• Title/Summary/Keyword: Cohort trends

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Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

  • Kim, Taejae;Do, Young Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.2
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    • pp.82-88
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    • 2020
  • Objectives: The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

Intensity-modulated radiation therapy in early stage squamous cell carcinoma of the larynx: treatment trends and outcomes

  • Wegner, Rodney E.;Abel, Stephen;Bergin, John J.;Colonias, Athanasios
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.11-17
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    • 2020
  • Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

A Review of Clinical Studies about Acupuncture Therapy for Whiplash Associated Disorder (교통사고로 인한 편타 손상의 침 치료에 대한 임상연구의 국내외 동향)

  • Jeon, Jun-Young;Yoo, Duk-Joo;Maeng, Tae-Ho;Shim, Jae-Woo;Cho, Woo-Young;Kim, Hyungsuk;Lim, Woong-jin;Lee, Jong-soo
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.47-54
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    • 2015
  • Objectives This study aimed to research current trends of acupuncture treatment of whiplash associated disorder (WAD). Methods Clinical studies about acupuncture therapy on WAD were searched in 7 databases. The included studies were classified according to their publication dates, methods, interventions, outcome measures. Interventions were analyzed by accompanied intervention, acupoint, acupuncture retaining time and treatment period. Results 14 articles were included. The number of studies on acupuncture for WAD shows increasing tendency since 1990. The included studies consist of 6 randomized controlled trials (RCTs), 2 non-randomized controlled trials (nRCTs), 2 cohort studies, 1 before and after study, 1 case study and 2 case reports. Most studies used visual analogue scale (VAS) as primary outcome. Conclusions This review demonstrates that further clinical studies need to be carried out under the formal clinical practice guidelines of acupuncture therapy for WAD in order to support clinical treatment objectively.

Review of Clinical Study over the Last 10 Years on Korean Medicine Treatment for Cancer: Focusing on Korean Database (한방 암 치료에 대한 최근 10년간 임상연구 고찰: 국내 데이터베이스를 중심으로)

  • Choi, Ji-Won;Nam, Yeon-Kyeong;Lee, Jung-Han;Woo, Hyeon-Jun
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.75-86
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    • 2021
  • Objectives This study aimed to analyze the research trends in clinical studies on the traditional Korean medicine used for cancer treatment between 2011 and 2020. Methods We searched 7 Korean web databases (Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies Information Service System [KISS], Korean Medical database [KMBASE], DBpia, Korea Institute of Science and Technology Information [KISTI], and KoreaMed) and classified collected papers dated between 2011 and 2020 by the year of publication, publication journal, study design, type of cancer affecting the patients, interventions used, evaluation system used, and combination with conventional medicine. Results A total of 167 papers were collected. More than 10 papers were published annually. The papers were mainly published in the Journal of Korean Traditional Oncology (28.7%). The predominant type of the study was case study (67.7%). The main type of cancer was breast cancer, affecting 262 patients. Most of the studies reported using multiple traditional Korean medicine treatments (55.1%). Eighty-nine studies reported using clinical laboratory tests for evaluation. Most of the patients took conventional medicine simultaneously (608 patients). Conclusions Research related to Korean medicine for cancer patients is at a rudimentary level. Therefore, for further clarity, high evidence-based researches, including randomized controlled trials and cohort studies, should be conducted.

Social media impact in the Match: A survey of current trends in the United States

  • Steele, Thomas N.;Galarza-Paez, Laura;Aguilo-Seara, Gabriela;David, Lisa R.
    • Archives of Plastic Surgery
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    • v.48 no.1
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    • pp.107-113
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    • 2021
  • Background Applicants to integrated plastic and reconstructive surgery (PRS) residency in the United States spend exorbitant amounts of time and money throughout the interview process. Outside of first-hand experience through a visiting rotation, applicants utilize various resources in learning about a program. Today's applicants are "Millennials," the demographic cohort raised during the information age and proficient with digital technology. The authors evaluated whether programs have a presence on social media, and whether applicants are following these accounts. Methods An online survey was sent to applicants to a single integrated plastic surgery program evaluating basic demographics, social media utilization, and sources of information accessed throughout the residency application process. A manual search of popular social media platforms (Instagram, Facebook, and Twitter) was performed in October 2019. Accounts affiliated with integrated PRS programs were identified and analyzed. Results Eighty-four of 222 applicants (37.8%) completed the survey. Ninety-six percent of applicants were within the Millennial demographic. Ninety-six percent of applicants had some form of social media presence, with Facebook (90%) and Instagram (87%) being the most popular platforms. Seventy-three percent of applicants reported following a PRS residency social media account. As of October 2019, 59 integrated residency programs (73%) have active Instagram accounts. Conclusions Applicants still rely on the program website when researching potential residencies, but social media is being rapidly adopted by programs. Program social media accounts should be used as a dynamic form of communication to better inform applicants of program strengths and weaknesses.

