PURPOSE: We made a clinical comparison of elderly patients from home and residential aged care facilities (RACFs) who visited the emergency department and were hospitalized with acute ischemic stroke. In addition, we investigated the factors associated with prehospital delay in acute ischemic stroke. METHODS: A retrospective study was conducted in a public hospital between January 2013 and December 2016. Information regarding the patients was registered including gender, age, comorbidities, symptoms at onset, use of emergency medical services, National Institute of Health Stroke Scale (NIHSS) at the emergency department, symptom-to-door time, etc. Characteristics of the patients were analyzed and logistic regression analysis was conducted to identify factors associated with symptom-to-door time. RESULTS: A total of 402 patients were enrolled during the study period. Overall, 339 elderly patients visited from home and 63 patients from RACFs, and patients from home were divided into two groups, living with family (n=274) and living alone (n=65). Patients from RACFs were older (≤0.001) and had higher NIHSS (p=0.007) than patients from home, but there were no significant relationships between symptom-to-door time and age (p=0.525), NIHSS (p=0.428). There was no difference in symptom-to-door time between patients living with family and patients from RACFs, but patients living alone had delayed symptom-to-door time (p < 0.001). CONCLUSION: Elderly patients living alone were among the three groups that had the most delayed symptom-to-door time. Therefore, it is necessary to expand and supplement support for elderly patients living alone, as well as to improve education regarding acute ischemic stroke.
Aged ; Cerebral Infarction ; Comorbidity ; Education ; Emergency Medical Services ; Emergency Service, Hospital ; Hospitals, Public ; Housing for the Elderly ; Humans ; Logistic Models ; Nursing Homes ; Retrospective Studies ; Stroke ; Transportation of Patients

PURPOSE: The purpose of this study was to construct the clear definition of the concept 'self-reliance' among persons with psychiatric disabilities. METHODS: A hybrid model (comparative analysis between literature review findings and actual interview data) was employed to extract essential components of 'self-reliance' and develop its clear definition among those subjects. RESULTS: Self-reliance appeared to have complex nature and consist of multi-dimensional meaning units with 4 different levels (including 8 attributes and 21 indicators). 4 different levels of dimensions and their 8 attributes are suggested as follows: 1) Personal dimension (increasing insight, improving motivation for recovery); 2) Procedural dimension (encouraging empowerment and overcoming internalized stigma, self-esteem); 3) Institutional dimension (utilizing social and government support, formulating social-networks); 4) Consequential dimension (financial independence, planning for independent housing, self-determination). CONCLUSION: The findings of this study will contribute to developing valid measurements to examine self-reliance and establishing nursing interventions aiming at increasing self-reliance in persons with psychiatric disabilities.
Housing ; Humans ; Independent Living ; Motivation ; Nursing ; Power (Psychology)

OBJECTIVEBy means of Delphi method and expert panel consultations, to choose suitable indicators and improve the score table for classifying the hygienic condition of hotels so that it can be widely used at nationwide.

METHODSA two-round Delphi consultation was held to choose suitable indicators among 78 experts from 18 provinces, municipalities and autonomous regions. The suitable indicators were selected according to the importance recognized by experts.

RESULTSThe average length of service in public health of the experts was (21.08 +/- 5.78) years and the average coefficient of experts' authorities C(r) was 0.89 +/- 0.07. The response rates of the two-round consultation were 98.72% (77/78) and 100.00% (77/77). The average feedback time were (8.49 +/- 4.48) d, (5.86 +/- 2.28) d, and the difference between two rounds was statistically significant (t = 4.60, P < 0.01). Kendall's coefficient were 0.26 (chi(2) = 723.63, P < 0.01), 0.32 (chi(2) = 635.65, P < 0.01) and opinions among experts became consistent. The score table for the hygienic quantifying and classification of hotels was composed of three first-class indicators (hygienic management, hygienic facilities and hygienic practices) and 36 second-class indicators. The weight coefficients of the three first-class indicators were 0.35, 0.34, 0.31.

CONCLUSIONDelphi method might be used in a large-scale consultation among experts and be propitious to improve the score table for the hygienic quantifying and classification.

Delphi Technique ; Housing ; classification ; standards ; Hygiene ; Outcome Assessment (Health Care) ; Public Health Administration ; methods

OBJECTIVETo investigate thirdhand smoke (THS) pollution in certain places of Nanjing, as well as to analyze its distribution characteristics.

METHODSFrom March to May, 2014, we selected 3 types of places (residencies, public places and transportation vehicles) that were close to people's living in Jianye,Yuhua,Jiangning,Xuanwu,Gulou and Pukou districts of Nanjing city.For each of the above 3 types of places, 2-3 smoking and non-smoking (smoking ban) locations were investigated, totally 51 locations, 9-10 samples were collected each location, totally 477 samples. The surface wipe sampling method in conjunction with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was utilized to quantify the levels of nicotine that served as the tracer of THS pollution.One-way ANOVA and t-tests were employed to compare the levels of nicotine collected at different places and locations.

