• Title/Summary/Keyword: unmet medical need

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A Study on Unmet Dementia Information of Dementia Caregiver Using Dementia Relief Center and Program Effect Recognition of Workers (치매안심센터 이용 보호자의 미충족 치매정보와 종사자의 프로그램 효과성 인식에 관한 연구)

  • Kim, In-Ok;Koh, Myung-Suk
    • Journal of Convergence for Information Technology
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    • v.10 no.5
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    • pp.75-82
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    • 2020
  • This study is a descriptive research study to identify Unmet Dementia Information Needs (UDIN) for caregivers of dementia patients at Dementia Relief Center and to understand the effectiveness of the program for workers. The subjects were 114 caregivers and 217 practitioners from dementia relief centers in 25 autonomous districts of S city from November 1, 2019 to January 31, 2020. The UDIN questionnaire is a 7-point Likert scale. The Crisis Management Questionnaire is a Likert 5-point scale consisting of 10 questions from 6 categories. As a result of the study, the proportion of depressed caregivers experiencing UDIN was 12.3times higher than those who did not (p<.001). The program effectiveness was 8.98times better than those who perceived the lack of risk management as good (p=.004), and social workers were 2.81times better than nurses (p=.091). It is necessary to conduct interactive operations to meet the needs of the community residents by listening to their diverse opinions rather than simply implementing a one-sided policy to raise the service of a dementia relief center to the highest level in a short period of time.

Needs for Integrated Care for Older Adults in Seoul (서울특별시 지역사회 거주 노인의 통합돌봄 요구)

  • Kim, Hyeongsu;Ko, Young;Son, Miseon
    • Journal of Convergence for Information Technology
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    • v.10 no.5
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    • pp.177-187
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    • 2020
  • The purpose of this study was to classify the care needs of the older adults aged 65 and over and to identify characteristics of care need groups. This was a secondary analysis study using data from 2017 National Survey of Older Persons in Seoul. There were 50.4% in the general group without any support needs, 17.9% in the medical needs group, 14.2% in the welfare needs group with support needs of daily living or social activity, and 17.5% in the complex needs group with both medical and welfare needs. Significant differences were shown in most variables of the general characteristics, grading of long-term care or disability, financial burden and caregiving, health behaviors, health status, and life satisfactions among groups (p<.001). The complex care need group should be provided with integrated care service for medical and welfare through multidisciplinary team approach.

Ginsenosides: potential therapeutic source for fibrosis-associated human diseases

  • Li, Xiaobing;Mo, Nan;Li, Zhenzhen
    • Journal of Ginseng Research
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    • v.44 no.3
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    • pp.386-398
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    • 2020
  • Tissue fibrosis is an eventual pathologic change of numerous chronic illnesses, which is characterized by resident fibroblasts differentiation into myofibroblasts during inflammation, coupled with excessive extracellular matrix deposition in tissues, ultimately leading to failure of normal organ function. Now, there are many mechanistic insights into the pathogenesis of tissue fibrosis, which facilitate the discovery of effective antifibrotic drugs. Moreover, many chronic diseases remain a significant clinical unmet need. For the past five years, many research works have undoubtedly addressed the functional dependency of ginsenosides in different types of fibrosis and the successful remission in various animal models treated with ginsenosides. Caveolin-1, interleukin, thrombospondin-1 (TSP-1), liver X receptors (LXRs), Nrf2, microRNA-27b, PPARδ-STAT3, liver kinase B1 (LKB1)-AMPK, and TGF-β1/Smads are potential therapy targeting using ginsenosides. Ginsenosides can play a targeting role and suppress chronic inflammatory response, collagen deposition, and epitheliale-mesenchymal transition (EMT), as well as myofibroblast activation to attenuate fibrosis. In this report, our aim was to focus on the therapeutic prospects of ginsenosides in fibrosis-related human diseases making use of results acquired from various animal models. These findings should provide important therapeutic clues and strategies for the exploration of new drugs for fibrosis treatment.

Yeosin-san Increases Female Fertility through Inducing Uterine Receptivity and Ovarian Function

