Throughout the past 2020, the pandemic COVID-19 has caused a big global shock, meanwhile it brought a great impact on the public health network. Trauma emergency system faced a giant challenge and how to manage trauma under the pandemic of COVID-19 was widely discussed. However, the trauma treatment of special population (geriatric patients and patients taking anticoagulant drugs) has received inadequate attention. Due to the high mortality following severe traumatic hemorrhage, hemostasis and trauma-induced coagulopathy are the important concerns in trauma treatment. Sepsis is another topic should not be ignored when we talking about trauma. COVID-19 itself is a special kind of sepsis, and it may even be called as serious systemic infection syndrome. Sepsis has been become a serious problem waiting to be solved urgently no matter in the fields of trauma, or in intensive care and infection, etc. This article reviewed the research progress in areas including trauma emergency care, trauma bleeding and coagulation, geriatric trauma and basic research of trauma within 2020.
COVID-19 ; Community Networks ; Disseminated Intravascular Coagulation/therapy* ; Emergency Medical Services ; Female ; Health Services for the Aged ; Hemorrhage/therapy* ; Hemostasis ; Humans ; Male ; Pandemics ; Public Health ; Sepsis/therapy* ; Time Factors ; Trauma Centers ; Wounds and Injuries/therapy*

INTRODUCTIONThis study was conducted to provide an overview of the community-based hypertension and diabetes control programme of 19 cities in Korea and to evaluate its effectiveness in controlling hypertension at the community level.

MATERIALS AND METHODSIn this longitudinal observational study, we analysed the data of 117,264 hypertensive patients aged ≥65 years old from the time of their first enrolment in July 2012 to October 2013 (up to their 2-year follow-up).

RESULTSThe hypertension control rate of 72.5% at the time of enrolment increased to 81.3% and 82.4% at 1 and 2 years after enrolment. Treatment continuity, completion of hypertension self-management education, and longer enrolment duration in the programme contributed to improvements in hypertension control rate.

CONCLUSIONThis programme was characterised by a public health-clinical partnership at the community level. Despite its simplicity, the programme was evaluated as a successful attempt to control hypertension among patients aged >65 years at the community level.

Aged ; Community Networks ; Humans ; Hypertension ; drug therapy ; Longitudinal Studies ; Patient Education as Topic ; Program Evaluation ; Republic of Korea ; Self Care

OBJECTIVETo reduce health-related threats of heat waves, interventions have been implemented in many parts of the world. However, there is a lack of higher-level evidence concerning the intervention efficacy. This study aimed to determine the efficacy of an intervention to reduce the number of heat-related illnesses.

METHODSA quasi-experimental design was employed by two cross-sectional surveys in the year 2014 and 2015, including 2,240 participants and 2,356 participants, respectively. Each survey was designed to include one control group and one intervention group, which conducted in Licheng, China. A representative sample was selected using a multistage sampling method. Data, collected from questionnaires about heat waves in 2014 and 2015, were analyzed using a difference-in-difference analysis and cost effectiveness analysis. Outcomes included changes in the prevalence of heat-related illnesses and cost-effectiveness variables.

RESULTSRelative to the control participants, the prevalence of heat-related illness in the intervention participants decreased to a greater extent in rural areas than in urban areas (OR=0.495 vs. OR=1.281). Moreover, the cost-effectiveness ratio in the intervention group was less than that in the control group (US$15.06 vs. US$15.69 per participant). Furthermore, to avoid one additional patient, the incremental cost-effectiveness ratio showed that an additional US$14.47 would be needed for the intervention compared to when no intervention was applied.

CONCLUSIONThe intervention program may be considered a worthwhile investment for rural areas that are more likely to experience heat waves. Meanwhile, corresponding improving measures should be presented towards urban areas. Future research should examine whether the intervention strategies could be spread out in other domestic or international regions where heat waves are usually experienced.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Community Networks ; Cost-Benefit Analysis ; Cross-Sectional Studies ; Female ; Heat Stress Disorders ; epidemiology ; prevention & control ; Hot Temperature ; adverse effects ; Humans ; Logistic Models ; Male ; Middle Aged ; Prevalence ; Young Adult

