• 제목/요약/키워드: sub-health center

검색결과 460건 처리시간 0.034초

Dynamic Cardiac Magnetic Resonance Fingerprinting During Vasoactive Breathing Maneuvers: First Results

  • Luuk H.G.A. Hopman;Elizabeth Hillier;Yuchi Liu;Jesse Hamilton;Kady Fischer;Nicole Seiberlich;Matthias G. Friedrich
    • Journal of Cardiovascular Imaging
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    • 제31권2호
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    • pp.71-82
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    • 2023
  • BACKGROUND: Cardiac magnetic resonance fingerprinting (cMRF) enables simultaneous mapping of myocardial T1 and T2 with very short acquisition times. Breathing maneuvers have been utilized as a vasoactive stress test to dynamically characterize myocardial tissue in vivo. We tested the feasibility of sequential, rapid cMRF acquisitions during breathing maneuvers to quantify myocardial T1 and T2 changes. METHODS: We measured T1 and T2 values using conventional T1 and T2-mapping techniques (modified look locker inversion [MOLLI] and T2-prepared balanced-steady state free precession), and a 15 heartbeat (15-hb) and rapid 5-hb cMRF sequence in a phantom and in 9 healthy volunteers. The cMRF5-hb sequence was also used to dynamically assess T1 and T2 changes over the course of a vasoactive combined breathing maneuver. RESULTS: In healthy volunteers, the mean myocardial T1 of the different mapping methodologies were: MOLLI 1,224 ± 81 ms, cMRF15-hb 1,359 ± 97 ms, and cMRF5-hb 1,357 ± 76 ms. The mean myocardial T2 measured with the conventional mapping technique was 41.7 ± 6.7 ms, while for cMRF15-hb 29.6 ± 5.8 ms and cMRF5-hb 30.5 ± 5.8 ms. T2 was reduced with vasoconstriction (post-hyperventilation compared to a baseline resting state) (30.15 ± 1.53 ms vs. 27.99 ± 2.07 ms, p = 0.02), while T1 did not change with hyperventilation. During the vasodilatory breath-hold, no significant change of myocardial T1 and T2 was observed. CONCLUSIONS: cMRF5-hb enables simultaneous mapping of myocardial T1 and T2, and may be used to track dynamic changes of myocardial T1 and T2 during vasoactive combined breathing maneuvers.

농촌형 노인 주간보호시설 모형개발 (Development of a Model of a Day Care Center for Rural Elderly People)

  • 강경숙
    • 지역사회간호학회지
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    • 제15권4호
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    • pp.551-565
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    • 2004
  • Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

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체중 및 체질량지수 차이에 따른 폐 기능과의 연관성 (Relationship between the Change in Body Weight or Body Mass Index and Pulmonary Function)

  • 김태영;우정현;이우현;조선경;전혜진
    • Korean journal of health promotion
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    • 제19권2호
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    • pp.91-95
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    • 2019
  • 연구배경: 비만과 폐 기능의 저하는 만성 질환 이환율과 사망률 증가와 관련 있는 것으로 알려져 있다. 하지만 국내에서 체중이나 체질량지수(BMI)의 변화가 폐 기능에 미치는 영향에 대한 연구는 없어 본 연구는 건강증진센터에서 연속적인 검진을 받은 한국인 수검자를 대상으로 체중이나 BMI 변화가 폐 기능 검사(PFT)의 인자들에 미치는 영향에 대해 알아보고자 한다. 방법: 2015년과 2017년에 일개 건강증진센터에서 건강검진을 연속적으로 받은 사람 중 신체계측과 PFT를 모두 시행한 5,032명을 대상으로 체중과 BMI의 변화와 PFT와 연관성을 상관분석 및 t-검정을 통하여 분석하였다. 결과: 체중과 BMI 변화에 따른 PFT 인자들과의 관련성에 있어서 남성에서는 유의미한 차이를 확인할 수 없었고 다만 체중이 증가한 그룹에서 FEV1이 체중이 감소한 그룹에 비해 더 낮은 것으로 확인되었다. 여성에서는 체중과 BMI가 증가한 그룹에서 FEV1/FVC와 FEF25-75%가 체중이 감소한 그룹에 비해 더 낮았고, 체중과 BMI 변화에 따른 PFT 인자들과의 관련성에서 FEV1/FVC와 FEF25-75%가 음의 상관관계를 보여 비만도의 증가에 따라 FEV1/FVC와 FEF25-75%가 낮아지는 것과 관련이 있을 수 있음을 확인하였다. 결론: 본 연구에서는 비만도의 변화에 따라 PFT의 인자들의 변화가 있을 수 있음을 확인하였고 비만의 적절한 관리가 폐 기능에도 긍정적인 영향을 미칠 수 있을 가능성을 확인한 것에 의의가 있다. 향후 대규모 다기관 연구를 통해 지속적인 비만의 관리가 폐 기능 및 폐질환에 미치는 영향에 대한 연구가 필요할 것으로 생각된다.