  • Choi, Hee Jung;Joo, Bo Sun;Park, Mi Ju;Park, Min Jung;Bae, Boram;Kim, Bo Sung;Park, Hye Rin;Kim, Keuk Jun;Yang, Hee Jin;Yoo, Jeong Eun;Chung, Tae Wook;Joo, Jongkil;Ha, Ki Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.33 no.2
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    • pp.141-150
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    • 2019
  • Despite the development of assisted reproduction technologies (ART) including in vitro fertilization (IVF), the poor ovarian response and endometrial receptivity remains clinically a major unmet need. Although these problems are difficulties to solve in infertility treatment, there are no good therapeutic option yet. Traditional herbal remedies and acupuncture, therefore are being proposed as alternative treatment. Our group found that traditional herbal medicines such as Paeonia lactiflora L.(PL, 芍藥), Cyperus rotundus L.(CR, 香附子), and Perilla frutescens (PF, 紫蘇葉) could improve endometrial receptivity. In this study, we found out Yeosin-san (如神散) as an optimal herbal formula via combination of the previously established herbal medicines. Yeosin-san is a traditional Korean medical formula which was established by Ziming Jin (陳自明) and recorded in Furendaiquanliangfang (婦人大全良方) at first. The formula traditionally used for treating abnormal uterine bleeding and leukorrhea. It showed a highest effect on leukemia inhibitory factor (LIF) expression and on the adhesion between trophoblastic cells and endometrial cells. In addition, it has been shown that the Yeosin-san not only increases the endometrial receptivity to improve the embryo implantation but also enhances the ovary function by expressing the angiogenesis-related genes. Here we suggest that Yeosin-san could be a novel and effective candidate for treating female infertility.

Chronicles of EGFR Tyrosine Kinase Inhibitors: Targeting EGFR C797S Containing Triple Mutations

  • Duggirala, Krishna Babu;Lee, Yujin;Lee, Kwangho
    • Biomolecules & Therapeutics
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    • v.30 no.1
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    • pp.19-27
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    • 2022
  • Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase widely expressed in many cancers such as non-small cell lung cancer (NSCLC), pancreatic cancer, breast cancer, and head and neck cancer. Mutations such as L858R in exon 21, exon 19 truncation (Del19), exon 20 insertions, and others are responsible for aberrant activation of EGFR in NSCLC. First-generation EGFR tyrosine kinase inhibitors (TKIs) such as gefitinib and erlotinib have clinical benefits for EGFR-sensitive (L858R and Del19) NSCLC patients. However, after 10-12 months of treatment with these inhibitors, a secondary T790M mutation at the gatekeeper position in the kinase domain of EGFR was identified, which limited the clinical benefits. Second-generation EGFR irreversible inhibitors (afatinib and dacomitinib) were developed to overcome this T790M mutation. However, their lack of selectivity toward wild-type EGFR compromised their clinical benefits due to serious adverse events. Recently developed third-generation irreversible EGFR TKIs (osimertinib and lazertinib) are selective toward driving mutations and the T790M mutation, while sparing wild-type EGFR activity. The latest studies have concluded that their efficacy was also compromised by additional acquired mutations, including C797S, the key residue cysteine that forms covalent bonds with irreversible inhibitors. Because second- and third-generation EGFR TKIs are irreversible inhibitors, they are not effective against C797S containing EGFR triple mutations (Del19/T790M/C797S and L858R/T790M/C797S). Therefore, there is an urgent unmet medical need to develop next-generation EGFR TKIs that selectively inhibit EGFR triple mutations via a non-irreversible mechanism.

Community Care for Cancer Patients in Rural Areas: An Integrated Regional Cancer Center and Public Health Center Partnership Model

  • Kang, Jung Hun;Jung, Chang Yoon;Park, Ki-Soo;Huh, Jung Sik;Oh, Sung Yong;Kwon, Jung Hye
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.226-234
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    • 2021
  • Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

Complementary and Alternative Medicine Use among Cancer Patients at the End of Life: Korean National Study

  • Choi, Jin-Young;Chang, Yoon-Jung;Hong, Young-Seon;Heo, Dae-Seog;Kim, Sam-Yong;Lee, Jung-Lim;Choi, Jong-Soo;Kang, Ki-Mun;Kim, Si-Young;Jeong, Hyun-Sik;Lee, Chang-Geol;Choi, Youn-Seon;Lim, Ho-Yeong;Yun, Young-Ho
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1419-1424
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    • 2012
  • Objectives: To investigate in depth the use of complementary and alternative medicines (CAMs) by cancer patients at the end-of-life (EOL) and how they communicate with physicians about them. Design and location: In 17 hospitals in Korea between January and December 2004 we identified 4,042 families of cancer patients. Results: The prevalence of CAM use among cancer patients at the EOL was 37.0%, and 93.1% had used pharmacologic types of agents. The most frequent motive for CAM use was the recommendation of friends or a close relative (53.4%) or a physician (1.6%). Only 42.5% discussed CAM use with their physicians. Satisfaction with CAMS was recalled for 37.1%. The most common reason given for that satisfaction was improvement of emotional or physical well-being, while ineffectiveness was the most common reason given for dissatisfaction. The average cost of CAM during the last month of life was $US 900. CAM use was associated with longer disease periods, primary cancers other than liver, biliary, and pancreatic, and need of support from physicians or religion. Conclusions: CAM use among cancer patients at the EOL was common, not discussed with physicians, and associated with expectation of cure. Expectations were generally unmet while the treatments were a financial burden. Further studies evaluating the effects of CAM at the EOL and factors that enhance communication with the physician are needed.