OBJECTIVES: The purpose of this study was to evaluate the quality of life (QOL) in postmenopausal members and non-members of the elderly support association in Borujen city, Iran. METHODS: This study was a cross-sectional descriptive study being applied to the participants were postmenopausal women of over 55 years. Thus, 40 postmenopausal members of the elderly support association of Borujen city and 40 non-members were randomly selected. The 36 item short-form health survey (SF-36), with the 4 psychological, social, physical-movement, and environmental domains, was completed. Data were analyzed using SPSS software. RESULTS: The mean total score of QOL of member of the association was significantly greater than non-members. Student's t-test showed a significant relationship between QOL and membership of the association (P < 0.05). One-way analysis of variance (ANOVA) showed that the mean QOL of postmenopausal women, according to membership and marital status (P < 0.01), housing (P < 0.01), and underlying disease (P < 0.01), was statistically significant. CONCLUSIONS: According to the results, supportive measures, such as increasing the participation of the elderly in public life through proper preparations to join them and membership in peer groups such as support associations and non-governmental organizations (NGOs) can be greatly effective in improving QOL. The results showed that the QOL of the participants was at a moderate level and membership in support associations for the elderly was effected on the QOL in postmenopausal women. Moreover, considering the importance of the elderly in the community.
Aged* ; Community Networks ; Female* ; Health Surveys ; Housing ; Humans ; Iran ; Marital Status ; Peer Group ; Postmenopause ; Quality of Life* ; Women's Health

OBJECTIVES: To use focus-group interviews (FGI) to determine the current state of the Korean mental health service delivery system, inter-agency patient links, and identify associated problems. METHODS: The FGI were conducted by seven workers from psychiatric rehabilitation centers and community mental health centers and seven social workers from mental health hospitals. RESULTS: Within the mental health service delivery system, disconnection of the community network after discharge is considered a serious problem. The following improvement proposals are suggested : 1) the control tower should govern the community network after discharge, 2) consider insurance costs during activation of hospital links, and 3) expand information sharing related to community social facilities. With regard to non-voluntary admission and long-term hospitalization, most focus group members considered the revolving-door phenomenon to be more serious than non-voluntary admission. In order to prevent unnecessary long-term hospitalization, the FGI results indicated that the government should proactively intervene in the admission/discharge process. In addition, the following improvement proposals were suggested : 1) functional activation of the mental health review board via the reinforcement of workers' expertise, 2) expansion of local mental health centers, and 3) undertake institutional changes related to the family-related issue of preferring hospitalization over a stay at a secure facility. CONCLUSION: For the government to improve the efficiency of the mental health service delivery system, it is necessary to improve institutional linkages, expand mental health infrastructure, and develop an integrated management system.
Community Mental Health Centers ; Community Networks ; Focus Groups ; Hospitalization ; Humans ; Information Dissemination ; Insurance ; Mental Health Services* ; Mental Health* ; Psychiatric Rehabilitation ; Social Work ; Social Workers

PURPOSE: Today, an increasing number of divorce is shifting family forms and gender role practices. The purpose of this qualitative study was to understand life's experiences of middle-aged divorced women with higher education and profession lives in Korea. METHODS: For this study, 6 middle-aged divorced women with similar backgrounds were recruited from December 2013 to June 2014, using in-depth individual interviews. Data analysis was performed using Giorgi's phenomenological methodology. RESULTS: Individual interviews revealed the following 15 meaning of themes and 5 themes. 1) A woman considering herself to be ashamed that she has not lived an ordinary life. 2) The destiny of a woman not having a fortune. 3) An exhilarated mood like a teenage girl's 4) Suppressing an instinctive desire of sex. 5) Being a mother as a woman head of household. CONCLUSION: This study provides deep understanding of middle-aged divorced women with higher levels of education and professional lives of women who experienced difficult times and overcame their problems. Based on the results of this study, nursing strategies for enhancing quality of life need to be created and implemented for all professional women by Korean community networking gradually.
Community Networks ; Divorce* ; Education* ; Family Characteristics ; Female ; Gender Identity ; Humans ; Instinct ; Korea ; Middle Aged ; Mothers ; Nursing ; Quality of Life ; Statistics as Topic

PURPOSE: The purpose of this study was to explore the utility of autism spectrum disorder (ASD) screening tools using community network of home childcare center visiting nurses. METHODS: The design of this study is multilevel survey to find the ASD using modified checklist for autism in toddlers (M-CHAT) for first screening by childcare teachers, checklist for autism in toddlers (CHAT) for secondary screening by nurses, Autism diagnostic observation schedule (ADOS) and Autism diagnostic interview revised (ADI-R) for final diagnosis by pediatric psychiatrists. RESULTS: In first screening by using M-CHAT, 61 subjects(0.56%) were detected among 8,926 subjects. Among the first screened 61 subjects, 13 subjects were exempted for normal finding in CHAT. 24 subjects consented participation for final diagnosis and 23 of them were diagnosed ASD. CONCLUSION: In conclusion, M-CHAT and CHAT were verified their utility as screening tools for ASD in the community and the community health networks as a childcare visiting nurses can be useful network in early detection and referral of ASD.
Appointments and Schedules ; Autistic Disorder* ; Checklist ; Child ; Autism Spectrum Disorder* ; Community Networks ; Diagnosis ; Mass Screening* ; Nurses, Community Health* ; Psychiatry ; Referral and Consultation