Coronavirus Disease (COVID-19) Pandemic: The Psychological Well-Being in a Cohort of Workers of a Multinational Company

  • Lovreglio, Piero;Leso, Veruscka;Riccardi, Elisabetta;Stufano, Angela;Pacella, Daniela;Cagnazzo, Francesco;Ercolano, Maria Luigia;Iavicoli, Ivo
    • Safety and Health at Work
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    • v.13 no.1
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    • pp.66-72
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    • 2022
  • Background: The aim of the present study was to evaluate the psychological well-being (PWB) during the coronavirus disease (COVID-19) pandemic in workers of a multinational company. Methods: Employees (aged ≥18 years) were recruited from Latin American, North American, New Zealand, and European sites of a multinational company operative during all the pandemic period. The self-reported Psychological General Well-Being Index was used to assess the global PWB and the effects on six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing role of age, gender, geographical location, COVID-19 epidemiology, and restrictive measures adopted to control the pandemic was explored. Results: A total of 1335 workers completed the survey. The aggregate median PWB global score was in a positive range, with significantly better outcomes detected in the Mexican and Colombian Latin American sites compared with the other worldwide countries (p < 0.001). Among the European locations, a significantly higher PWB score was determined in Spain compared with the German and French sites (p < 0.05). Comparable geographical trends were demonstrated for all the PWB subdomains. Male workers had a significantly better PWB compared with females (p < 0.05), whereas a negative correlation emerged with aging (p = 0.01). COVID-19 epidemiology and pandemic control measures had no clear effects on PWB. Conclusion: Monitoring PWB and the impact of individual and pandemic-related variables may be helpful to clarify the mental health effects of pandemic, define targeted psychological-supporting measures, also in the workplace, to face such a complex situation in a more constructive way.

Effect of Government Guidelines and Corporate Governance on Telework Adoption and Occupational Health Measures in Taiwanese-Listed Companies

  • Chia-Jung Li;Louise E. Anthony;Tomohisa Nagata;Yawen Cheng;Ro-Ting Lin
    • Safety and Health at Work
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    • v.15 no.2
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    • pp.164-171
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    • 2024
  • Background: Telework adoption in Taiwan has surged because of government guidelines during the COVID-19 pandemic. This study examined the disclosure practices of Taiwanese-listed companies, assessing their adherence to government telework guidelines and their correlation with corporate governance, focusing on occupational health measures. Methods: We conducted a guideline-adherent cohort analysis of the 2020 and 2021 sustainability reports of 295 Taiwanese-listed companies. We assessed their disclosure of corporate measures for teleworking in alignment with two government guidelines, specifically occupational health measures. Using the McNemar test and general estimating equation analysis, we compared the 2020 and 2021 responses and examined their associations with corporate governance rankings. Results: Telework adoption increased significantly from 2020 to 2021, with 68% of companies reporting new work modes. The mentioning of government guidelines also increased to 67% by 2021. Companies with higher governance rankings were more likely to adopt online occupational health measures, including occupational health services (RR = 2.03; 95% CI = 1.41-2.94; p < 0.001) and mental health promotion activities (RR = 2.01; 95% CI = 1.06-3.82; p = 0.032), than those with low rankings. Although on-site and online occupational health services increased, home workspace assessments did not. Conclusion: Our findings highlight significant upward trends in the disclosure of telework measures following the issuance of government guidelines. Corporate governance is significantly associated with the implementation of occupational health measures. Amid the evolution of teleworking, both government guidelines and corporate governance have become essential for shaping work arrangements and ensuring workforce well-being.

