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커뮤니티케어, 다가오는 초고령사회 부담에서 지역사회계속 거주에 이르는 지름길
강희택(Hee-Taik Kang),손창우(Changwoo Shon),전성연(Sung-Youn Chun),한동헌(Dong-Hun Han),황진욱(Jinwook Hwang),이용제(Yong-Jae Lee),유지원(Ji Won Yoo) 대한임상노인의학회 2019 대한임상노인의학회지 Vol.20 No.1
Successful or health aging may not be enough of explaining all perspectives of aging-related consequences in the upcoming super-aged society. Korea has experienced a rapid decline in the traditional family structure and a soar in nuclear families or solitude. Korea sustains paradoxically dissociated delivery of health care and welfare despite a decade of policy implementation of long-term care insurance. On November 20th, 2018, to resolve these challenges, the Ministry of Health and Welfare proclaimed a comprehensive blueprint, “community-based care program for the elderly”. “Community-based care program for the elderly” is considered as a shortcut to “Aging in Place”, later life residential sustainability in the same community and a proven better living outcome compared with institutionalization. As the frontline practitioners of caring older adults, this proclamation needs more practical details of integrating health care, physical dependence, monetary status, and eventually, placement. Despite differ-ent health care system structure and preferences of patients and their caregivers between Korea and United States, current review aims at assisting Korean practitioners with understanding the all-relevant trajectories of an elderly lung-cancer surviving man in Ohio, where remains geographic mixture of rural and metropolitan characteristics.
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우미선(Miseon Woo),차지현(Ji Hyeon Cha),김용환(Yonghwan Kim),강희택(Hee-Taik Kang),김현덕(Hyeondok Kim),조경원(Kyong Won Cho),박성선(Sung Sun Park),이종훈(Jong Hun Lee) 한국식품과학회 2021 한국식품과학회지 Vol.53 No.1
숙취를 해결하기 위해서는 숙취를 직접적으로 유발하는 물질인 아세트알데하이드의 조절이 가장 중요한 인자로 작용한다. 숙잠을 함유하는 복합물인 시험식품(CKDHC)의 섭취로 혈중 아세트알데하이드 농도가 대조식품 대비 통계적으로 유의하게 감소하여 숙취개선 효능을 확인하였다. 특히, 30분부터 각 시간별(mg/L), 혈중 아세트알데하이드 농도-시간곡선하 면적(AUC), 최고 혈중 아세트알데하이드 농도(C<SUB>max</SUB>)의 감소를 통해 30분부터 빠른 숙취개선 효능을 확인하였다. 본 연구의 주원료로 사용된 숙잠은 Ji등(2016a)에 따르면 18종의 아미노산 및 무기질을 모두 함유하며, 고단백 식용곤충으로 간에 좋은 주요 아미노산인 Alanine, Arginine 등을 많이 함유하여 간의 효소활성에 긍정적인 영향을 줄 수 있음을 알수있다. 본 연구결과를 통해 숙잠을 함유하는 시험식품이 숙취해소제로 작용할 수 있으며, 특히 음주 전 섭취시 아세트알데하이드를 빠르게 분해하여 30분부터 숙취 개선에 효과가 있음을 입증하였다. Silkworms have traditionally been used to produce silk and textiles. However, steamed and freeze-dried mature silkworm larval powder (SMSP) contain large amounts of amino acids, vitamins, and essential minerals. In this study, we investigated the potential of SMSP as a hangover-relieving agent. Thirty individuals who met the selection criteria and exclusion criteria were included in the study and subsequently underwent a double-blind, randomized, placebo-controlled, cross-design human application test. Importantly, the test product containing SMSP (CKDHC) was proven to alleviate hangovers through a significant reduction in the plasma concentration of acetaldehyde in the context of an alcohol-induced hangover model. In particular, from 0.5 h after SMSP intake, the blood acetaldehyde concentration (mg/L), area under the time curve (AUC; indicating the degree of bioabsorption of blood acetaldehyde), and the highest blood acetaldehyde concentration (Cmax) were reduced. Altogether, these results suggest that the test product (CKDHC) exhibits an accelerated hangover-relieving effect.
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이재우(Jae-woo Lee),김예슬(Ye-Seul Kim),김용환(Yonghwan Kim),유효선(Hyo-Sun Yoo),강희택(Hee-Taik Kang) 대한임상노인의학회 2021 대한임상노인의학회지 Vol.22 No.2
As the average life expectancy increases, there is also a growing interest in how to organize the rest of life of the elderly. As end-of-life becomes important, predicting the last few days of end-of-life in terminal cancer patients and preparing death for patients and their families could be meaningful in a super-aged society in the future. It is difficult to accurately predict the remaining life expectancy for terminal cancer patients. An early warning score (EWS) is an simple indicator aimed at detecting clinical deterioration to improve patient safety in hospitals. This was developed to quantify the abnormal levels of vital signs and patients with sudden deterioration in the early stage. EWS is closely related with short-term mortality or acute exacerbations in patients, such as intensive care unit admissions. Therefore, applying the EWS to terminal cancer patients at end-of-life time, it can be considered that it has the potential to be used as an auxiliary indicator to inform that the death of patients is impending.
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가정형 호스피스에서 사물인터넷 이용에 따른 의료 이용과 의료 비용 비교
김예슬(Ye-Seul Kim),이재우(Jae-woo Lee),김용환(Yonghwan Kim),유효선(Hyo-Sun Yoo),강희택(Hee-Taik Kang) 대한임상노인의학회 2021 대한임상노인의학회지 Vol.22 No.2
Background: Hospice-palliative care (HPC) aims to provide comprehensive comfort through impeccable assessment and the physical, psychological, socioeconomic, and spiritual care of terminally ill patients and their caregivers. This study aims to analyze the medical use and cost of home-based HPC according to the use of Internet of Things (IoT) service in. Methods: 89 terminal cancer patients enrolled in home-based HPC were included in this prospective study. Of these, 11 patients agreed to use IoT monitoring at home. Using the Mann-Whitney U test, we compared the medical usage and cost in HPC and palliative care units (PCUs) with the control group (IoT non-users). Results: The median age of IoT users and non-users was 77.0 and 69.5 years, respectively. Marital status, insurance type, and awareness of the terminal stage were not significantly different between IoT users and non-users. The percentage of caregivers living with patients was higher in IoT non-users in all participants and in patients who used both home-based HPC and a PCU than in IoT users. The duration of home-based HPC was longer in IoT users (53.0 days) than in IoT non-users (18.0 days). The median medical cost of home-based HPC was higher in IoT users than in non-users (2,005,000 vs 633,000 KRW). The length of stay in a PCU, total cost of a PCU, and total cost of HPC did not show a significant difference between IoT users and non-users. Conclusion: The use of IoT services in home-based HPC could help in the community care of terminal cancer patients without increasing overall medical costs.
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