The effects of the direct nursing care hours with establishment of the nurse substations (Nurse Substation 운영이 직접간호시간 증가에 미치는 효과)

  • Lee, Chug-Hee;Sung, Young-Hee;Kwon, In-Gak;Lee, Soon-Kyu;Jung, Yoen-Yi;Hoe, Sung-Hee;Ryoo, Sung-Suk;Kim, Jung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.61-80
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    • 1997
  • The purpose of this study is to measure the direct and indirect nursing care hours with establishment of nurse substations and compare the experimental nursing units with the existing nursing units For this study, two experimental nursing units: (1) a medical nursing unit and (2) a surgical nursing unit with a nurse substation were selected. And two control nursing units : (1) a medical nursing unit and (2) a surgical nursing unit without a nurse substation were selected. After a three-month experimental operation from June 1 to August 31,1996, research data were collected for three days from September 2 to 4, 1996. We investigated the effects of the direct & indirect nursing care hours with establishment of the nurse substations (improved nursing environment) without adding the staff nurses. The effect of establishment of the nurse sub-station was measured for the differences direct & indirect nursing care hours between experimental and control nursing units. An investigator measured the time for a staff nurse to practice each nursing activity and recorded it every minute. Percentage, average, standard deviation, t-test and ANOVA were used for data analysis. The results are as follows: 1. There was no significant difference between the experimental and control nursing units in staffs' working hours during their shift. 2. There were significant diffferences between the experimental and control nursing units in dierct nursing care hours (t=0.0288, p=0.0001) and indirect nursing care hours (t=0.3886, p=0.0103) per patient. 3. There was significant difference between the experimental and control nursing units in direct nursing care hours done by nurses(t=0.0012, p=0.0111) and aids(t=0.3011, p=0.0027). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0051, p=0.0253), nurses(t=0.0071, p=0.0024) and aids (t=0.3227, p=0.0351). There was significant difference between the experimental and control nursing units in indirect nursing care hours done by nurses(t=0.0005, p=0.0015) and aids(t=0.2400, p=0.0013) per patient. There was significant difference between the experimental and control nursing units in indirect nursing care hours done by head-nurses(t=0.0005, p=0.0379) and nurses (t=0.0035, p=0.0198) per patient. 4. Thre were significant differences between the experimental and control nursing units in direct nursing care hours (t=0.1134, p=0.0010) and indirect nursing care hours (t=0.7106, p=0.0008) per staff during the day shift. There were significant differences between the experimental and control nursing units in direct nunsing care hours during the day(t=0.0723, p=0.0003) and evening shift (t=0.0004, p=0.0285) per patient, and indirect nursing care hours during the day shift(t=0.5565, p=0.0036) per patient. 5. There were differences between the experiemental and control nursing units in dircet nursing activities including measurement and observation, medication, communication, teratment, hygiene, and nutrition, and in indirect nursing activities including confirmantion, communication, record, computer work, management of goods. But it was not statistically proven. 6. There was difference between the experimental and control nursing units in unmet-need nursing care hours per patient, but not statistically proven.

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Comparision of Medical Care Utilization Patterns between Beneficiaries of Medical Aid and Medical Insurance (의료보호대상자의 의료이용양상)

  • Kim, Bok-Youn;Kim, Seok-Beom;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.185-201
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    • 1991
  • A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

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Variation Analysis of Medical Service Utilization in Oriental Medicine Frequent Disease of Rural Area (농어촌지역 한방 외래 다빈도 상병의 의료이용 변이분석)

  • Jang, Yong-Myung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.2
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    • pp.713-720
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    • 2013
  • The objectives of this study are to identify whether the small area variation also exists in the oriental medicine and, if it exists, what causes, to expand our boundary of research interests on the small area variation observed at the western medicine toward the oriental medicine as one of the fundamental research foundations and to provide any fundamental findings from this study results to the healthcare politicians to promote consumer's rational behaviors for the use of healthcare. This study analyzed the health insurance claim data (2010, 2011) which were the patients of western medicine and the outpatients of the oriental medicine with the top 10 most frequent diseases and looked into the variation of healthcare utilization among the areas after grouping resident area into an 86-area category. The study result shows that the small area variation was also observed at the part of the oriental medicine in which the characteristics of patients critically affect the healthcare expenditure per visit day rather than those of providers and the characteristics of both patients and providers equally affect the healthcare expenditure per patient. Therefore, this study suggests that government set up healthcare policies on the standardization of oriental medicine to prevent its over-utilization and unmet need, enforcing the roles of oriental medicine in the markets, enhancing the appropriate health care utilization, and expanding provision and sharing the health care information to reduce unnecessary health care utilization.