유통 한약재의 산패에 따른 품질변화 및 산패 저감화 연구 (Study on Quality Changes Caused by Rancidity and Methods to Reduce Rancidity for Domestically Distributed Herbal Medicines)

  • 박영애;고숙경;이현경;최은정;홍성초;박윤선;정지헌;박주성;신용승
    • 생약학회지
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    • 제54권2호
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    • pp.80-87
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    • 2023
  • Rancidity changes were examined for 6 herbal medicines, namely Persicae Semen, Armeniacae Semen, Lini Semen, Trichosanthis Semen, Arecae Semen, Myristicae Semen known to have relatively high fat content. In order to reduce rancidity of herbal medicines, samples were stored at 3 different conditions of room, refrigerating and freezing temperatures, and the rancidity was measured for 10 months with every 2 month interval. Fat content was extracted by using ethyl ether, and acid values and peroxide values, which are generally accepted indicators of fat rancidity, were measured. When storing Persicae Semen, Lini Semen and Arecae Semen at room temperature, the acid values increased as the storage period increased, and it was higher than when stored in refrigeration or freezing. The measurement of peroxide value showed more significantly higher initial degree of rancidity when Persicae Semen, Trichosanthis Semen, Arecae Semen and Myristicae Semen were stored at room temperature. It was observed that storing herbal medicines in refrigeration or freezing inhibited their rancidity compared to storing them at room temperature. To investigate the quality changes according to rancidity, the analysis of aflatoxins and indicator components showed that aflatoxins B1 and B2 were detected in Armeniacae Semen, Arecae Semen and Myristicae Semen, and the amount of amygdalin was well maintained within the specification standard.

농어촌 보건지소 진료실적과 관련 요인 (Factors Related to the Medical Service Performance of Rural Health Sub-centers)

  • 이수진;나백주
    • 농촌의학ㆍ지역보건
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    • 제35권4호
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    • pp.350-360
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    • 2010
  • 본 연구는 농어촌 보건지소에서 수행하는 진료실적에 영향을 미치는 관련 요인을 파악하여 향후 보건지소 기능을 활성화할 수 있는 방안을 마련하고자 하였다. 연구의 분석단위는 읍 면 지역에 위치한 보건지소이며, 2009년 12월 31일 현재 설치 운영 중인 1,242개소를 대상으로 하였다. 보건지소간 진료실적의 차이는 지역간 인구의 차이를 보정한 인구당 진료실적을 산출하여 분석하였다. 그 결과 보건지소 진료실적은 관할지역 내 민간 병 의원과 보건진료소가 없는 경우, 보건지소에서 보건소 및 가장 가까운 응급의료기관까지 거리가 먼 경우, 65세 이상 인구 비율이 높을수록 유의하게 많았다. 반면 0-4세 인구 비율과 공중보건의사 인턴 수료자 배치 유무는 유의한 영향요인이 되지 못하였다. 이상의 결과를 보면 읍 면에 소재한 보건지소의 진료실적은 관할지역 인구와 보건의료환경 특성에 의해 유의한 영향을 받고 있어 이러한 특성을 바탕으로 하여 차별화된 서비스 제공전략을 마련할 필요가 있겠다.

보건지소 공중보건의사의 지역보건사업 참여 실태 (A Study on Public Health Doctors' Participation in District Public Health Program of Health Sub-centers in Korea)

