Purpose: The purpose of this study was to examine the status of health care in acquired vision impairments. Methods: Data of 511 subjects who had recruited in National Survey of the Disabled Person of 2017 were analyzed.Collected data were analyzed by descriptive statistics, x 2 test, Fisher's exact test with SPSS 25.0 version. Results: The mean age was 68.4 years. 39.1% of the subjects lived alone, and 97.4% of the subjects were unable to decipher the braille. The prevalence of chronic diseases was high blood pressure (56.2%), diabetes (32.7%), and osteoarthritis (25.2%). 54.5% of the subjects experienced stress in their daily activities. In addition, 14.1% of the subjects thought they had a thought of suicide in the last year. The major needed health informations were related with disease and healthy life. In order to manage chronic diseases, they had continuously treated, but they did not receive proper management regarding mental health. There was a lack of exercise in health promotion behaviors in acquired vision impairments. Conclusion For the health management of people with acquired vision impairments, it is needed that the exercise and health education programs should be developed for people who cannot understand the braille. Also, it is needed for them to manage the mental health.

PURPOSE: The purpose of this study was to identify the risk factors for falls among the elderly living in community. METHOD: This was a descriptive study. The subjects comprised 80 elderly aged 65 years or over living in D city. The instruments used for this study was the MDS-HC V2.0. The data was analyzed by SPSS Win 14.0 using t-test, ANOVA, and Pearson correlation. RESULT: Among the socio-demographic characteristics, the significant differences were found in ADL by gender and marital status. Older elderly(> or =85) used more medications than other elderly. The elderly were use average 4.33 medications, but 46.3% of the subjects didn't have the physician reviewed all medications. There was statistically significant correlation between number of medications and accidental falls. CONCLUSION: Nurses should inspect about the number of medications, drug interaction, and side effects. It would be preventive intervention for falls in elderly.
Accidental Falls ; Activities of Daily Living ; Aged ; Drug Interactions ; Humans ; Marital Status ; Obesity ; Risk Factors

Purpose: This study aimed to evaluate the functional status and health service accessibility of the disabled children in Dar es Salaam, Tanzania. Methods: The research design for this study was a descriptive survey using convenience sampling using questionnaires. A total of 184 subjects were used to analysis. Data were analyzed using SPSS program version 22.0 to conduct independent t-tests, one-way ANOVA tests, χ2 tests, and multiple regressions. Results: The disabled children had more difficulty accessing health services compared to those without any disabilities. Factors negatively influencing health service accessability were inadequate drugs or medical equipment (t=2.18, p=.031), inability to afford transportation(t=3.00, p=.003), and inability afford the medical costs (t=2.54, p=.012). Also, Mother’s anxiety (β=-.50, p<.001) and child’s education experience (β=.22, p=.029) were identified as the influencing factors on the barriers to health care services. The relevant variables showed 30.5% influence (F=16.60, p<.001) on the barriers to health care services in disabled children. Conclusion The findings indicate that in order to enhance the disabled children‘s accessibility to health services, governmental support for transportation and medical costs are needed. In addition, it is necessary to promote the mental health of mothers raising children with disabilities.

PURPOSE: The purpose of this research was to develop and evaluate the effect of a mind map for relief of emotional labor and burnout among nurses in outpatient departments in cancer hospitals. METHODS: We developed a mind map to reduce emotional labor and burnout. A quasi-experimental study was used with a nonequivalent control group pretest-posttest design. Data were collected from December 2012 to April 2013. Participants were 35 nurses working in the outpatient department of a cancer hospital. The experimental group participated in the mind map program biweekly for 10 weeks. Data were analyzed using chi2-test, Mann-Whitney U test, paired t-test, and Wilcoxon sign rank test with the SPSS 21.0 program. RESULTS: The physical burnout and total burnout scores decreased significantly in the intervention group which took the mind map program. CONCLUSION: Findings indicate that the mind map is an effective intervention to reduce burnout in outpatient department nurses.
Cancer Care Facilities* ; Humans ; Outpatients*