Changes in the Prosthesis Types Used for Aortic Valve Replacement after the Introduction of Sutureless and Rapid Deployment Valves in Korea: A Nationwide Population-Based Cohort Study

  • Woo, Hyeok Sang;Hwang, Ho Young;Kim, Ho Jin;Kim, Joon Bum;Lee, Sak;Lim, Cheong;Chang, Byung-Cheul;Lee, Na Rae;Suh, Youshin;Choi, Jae Woong
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.369-376
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    • 2021
  • Background: Sutureless and rapid deployment valves for aortic valve replacement (AVR) were introduced in Korea in December 2016. This study evaluated changing trends in the prosthetic valves used for AVR in Korea after the introduction of sutureless and rapid deployment valves. Methods: From December 2016 to December 2018, 4,899 patients underwent AVR in Korea. After applying the exclusion criteria, 4,872 patients were analyzed to determine changes in the type of prosthetic valve used for AVR. The study period was divided into 5 groups corresponding to 5-month intervals. Results: The total number of AVR cases was 194.88±28.78 per month during the study period. Mechanical valves were used in approximately 27% to 33% of cases, and the proportion of mechanical valve use showed a tendency to decrease, with marginal significance overall (p=0.078) and significant decreases in patients less than 60 years of age and in men (p=0.013 and p=0.023, respectively). The use of sutureless valves increased from 13.4% to 25.8% of cases (p<0.001), especially in elderly patients (>70 years) and those requiring concomitant surgery. In a comparison between sutureless and rapid deployment valves, the use of Perceval S valves (a type of sutureless valve), gradually increased (p<0.001). Conclusion: After the introduction of sutureless and rapid deployment valves in Korea, the rate of use of these new valves remarkably increased, especially in elderly patients and those requiring concomitant surgery. Further studies should investigate the clinical outcomes of these new prostheses.

Trends of Life-Space Mobility in Community-dwelling Elderly (지역사회 거주 노인 대상의 생활공간 이동성(Life-space mobility) 연구 동향)

  • Jeong, Eun-Hwa
    • Therapeutic Science for Rehabilitation
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    • v.10 no.1
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    • pp.19-35
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    • 2021
  • Objective : This study aimed to systematically examine studies on the life-space mobility in community-dwelling elderly and analyze and summarize the research trends. Methods : The Embase and PubMed databases were searched for articles on the life-space mobility of community-dwelling elderly published between January 2010 and January 2020. Based on the selection and exclusion criteria of the 335 articles, a total of 27 articles were finally selected and analyzed. Results : As a results, 11 (40.7%) cohort studies had evidence level II. This study showed that the participants in the studies were healthy elderly (81.5%), and the University of Alabama Life-Space Assessment (UAB-LSA) used the most participants (88.9%). Of the foci of the 27 finally selected studies, 8 (29.6%) were physical, 8 (29.6%) were psychosocial, 6 (22.2%) were cognitive, and 2 (7.4%) were social, and 3 (11.1%) were others. The life-space mobility of the elderly needs to be analyzed from a multidimensional point of view, and not based on a single factor such as the physical, cognitive, psychosocial, or social. Conclusion : The results of this study are expected to verify causality through the study of life-space mobility for the elderly staying in various communities and provide future directions for the study on the mobility of the elderly's and the development of community-based intervention programs.

Quantitative Research Trends for Critical Care Survivors' Health related Quality of Life after Intensive Care Unit Discharge (중환자실 생존 환자의 퇴원 후 건강관련 삶의 질에 관한 국내·외 양적연구 동향)

  • Son, Youn-Jung;Song, Hyo-Suk
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.6 no.12
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    • pp.55-67
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    • 2016
  • Purpose: The aims of this were to analyse the quantitative research trends and describe the factors influencing health related to quality of life (HRQoL) and instruments used to HRQoL after Intensive care units (ICU) discharge. Methods: This study were included 84 published papers regarding HRQoL after ICU discharge from initial data to December 2015. Results: The majority of papers were performed abroad. Only 4 papers with regard to HRQoL of ICU survivors were performed by nurses. 36 studies (42.8%) were used to measure HRQoL ICU survivors using the SF-36. 29 studies (34.5%) were used to measure HRQoL at 3~6 months after ICU discharge. Older age, longer length of stay at ICU, severity of illness, anxiety and depression were main risk factors to lower HRQoL in ICU patients. Conclusions: This study provides a better understanding of quality of life follwing critical illness. Therefore, further stduy is needed to develop patient centered intervention considered patients'health status and recovery phase. Additionally, large prospective multicenter cohort studies should be required.