OBJECTIVES: To assess the current public participation in-local health policy and its implications through the analysis of policy networks in health center programs. METHODS: We examined the decision-making process in sub-health center installations and the implementation process in metabolic syndrome management program cases in two districts ('gu's) of Seoul. Participants of the policy network were selected by the snowballing method and completed self-administered questionnaires. Actors, the interactions among actors, and the characteristics of the network were analyzed by Netminer. RESULTS: The results showed that the public is not yet actively participating in the local public health policy processes of decision-making and implementation. In the decision-making process, most of the network actors were in the public sector, while the private sector was a minor actor and participated in only a limited number of issues after the major decisions were made. In the implementation process, the program was led by the health center, while other actors participated passively. CONCLUSIONS: Public participation in Korean public health policy is not yet well activated. Preliminary discussions with various stakeholders, including civil society, are needed before making important local public health policy decisions. In addition, efforts to include local institutions and residents in the implementation process with the public officials are necessary to improve the situation.
Community Networks ; *Consumer Participation ; Decision Making ; *Health Policy ; Health Services Needs and Demand ; Humans ; Metabolic Syndrome X/prevention & control ; Program Development ; Questionnaires

OBJECTIVETo study the efficacy of community management model of bronchial asthma in children.

METHODThrough community outreach and clinic, 120 cases of children with asthma were enrolled from the 11 000 children aged 0 to 14 in Zhanlanlu area, and a community management model of asthma was established according to the Global Initiative for Asthma requirements combined with the actual situation of the community, both physicians and patients participated in case identification, file creation, and long-term standardized management. Through repeated medical education, the telephone hotline and interactive network of asthma among physicians, children and parents, a physician-patient relationship was established. The data of standardized medication, scheduled re-visit to the hospital, frequency of asthma attacks, antibiotic use, medical expenses, the loss of parents work hours etc. before and after the implementation of community management model were analyzed and compared.

RESULTAfter implementation of community management model, the use of systemic corticosteroids (19.4%), oral medication (31.6%) was significantly lower than those before implementation (68.3% and 90.0%) (χ(2) = 51.9, 41.1, P < 0.01), use of inhaled corticosteroids (76.5%) and oral leukotriene receptor antagonist (79.6%) was significantly higher compared with control and before management level (10.0%), χ(2) = 106.0, P < 0.01. The days of attacks of asthma (4.6 ± 2.3), the use of antibiotics (16.2 ± 6.1), (5.7 ± 2.9) and the cost of treatment significantly decreased. In 16 cases (13.3%) two-way referral was applied. In this study, the dropout rate was 18.3%, by telephone and network supervision of lost cases, re-education, made some children return to management, eventually the dropout rate was 9.2%.

CONCLUSIONEnrollment of children with bronchial asthma into community management model made the children adhere to the management regularly and a standardized management was achieved.

Adolescent ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Anti-Asthmatic Agents ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; therapy ; Child ; Child Health Services ; methods ; organization & administration ; Child, Preschool ; Community Health Services ; methods ; organization & administration ; Community Networks ; Disease Management ; Drug Administration Schedule ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Compliance ; Patient Education as Topic ; organization & administration ; Self Care

PURPOSE: In most areas of the world, transfers between emergency centers are performed through direct communication between physicians of transferring and receiving hospitals. The emergency medical information center "1339" (or 1339, for short), which had mediated inter-hospital transfers for about 10 years, was recently discontinued. This study aimed to survey the stance of physicians at transferring and receiving hospitals on the importance of 1339 functions. METHODS: In May 2012, before the discontinuation of 1339 as a mediator, a questionnaire was distributed to emergency-related physicians at several hospitals on the level of emergency care in Busan. RESULTS: There were 202 answers. Physicians of high level emergency centers had a higher tendency to transfer patients without pre-contact for transfer (p=0.019). The physicians at each level of care thought that direct communication between physicians was more accurate (69.9%), but mediation through 1339 was more convenient (53.6%). Mediation through 1339 was the most frequent resource used for pre-contact of inter-hospital transfers (58.1%). CONCLUSION: Physicians at each level of care tended to find pre-contact between physicians more accurate for inter-hospital transfers; however, they also thought mediation through 1339 was more convenient and it was the most frequently used resource for pre-contact of inter-hospital transfers.
Community Networks ; Emergencies ; Emergency Medical Services ; Hospital Information Systems ; Humans ; Information Centers ; Negotiating ; Surveys and Questionnaires