Background/Aims: Adequate bowel preparation is important for successful colonoscopy. We aimed to evaluate the clinical feasibility and effectiveness of abdominal vibration stimulation in bowel preparation before therapeutic colonoscopy. Methods: A single center, prospective, randomized, investigator-blinded study was performed between January 2016 and December 2016. Patients for therapeutic colonoscopy were prospectively enrolled and assigned to either the vibrator group or walking group. Patients who refused to participate in this study as part of the experimental group consented to register in the control group instead. During the preparation period, patients assigned to the walking group walked ≥3,000 steps, whereas those assigned to the vibrator group received abdominal vibrator stimulation and restricted walking. All patients received the same colon cleansing regimen: 4-L split-dose polyethylene glycol (PEG) solution. Results: Three hundred patients who received PEG solution for therapeutic colonoscopy were finally enrolled in this study (n=100 per group). Bowel cleansing with abdominal vibration stimulation showed almost similar results to that with walking exercise (Boston Bowel Preparation Scale score for the entire colon: vibrator vs walking vs control, 7.38±1.55 vs 7.39±1.55 vs 6.17±1.15, p<0.001). There were no significant differences between the vibrator group and walking group regarding instances of diarrhea after taking PEG, time to first diarrhea after taking PEG, total procedure time, and patient satisfaction. Conclusions This study indicates that, compared with conventional walking exercise, abdominal vibration stimulation achieved similar rates of bowel cleansing adequacy and colonoscopy success without compromising safety or patient satisfaction.

Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis, but differentiating between the diagnosis of TBM and viral meningitis (VM) is difficult. Thus, we have developed machine-learning modules for differentiating TBM from VM.Material and Methods: For the training data, confirmed or probable TBM and confirmed VM cases were retrospectively collected from five teaching hospitals in Korea between January 2000 - July 2018. Various machine-learning algorithms were used for training. The machinelearning algorithms were tested by the leave-one-out cross-validation. Four residents and two infectious disease specialists were tested using the summarized medical information. Results: The training study comprised data from 60 patients with confirmed or probable TBM and 143 patients with confirmed VM. Older age, longer symptom duration before the visit, lower serum sodium, lower cerebrospinal fluid (CSF) glucose, higher CSF protein, and CSF adenosine deaminase were found in the TBM patients. Among the various machinelearning algorithms, the area under the curve (AUC) of the receiver operating characteristics of artificial neural network (ANN) with ImperativeImputer for matrix completion (0.85; 95% confidence interval 0.79 - 0.89) was found to be the highest. The AUC of the ANN model was statistically higher than those of all the residents (range 0.67 - 0.72, P <0.001) and an infectious disease specialist (AUC 0.76; P = 0.03). Conclusion The machine-learning techniques may play a role in differentiating between TBM and VM. Specifically, the ANN model seems to have better diagnostic performance than the non-expert clinician.

Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis, but differentiating between the diagnosis of TBM and viral meningitis (VM) is difficult. Thus, we have developed machine-learning modules for differentiating TBM from VM.Material and Methods: For the training data, confirmed or probable TBM and confirmed VM cases were retrospectively collected from five teaching hospitals in Korea between January 2000 - July 2018. Various machine-learning algorithms were used for training. The machinelearning algorithms were tested by the leave-one-out cross-validation. Four residents and two infectious disease specialists were tested using the summarized medical information. Results: The training study comprised data from 60 patients with confirmed or probable TBM and 143 patients with confirmed VM. Older age, longer symptom duration before the visit, lower serum sodium, lower cerebrospinal fluid (CSF) glucose, higher CSF protein, and CSF adenosine deaminase were found in the TBM patients. Among the various machinelearning algorithms, the area under the curve (AUC) of the receiver operating characteristics of artificial neural network (ANN) with ImperativeImputer for matrix completion (0.85; 95% confidence interval 0.79 - 0.89) was found to be the highest. The AUC of the ANN model was statistically higher than those of all the residents (range 0.67 - 0.72, P <0.001) and an infectious disease specialist (AUC 0.76; P = 0.03). Conclusion The machine-learning techniques may play a role in differentiating between TBM and VM. Specifically, the ANN model seems to have better diagnostic performance than the non-expert clinician.