RESULTSTotally 477 samples were collected in this study, of which 27.0% was from residencies (129/477), 61.0% (291/477) from public places and 11.9% (57/477) from transportations. The levels of indoor surface nicotine in smoking residences, public places and transportations were (214 ± 55),(1 408 ± 177) and (1 511 ± 785) µg/m(2), respectively, which were all higher than those in the corresponding non-smoking places ((23 ± 9),(62 ± 11), and (46 ± 15) µg/m(2); t values were 13.79, 13.15, 3.45, respectively. P values were <0.001, <0.001 and 0.006, respectively).In the smoking places, the levels of surface nicotine on walls, desks, sofas, cabinets, door backsides and air conditioning openings were (171 ± 62),(232 ± 38),(373 ± 151),(903 ± 239), (978 ± 212), (1 721 ± 517) µg/m(2) (F = 7.06, P = 0.009).In the smoking condition, the levels of surface nicotine collected from public places were higher (F = 9.25, P = 0.024), while under non-smoking (smoking ban) conditions, the levels of surface nicotine collected from residences were lower (F = 7.88, P < 0.001).

CONCLUSIONTHS pollution was widespread in public places, residences and transportations in Nanjing city, which was more serious in the smoking environments than non-smoking (smoking ban) environments; the contamination was less serious in non-smoking (smoking ban) private residences; in the smoking condition, the levels of surface nicotine were relatively high at locations close to air conditioning openings, door backsides and cabinets.

Air Conditioning ; China ; Housing ; Humans ; Nicotine ; Public Facilities ; Smoking ; Tandem Mass Spectrometry ; Tobacco Smoke Pollution ; Transportation

PURPOSE: This study was to investigate the needs of health & community services among the disabled at home in rural areas. METHODS: The subjects were 146 persons with disabilities living in J-gun. The questionnaire was based on the needs of 8 categorical services. Data were analyzed using frequency, percentage, mean, standard deviation, minimum, maximum, t-test, one-way ANOVA and Scheffe test. RESULTS: Among the respondents, 27.4% visited the public health center in community for rehabilitation therapy. The average score of need was 2.62+/-.79: education services (2.92+/-1.05); medical services (2.81+/-.82); nursing care services (2.75+/-1.08); connection services (2.62+/-1.20); housing services (2.60+/-1.09); emotional services (2.41+/-1.03); other services (2.24+/-1.06); and support of self-sustenance service (1.92+/-1.15). The items in highest need were medical checkup (70.7%), medication (62.1%), traditional oriental therapy (60.4%) and physical therapy (58.9%), and those of lowest need were device repair (8.7%) and guidance of facility admission (7.1%). Needs were significantly different according to age (F=4.751, p=.001), employment status (t=2.108, p=.037) and medical fee payer (F=5.061, p=.002). CONCLUSION: The needs of education & medical services were relatively high. Demographic factors were statistically significant in determining needs. For the disabled at home in rural areas, more various services or programs should be executed based upon the needs and characteristics of based upon the needs and characteristics of the subjects.
Surveys and Questionnaires ; Demography ; Disabled Persons ; Education ; Employment ; Fees, Medical ; Health Services ; Housing ; Humans ; Nursing Care ; Public Health ; Rehabilitation ; Social Welfare*

BACKGROUND: Homelessness is associated with an increased risk of exposure to Mycobacterium tuberculosis. Several factors, including alcoholism, malnutrition, lack of stable housing, combine to make tuberculosis more prevalent in the homeless. The aims of this study were to determine the factors associated with increasing success rate of tuberculosis treatment in the homeless. METHODS: A cross-sectional analysis of the clinical features in 142 pulmonary tuberculosis-positive homeless patients admitted to the Busan Medical Center from January 2001 to December 2010 was carried out. These results were compared with a successful treatment group and incomplete treatment group. We also evaluated the risk factors of treatment non-completion. Statistical analysis for the comparisons was performed using a chi2 test, independent samples t-test, and multiple logistic regression. RESULTS: Comparison of clinical characteristics showed significant differences between the two groups in the type of residence (P < 0.001), diseases with risk factors (P = 0.003), and history of tuberculosis treatment (P = 0.009). Multiple regression analysis revealed the residence (odds ratio [OR], 4.77; 95% confidence interval [CI], 2.05 to 11.10; P < 0.001) and comorbidity with risk factor (OR, 2.72; 95% CI, 1.13 to 6.53; P = 0.025) to be independently associated with treatment success. CONCLUSION: To improve the success rate of tuberculosis treatment in the homeless person, anti tuberculosis medication should be taken until the end of treatment and a management system for the homeless person is required. Further social and medical concerns for stable housing and management of comorbidity may lead to an improvement in the successful tuberculosis treatment of homeless person.
Alcoholism ; Comorbidity ; Cross-Sectional Studies ; Homeless Persons ; Hospitals, Public ; Housing ; Humans ; Malnutrition ; Mycobacterium tuberculosis ; Risk Factors ; Tuberculosis ; Tuberculosis, Pulmonary