  • 이재천;박용문;안성복;이해영;황진원
    • 농촌의학ㆍ지역보건
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    • 제28권1호
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    • pp.53-66
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    • 2003
  • 본 연구는 2002년 2월 한 달 동안 전국 보건지소에 근무하는 공중보건의사 1,036명을 대상으로, 보건지소의 전반적인 의료서비스 제공여건과 지역사회를 기반으로 이루어지고 있는 보건사업의 수행 현황을 조사하고, 보건사업의 기획, 수행, 평가의 각 단계별 참여 현황과 지역보건사업에 대한 견해 및 관련특성 등을 파악하고자 하였다. 보건지소의 전반적인 의료여건으로는 근무하는 의사수가 1명 내지 2명인 경우가 98.7%였고, 의사 이외의 직원수는 3명 이내인 경우가 89.7%였다. 보건지소 관할 구역인 읍 면단위에서 보건지소 이외에 다른 의료기관이 있는 경우가 45.9%였고, 이 경우 해당 의료기관까지의 소요시간은 도보로 평균 5분정도였다. 보건지소의 33.5%가 의약분업제도 시행지역에 위치하고 있었고, 보건지소 이외에 타 의료기관이 있는 지역 중 의약분업을 시행하는 곳은 68.8%였다. 평균 1일 진료건수는 2000년 5월 18.0${\pm}$15.6건에서 2001년 11월 14.8${\pm}$14.8건으로 점차 감소하는 추세였으며, 특히 의약분업 실시 지역인 경우 감소정도가 크게 나타났다. 보건지소에서 이루어지고 있는 보건사업은 예방접종사업이 96.7%로 가장 높았고 보건교육이 76.5%로 가장 낮았으며, 각 사업의 기획 및 평가단계에 관여하는 경우는 예방접종사업과 방문보건사업이 각각 49.5%, 49.1%로 높게 나타난 반면 전혀 관여하고 있지 않은 경우가 29.6%였다. 보건사업의 세부 항목별 참여에서는 예방접종예진, 방문보건사업대상자 방문, 근무지역내 학교 수 인지도가 각각 94.2%, 81.5%, 75.5%로 높게 나타났으며, 보건사업의 기획, 수행, 평가의 각 단계별 참여는 평균적으로 수행 단계가 61.8%로 높게 나타났고, 기획 단계가 34.8%, 평가 단계가 22.6%로 나타났다. 보건지소에서 이루어지는 지역보건사업이 주민 보건향상에 긍정적인 효과를 나타낼 것이라고 보는 견해가 55.8%, 지역보건향상에 공중보건의사의 역할을 긍정적으로 보는 경우가 37.6%, 지역보건사업에 참여 의사가 있는 경우가 58.7%로 나타났다. 현재 농어촌 지역에서 보건지소의 단순진료실적이 감소하고 있는 상황인 반면 보건지소의 지역보건사업 중추기관으로서의 요구가 증가되고 있다. 주로 진료 위주의 역할에 국한되었던 공중보건의사를 보건사업 인력으로 활용하여 지역보건사업 인력 확충 및 전문화 등 지역보건사업의 양적 질적 향상을 도모할 수 있을 것이다. 아울러 공중보건의사에 대한 지속적인 보건사업 관련 교육 및 보건사업 참여에 대한 동기부여를 통해 지역보건사업의 수행단계에 수동적으로 참여하는 단계에서 기획 및 평가 단계에까지 능동적으로 참여하게끔 유도하는 정책적인 지원이 필요할 것으로 사료된다.

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인천시 자치구별 미세먼지 농도에 따른 호흡기 및 심혈관계 외래환자 수 상관분석 (Analysis of Respiratory and Cardiovascular Diseases according to PM Concentration in the Incheon Area)

  • 이승운;정승권
    • 한국환경보건학회지
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    • 제46권3호
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    • pp.276-284
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    • 2020
  • Objectives: This study was conducted to identify the effects of PM10 and PM2.5 on hospital visits in the Incheon area over the period of 2016-2018. Methods: We applied correlation analysis and Poisson regression to perform the analysis using cardiovascular disease and respiratory disease data from the National Health Insurance Service and the daily average PM10 and PM2.5 from the Korea Environment Corporation adjusting for time lag. Results: When the daily average PM10 concentration increased by 10 ㎍/㎥, the number of cardiovascular disease patients were 1.002 times higher (95% CI [Confidence Interval]; 1.000-1004) in Ganghwa County. As the daily average PM2.5 concentration increased by 10 ㎍/㎥, the number of cardiovascular disease patients were 1.012 times higher (95% CI; 1.008-1.016) in Ganghwa County. As the daily average PM10 concentration increased by 10 ㎍/㎥, the respiratory disease patients were 1.003 times (95% CI; 1.002-1.004) higher in Gyeyang and Michuhol Counties. As the PM2.5 concentration increased by 10 ㎍/㎥, the respiratory disease patients were 1.003 times higher (95% CI; 1.002-1.005) in Bupyeong County. Conclusions: In some parts of the Incheon area there was a correlation between the number of patients with respiratory and cardiovascular conditions and the concentration of PM10 and PM2.5.