Risk-reducing surgery is known as the most powerful preventive strategy for BRCA mutation carriers. This current case report represents the first documentation of the contralateral prophylactic mastectomy (CPM) and bilateral salphingo-oophorectomy (BSO) in a carrier of BRCA mutation in Korea. The patient was a 39-year-old woman who was seen in at a genetic counseling clinic for discussing of risk-reducing strategies for the breast and ovarian cancer. She presented at the age of 38 year with a 1.5 cm sized, grade 3, and ER/PR/HER2 negative infiltrating ductal carcinoma of the right breast. She was treated with wide local excision of the right breast and sentinel lymph node biopsy of the axilla. She was then treated with CAF (Cyclophosphamide+Doxorubicin+5-Fluorouracil) chemotherapy and radiation therapy. She was initially counseled at the time of surgery due to the family history of her mother, who suffered with breast cancer at the age of 58. After the completion of chemotherapy, we received the genetic test results and it was positive for the BRCA1 mutation (3746_3747insA). After a long discussion of cancer surveillance and risk-reducing options, she decided to undergo ipsilateral mastectomy and CPM and BSO. Before surgery, psychiatric consultation was done and questionnaires evaluating her depression, anxiety, body image, quality of life, and psychological distress were filled out. After discussion with the plastic surgeon, she decided to undergo delayed reconstruction of the breast. We performed endoscopic bilateral skin-sparing mastectomy and a laparoscopic bilateral salphingo-oophorectomy. There was no complication after surgery and the pathologic examination revealed no evidence of cancer in both breasts and ovaries. We think that CPM and BSO are feasible risk-reducing options for the breast cancer patients with the BRCA mutation in Korea.
Adult ; Anxiety ; Axilla ; Body Image ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Depression ; Female ; Genetic Counseling ; Humans ; Korea ; Mastectomy ; Mothers ; Nitriles ; Ovarian Neoplasms ; Ovary ; Pyrethrins ; Quality of Life ; Sentinel Lymph Node Biopsy ; Surveys and Questionnaires

This report describes a rare case of a patient with splenic tuberculosis (TB) who developed spontaneous splenic rupture after 10 weeks of antituberculous chemotherapy. The patient responded well to the antituberculous regimen prior to the spontaneous splenic rupture. We considered a paradoxical reaction as a cause of the splenic rupture. The patient underwent splenectomy and continuously received initial antituberculous drugs without change. To the best of our knowledge, this is the first report of spontaneous splenic rupture as a paradoxical reaction to antituberculous chemotherapy in an immunocompetent host with splenic TB.
Disease Progression ; Drug Therapy ; Humans ; Splenectomy ; Splenic Rupture* ; Tuberculosis ; Tuberculosis, Splenic*

Background: Information on the effectiveness of nirmatrelvir/ritonavir against the omicron is limited. The clinical response and viral kinetics to therapy in the real world need to be evaluated. Methods: Mild to moderate coronavirus disease 2019 (COVID-19) patients with risk factors for severe illness were prospectively enrolled as a treatment group with nirmatrelvir/ritonavir therapy versus a control group with supportive care. Serial viral load and culture from the upper respiratory tract were evaluated for seven days, and clinical responses and adverse reactions were evaluated for 28 days. Results: A total of 51 patients were analyzed including 40 in the treatment group and 11 in the control group. Faster symptom resolution during hospitalization (P= 0.048) was observed in the treatment group. Only minor adverse reactions were reported in 27.5% of patients. The viral load on Day 7 was lower in the treatment group (P = 0.002). The viral culture showed a positivity of 67.6% (25/37) vs. 100% (6/6) on Day 1, 0% (0/37) vs. 16.7 (1/6) on Day 5, and 0% (0/16) vs. 50.0% (2/4) on Day 7 in the treatment and control groups, respectively. Conclusions Nirmatrelvir/ritonavir against the omicron was safe and resulted in negative viral culture conversion after Day 5 of treatment with better symptomatic resolution.