selected multiple measures of body image were examined through factor analysis and for internal consistency. Correlations between Multi-dimensional Body Image Scale and body mass index (BMI), risk of eating disorders and self-esteem were assessed for construct validity. A seven factor model of a 62-item Multi-dimensional Body Image Scale for Malaysian female adolescents with construct validity and good internal consistency was developed. The scale encompasses 1) preoccupation with thinness and dieting behavior, 2) appearance and body satisfaction, 3) body importance, 4) muscle increasing behavior, 5) extreme dieting behavior, 6) appearance importance, and 7) perception of size and shape dimensions. Besides, a multidimensional body image composite score was proposed to screen negative body image risk in female adolescents. The result found body image was correlated with BMI, risk of eating disorders and self-esteem in female adolescents. In short, the present study supports a multi-dimensional concept for body image and provides a new insight into its multi-dimensionality in Malaysian female adolescents with preliminary validity and reliability of the scale. The Multi-dimensional Body Image Scale can be used to identify female adolescents who are potentially at risk of developing body image disturbance through future intervention programs.

Exploring Occupational and Behavioral Risk Factors for Obesity in Firefighters: A Theoretical Framework and Study Design

  • Choi, Bong-Kyoo;Schnall, Peter;Dobson, Marnie;Israel, Leslie;Landsbergis, Paul;Galassetti, Pietro;Pontello, Andria;Kojaku, Stacey;Baker, Dean
    • Safety and Health at Work
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    • v.2 no.4
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    • pp.301-312
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    • 2011
  • Firefighters and police officers have the third highest prevalence of obesity among 41 male occupational groups in the United States (US). However, few studies have examined the relationship of firefighter working conditions and health behaviors with obesity. This paper presents a theoretical framework describing the relationship between working conditions, health behaviors, and obesity in firefighters. In addition, the paper describes a detailed study plan for exploring the role of occupational and behavioral risk factors in the development of obesity in firefighters enrolled in the Orange County Fire Authority Wellness Fitness Program. The study plan will be described with emphasis on its methodological merits: adopting a participatory action research approach, developing a firefighter-specific work and health questionnaire, conducting both a cross-sectional epidemiological study using the questionnaire and a sub-study to assess the validity of the questionnaire with dietary intake and physical activity measures, and evaluating the strengths and weaknesses of the body mass index as an obesity measure in comparison to skinfold-based percent body fat. The study plan based on a theoretical framework can be an essential first step for establishing effective intervention programs for obesity among professional and voluntary firefighters.

Development of a Standardized Clinical Practice Education Program in Occupational Therapy Student (작업치료 대학생의 임상실습 교육 프로그램 개발)

  • Lee, Min-Jae;Lee, Sun-Min
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.1
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    • pp.27-38
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    • 2022
  • Purpose : This study is aimed to develop and validate the clinical practice education program and clinical competence scale of occupational therapy student. Methods : The development of the clinical practice education program used the delphi technique method, which had a total of five steps. Based on the occupational therapist's job analysis, the first stage assessed the importance of 21 experts, and the second stage examined the importance of 19 new specialists to derive constitutive factors. In the third stage, in-depth interviews were conducted with three experts based on the derived factors, and in the fourth stage, the final clinical practice education program was derived. In the final stage, the details of the clinical training program were drawn up based on the themes and were reviewed by two experts. Structured and unstructured interviews were conducted with 43 job experts. Results : The expert survey through the delphi technique was conducted three times, and content analysis and descriptive statistics were conducted to examine the distribution of responses. The final 11 educational program topics and contents were derived. Topics are confirmation of client information, evaluation and intervention, cognitive therapy, spinal cord injury, brain injury, musculoskeletal disorders, pediatric occupational therapy, interventions in activities of daily living, driving rehabilitation, vocational rehabilitation, occupational therapy assessment tool, safety training and management. Conclusion : The clinical practice education program reduce the difference between school education and clinical education of occupational therapy student. Occupational therapy helps college student understand occupational therapy practices and improve the quality of clinical education. Through more research and supplementation of clinical practice education programs in the future, it is suggested that clinical practice education be successfully operated in various practice institutions and used as basic data for designing and evaluating useful educational models.