OBJECTIVES: Malaria remains a public health concern worldwide, including Indonesia. Purworejo is a district in which endemic of malaria, they have re-setup to entering malaria elimination in 2021. Accordingly, actions must be taken to accelerate and guaranty that the goal will reach based on an understanding of the risk factors for malaria. Thus, we analysed malaria risk factors based on human and housing conditions in Kaligesing, Purworejo, Indonesia. METHODS: A case-control study was carried out in Kaligesing subdistrict, Purworejo, Indonesia in July to August 2017. A structured questionnaire and checklist were used to collect data from 96 participants, who consisted of 48 controls and 48 cases. Univariate, bivariate, and multivariate analyses were performed. RESULTS: Bivariate analysis found that education level, the presence of a cattle cage within 100 m of the house, not sleeping under a bednet the previous night, and not closing the doors and windows from 6 p.m. to 5 a.m. were significantly (p≤0.25) associated with malaria. Of these factors, only not sleeping under a bednet the previous night and not closing the doors and windows from 6 p.m. to 5 a.m. were significantly associated with malaria. CONCLUSIONS: The findings of this study demonstrate that potential risk factor for Malaria should be paid of attention all the time, particularly for an area which is targeting Malaria elimination.
Animals ; Case-Control Studies* ; Cattle ; Checklist ; Education ; Housing ; Humans ; Indonesia* ; Malaria* ; Multivariate Analysis ; Public Health ; Risk Factors*

PURPOSE: The purpose of this study is to develop and evaluate the effects of a multifaceted cognitive training program on cognitive function, depression, and instrumental activities of daily living (IADL) in community dwelling elders with mild cognitive impairment. METHODS: A non-equivalent control group pretest-posttest design was used. The subjects were recruited from a community health center in D metropolitan city and were assigned to the experimental or control group. Weekly 50-minute session intervention was delivered to the experimental group over 12 weeks. 8 weeks and 12weeks after intervention, the changes in cognitive function, depression, and IADL in the groups were measured and compared. Data were analyzed with Mann-Whitney U test, Wilcoxon Signed Rank test, and post-hoc test with Bonferroni correction using SPSS/WIN 23.0. RESULTS: When compared with their counterparts (n=15), the elders in the experimental group (n=12) showed significant improvement in cognitive function and depression at week 12. The mean scores of IADL at week 12 were not significantly different between the groups. CONCLUSION: The results indicate that this multifaceted cognitive training program is effective in improving cognitive function, depression, and avoiding deterioration of IADL among elders with mild cognitive impairment.
Activities of Daily Living ; Aged ; Cognition ; Cognitive Therapy ; Community Health Centers ; Depression ; Education ; Humans ; Independent Living ; Mild Cognitive Impairment

Subjects: Volunteers of the public social activities, officials of authorities and the social, political organizations in Hoa phu commune during 11/ 1998 - 9/2000. The results: 91,42% total households have contacted and discussed with the health volunteer. The discussion comprised the health education and communication for discussion comprised the health education and communication for disease prevention 93,75%), propagandization of the family planning (7,29%).
Community Health Aides ; Residence Characteristics

PURPOSE: Although breast milk is considered the best source of nutrition for infants because of its superiority over powdered milk, there are circumstances when breast milk is unavailable. Committee on Nutrition of the Korean Pediatric Society conducted an investigation into the current status of formula feeding in Korea. METHODS: This investigation was conducted using questionnaires produced by our committee and distributed to mothers of children under the age of two who were using formula feeding at 10 university hospitals and 22 public health centers nationwide between March 1999 to September 1999. A comparative analysis according to location, birth order, mother's occupation, education, housing tenure and normal birth status was performed on all 2696 questionnaires using the chi-square test. RESULTS: Formula feeding was found in 49.4% and formula feeding combined with breast milk were 21.5% of the respondents. The percentage of formula feeding was higher in working mothers who underwent a Cesarean section in metropolitan areas. The inadequacy of breast milk was the most common reason for feeding powdered rnilk followed by the unhealthy condition of the mother and mother's return to work. Of those investigated, 94.9% said that they changed products at each stage as recommended by the manufacturer. Promotions for special formulas were more active in metropolitan areas than other areas, and 57.7M said that they used special formulas based on recornmendations by the doctor and acquaintances(15.5%) or after seeing an advertisement(14.0%). CONCLUSION: This investigation revealed that many rnothers were misinformed concerning formula feeding and pediatricians should provide mothers with education, shedding light on proper feeding methods.
Birth Order ; Cesarean Section ; Child ; Surveys and Questionnaires ; Education ; Feeding Methods ; Female ; Hospitals, University ; Housing ; Humans ; Infant* ; Korea ; Milk ; Milk, Human ; Mothers ; Occupations ; Parturition ; Pregnancy ; Public Health ; Return to Work