서울시 보건소 맞춤형 방문건강관리 간호사의 직무스트레스 관련 요인 (Factors Related to the Job Stress of Home Health Care Nurses at Health Centers in Seoul Korea)

  • 김기숙;김순례
    • 가정∙방문간호학회지
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    • 제20권1호
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    • pp.44-52
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    • 2013
  • Purpose: To identify factors that affect the job stress of visiting nurses at health centers in Seoul, Korea, who perform home care services. Methods: Data were collected in the period from November 20 to December 10, 2008, from 206 visiting nurses working at 25 health centers in Seoul metropolitan city. Self-report questionnaires of the Organization-Based Self-Esteem (OBSE) and the Korean Occupational Stress Scale (KOSS) were used. Data were analyzed by the SPSS win 15.0. Results: Several findings were obtained from the study. First, the mean of job stress was 52.4 points, which was higher than that of Korean women. Second, it was shown that by the sub-domain of job stress, the mean value belonged to the top 50% in the four sub-domains of physical environment, job demand, interpersonal conflict, and organizational system. Additionally, it belonged to the top 25% in the sub-domain of job insecurity, wherein the job stress was the highest. Third, the self-esteem of the nurses had the most significant effect on their job stress. Conclusion: Stress related to job insecurity was the highest among the visiting nurses at health centers in Seoul who perform the custom home care service thus, institutional support is urgently needed to alleviate such stress and secure their employment.

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국소환경 모델을 이용한 초미세먼지(PM2.5) 노출 기여율 평가 (Evaluation of PM2.5 Exposure Contribution Using a Microenvironmental Model)

  • 신지훈;최영태;김동준;민기홍;우재민;김동준;신정현;조만수;성경화;이종대;양원호
    • 한국환경보건학회지
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    • 제48권2호
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    • pp.59-65
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    • 2022
  • Background: Since people move through microenvironments rather than staying in one place, they may be exposed to both indoor and outdoor PM2.5 concentrations. Objectives: The aim of this study was to assess the exposure level of each sub-population group and evaluate the contribution rate of the major microenvironments. Methods: Exposure scenarios for sub-population groups were constructed on the basis of a 2019 Time-Use survey and the previous literature. A total of five population groups were classified and researchers wearing MicroPEM simulated monitoring PM2.5 exposure concentrations in real-time over three days. The exposure contribution for each microenvironment were evaluated by multiplying the inhalation rate and the PM2.5 exposure concentration levels. Results: Mean PM2.5 concentrations were 33.0 ㎍/m3 and 22.5 ㎍/m3 in Guro-gu and Wonju, respectively. When the exposure was calculated considering each inhalation rate and concentration, the home showed the highest exposure contribution rate for PM2.5. As for preschool children, it was 90.8% in Guro-gu, 94.1% in Wonju. For students it was 65.3% and 67.3%. For housewives it was 98.2% and 95.8%, and 59.5% and 91.7% for office workers. Both regions had higher exposure to PM2.5 among the elderly compared to other populations, and their PM2.5 exposure contribution rates were 98.3% and 94.1% at home for Guro-gu and Wonju, respectively. Conclusions: The exposure contribution rate could be dependent on time spent in microenvironments. Notably, the contribution rate of exposure to PM2.5 at home was the highest because most people spend the longest time at home. Therefore, microenvironments such as home with a higher contribution rate of exposure to PM2.5 could be managed to upgrade public health.

Synthesis of New Boron Derived Compounds; Anticancer, Antioxidant and Antimicrobial Effect in Vitro Glioblastoma Tumor Model

  • Koldemir-Gunduz, Meliha;Aydin, Hasan Emre;Berikten, Derya;Kaymak, Gullu;Kose, Dursun Ali;Arslantas, Ali
    • Journal of Korean Neurosurgical Society
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    • 제64권6호
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    • pp.864-872
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    • 2021
  • Objective : The aim of our study is to investigate the cytotoxic, antioxidant, and antimicrobial effects of newly synthesized boron compounds in U87MG glioblastoma cell treatment. Methods : We synthesized boron glycine monoester (BGM) and boron glycine diester (BGD) structures containing boron atoms and determined their cytotoxic activities on glioblastoma by the MTT method. The inhibitory concentration 50 (IC50) value was calculated with GraphPad Prism 5.0 program. The IC50 values were administered 48 hours on U87MG glioblastoma cell. Catalase (CAT), acid phosphatase (ACP) and alkaline phosphatase (ALP) enzyme activity, malondialdehyde (MDA), total glutathione (GSH), and total protein levels were detected using spectrophotometric methods. We determined the antimicrobial activities of BGM and BGD with the disc diffusion method. Results : After 48 hours of BGM and BGD application to U87MG glioblastoma cells, we found the IC50 value as 6.6 mM and 26 mM, respectively. CAT and ACP enzyme activities were decreased in BGM and BGD groups. MDA which is a metabolite of lipid peroxidation was increased in both boron compounds groups. GSH level was reduced especially in BGD group. BGM and BGD have been found to be antimicrobial effects. Conclusion : Boron compounds, especially the BGM, can provide a new therapeutic approach for the treatment of glioblastoma with their anticancer, antioxidant, and antimicrobial effects.