Changing incidence and survival of intrahepatic cholangiocarcinoma based on Surveillance, Epidemiology, and End Results Database (2000-2017)

  • Hassam Ali;Brandon Tedder;Syed Hamza Waqar;Rana Mohamed;Edward Lawson Cate;Eslam Ali
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.3
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    • pp.235-243
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    • 2022
  • Backgrounds/Aims: Historically, the incidence and prognosis of patients diagnosed with intrahepatic cholangiocarcinoma (ICC) have been inadequately understood. Survival analysis in ICC has yet to be investigated in a population-based study. Methods: We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results Program (SEER) 18 Registry. Risk ratios were estimated via Poisson regression. Hazard ratios for 5-year survival were estimated using hierarchical Cox regression models. Results: Males show a higher rate of age-adjusted ICC incidence. Blacks carried a decreased risk of ICC diagnosis than Whites, while Asians revealed a higher risk of ICC diagnosis when compared with Whites. The observed survival rates at 12, 36, and 60 months were 36.3%, 12.8%, and 8.1%, respectively. Compared with Whites, Blacks showed an increased risk of death (p < 0.01). Lymph node resection during surgery was associated with a 64.1% reduced risk of mortality (p < 0.01). A higher T stage at diagnosis was associated with poor survival (p < 0.01). Surgery combined with chemoradiotherapy, radiotherapy, or chemotherapy was associated with a reduced risk of mortality compared with nonsurgical interventions (p < 0.01). Conclusions: ICC incidence has been increasing since 2000, especially in White males. The risk of ICC rises with age. Lymph node removal is associated with better survival. In recent years, survival had worsened, and surgical intervention improved survival compared with nonsurgical management.

A Study on the Principle of Subsidiarity on the National Basic Livelihood Security Act (국민기초생활보장법상 보충성원리에 관한 연구)

  • An, Bong-Geun
    • Korean Journal of Social Welfare
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    • v.61 no.3
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    • pp.5-28
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    • 2009
  • The purpose of this study is to examine the legal attribute of subsidiarity principle on the National Basic Livelihood Security Act. The principle of subsidiarity is applied to the regulation for 'fundamental principle of benefits' on the National Basic Livelihood Security Act, therefore it functions as legal theory. However, due to its both positive and negative characteristics it becomes to be interpreted and applied in a different meaning depending on the normative characteristics of related laws. In brief, as the passive meaning of subsidiarity principle guarantees the freedom of civilian by limiting national power, it is reasonable in social control norm like criminal law. However, as nation's active role of intervention and support is required in order to protect basic standard of human life according to the principle of Social(welfare)State, the active meaning of subsidiarity principle is reasonable in Social Security law, especially in public assistance. Hence, the principle of subsidiarity on the National Basic Livelihood Security Act becomes to realize, justice, goal fitness and legal stability when it is operated by system with interpreting in an active meaning.

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Comparative Study on Influencing Factors and Digestive Symptoms among Upper Gastrointestinal Disease Groups (상부 위장관 질환군별 영향 요인 및 소화기 증상에 관한 비교 연구)

  • Oh, Doo-Nam
    • The Journal of the Korea Contents Association
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    • v.11 no.12
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    • pp.335-346
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    • 2011
  • The aim of this study is to compare the differences of influencing factors and subjective digestive symptoms among upper gastrointestinal disease groups. Subjects of this study are the results of Helicobactor Pylori test, gastrofibroscopic findings, and the electronic data of medical questionnaires on individuals at the age of 20 to 79 who visited a Health Promotion Center in Seoul from October, 2003 to October, 2004. 2,708 cases are analysed for final with $x^2$ test and ANOVA test. The sociodemographic factors of sex, age and occupation, the living habits factors of smoking and drinking, the pathophysiological factor of H. pylori infection, and the psychological factor of stress show statistically significant differences among groups. The digestive symptoms of "the feeling of something remained in the stomach", "the burning feeling right after eating or at the empty state of stomach" and "the frequent reflux of watery acid from the stomach" show statistically significant differences among groups. This study provides meaningful data in finding distinctive features of each disease and will be applied as basic materials to the development of intervention methods for health promotion relating to the upper gastrointestinal diseases.

Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

  • Zhang, Xiao-Dan;Zhao, Qing-Yu;Fang, Yi;Chen, Guan-Xuan;Zhang, Hui-Fang;Zhang, Wen-Xiao;Yang, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7359-7366
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    • 2013
  • Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.