• Title/Summary/Keyword: Health outcome

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Dual-mobility versus Fixed-bearing in Primary Total Hip Arthroplasty: Outcome Comparison

  • Vivek Singh;Jeremy Loloi;William Macaulay;Matthew S. Hepinstall;Ran Schwarzkopf;Vinay K. Aggarwal
    • Hip & pelvis
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    • v.34 no.2
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    • pp.96-105
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    • 2022
  • Purpose: Use of dual mobility (DM) articulations can reduce the risk of instability in both primary and revision total hip arthroplasty (THA). Knowledge regarding the impact of this design on patient-reported outcome measures (PROMs) is limited. This study aims to compare clinical outcomes between DM and fixed bearing (FB) prostheses following primary THA. Materials and Methods: All patients who underwent primary THA between 2011-2021 were reviewed retrospectively. Patients were separated into three cohorts: FB vs monoblock-D vs modular-DM. An evaluation of PROMs including HOOS, JR, and FJS-12, as well as discharge-disposition, 90-day readmissions, and revisions rates was performed. Propensity-score matching was performed to limit significant demographic differences, while ANOVA and chi-squared test were used for comparison of outcomes. Results: Of the 15,184 patients identified, 14,652 patients (96.5%) had a FB, 185 patients (1.2%) had a monoblock-DM, and 347 patients (2.3%) had a modular-DM prosthesis. After propensity-score matching, a total of 447 patients were matched comparison. There was no statistical difference in the 90-day readmission (P=0.584), revision rate (P=0.265), and 90-day readmission (P=0.365) and revision rate due to dislocation (P=0.365) between the cohorts. Discharge disposition was also non-significant (P=0.124). There was no statistical difference in FJS-12 scores at 3-months (P=0.820), 1-year (P=0.982), and 2-years (P=0.608) between the groups. Conclusion: DM bearings yield PROMs similar to those of FB implants in patients undergoing primary THA. Although DM implants are utilized more often in patients at higher-risk for instability, we suggest that similar patient satisfaction may be attained while achieving similar dislocation rates.

Experience on Telemedicine Use of Community Health Practitioners (보건진료원의 원격관리 경험)

  • Kwon, Myung Soon;Park, Dong-Jin;Choi, Jounghwa
    • Korean Journal of Health Education and Promotion
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    • v.30 no.2
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    • pp.23-39
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    • 2013
  • Objectives: This study was conducted to investigate practical experiences of telemedicine of community health practitioners(CHPs). Methods: Qualitative data were collected by in-depth interviews from 10 CHPs who have experiences in managing telemedicine system. All interviews were recorded and transcribed according to qualitative conventional content analysis processes. Results: As a result, 32 themes were deduced and 11 theme clusters and 3 categories were formed and each coding categories were derived directly from the text data. 11 theme clusters derived from the 32 meaningful themes were as follows: Human resources, equipments and systems, computer program (Input resources), human resource management, patient registration and management, medication, laboratory test (Progress), benefits in telemedicine system managing, difficulties in telemedicine system managing, complains in telemedicine system managing, client responses to telemedicine system (Outcome evaluation). 3 categories derived 11 theme clusters were 'input', 'progress', and 'outcome evaluation'. Conclusions: This study has contributed to the understanding of operation of telemedicine by CHPs in community health posts. For more systematic and comprehensive management, further study should be conducted to reflect experience and positions of public health center physicians, collaborative hospital physician and patients.

Frailty assessed by the electronic frailty index and its impact on health outcomes in older adults with chronic diseases: a systematic review (전자허약지수(electronic frailty index)를 활용한 만성질환 노인의 허약평가와 건강결과 간의 관계: 체계적 고찰)

  • Jung-Wook Shin;Min-Young Yu;Youn-Jung Son
    • Journal of Korean Biological Nursing Science
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    • v.25 no.4
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    • pp.229-242
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    • 2023
  • Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion: Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

Adverse Outcome Pathways for Prediction of Chemical Toxicity at Work: Their Applications and Prospects (작업장 화학물질 독성예측을 위한 독성발현경로의 응용과 전망)

  • Rim, Kyung-Taek;Choi, Heung-Koo;Lee, In-Seop
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.29 no.2
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    • pp.141-158
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    • 2019
  • Objectives: An adverse outcome pathway is a biological pathway that disturbs homeostasis and causes toxicity. It is a conceptual framework for organizing existing biological knowledge and consists of the molecular initiating event, key event, and adverse output. The AOP concept provides intuitive risk identification that can be helpful in evaluating the carcinogenicity of chemicals and in the prevention of cancer through the assessment of chemical carcinogenicity predictions. Methods: We reviewed various papers and books related to the application of AOPs for the prevention of occupational cancer. We mainly used the internet to search for the necessary research data and information, such as via Google scholar(http://scholar.google.com), ScienceDirect(www.sciencedirect.com), Scopus(www.scopus. com), NDSL(http: //www.ndsl.kr/index.do) and PubMed(http://www.ncbi.nlm.nih.gov/pubmed). The key terms searched were "adverse outcome pathway," "toxicology," "risk assessment," "human exposure," "worker," "nanoparticle," "applications," and "occupational safety and health," among others. Results: Since it focused on the current state of AOP for the prediction of toxicity from chemical exposure at work and prospects for industrial health in the context of the AOP concept, respiratory and nanomaterial hazard assessments. AOP provides an intuitive understanding of the toxicity of chemicals as a conceptual means, and it works toward accurately predicting chemical toxicity. The AOP technique has emerged as a future-oriented alternative to the existing paradigm of chemical hazard and risk assessment. AOP can be applied to the assessment of chemical carcinogenicity along with efforts to understand the effects of chronic toxic chemicals in workplaces. Based on these predictive tools, it could be possible to bring about a breakthrough in the prevention of occupational and environmental cancer. Conclusions: The AOP tool has emerged as a future-oriented alternative to the existing paradigm of chemical hazard and risk assessment and has been widely used in the field of chemical risk assessment and the evaluation of carcinogenicity at work. It will be a useful tool for prediction, and it is possible that it can help bring about a breakthrough in the prevention of occupational and environmental cancer.

Korean Version of the Outcome Expectations for Exercise Scale-2: Validation Study (한국판 운동기대감 측정도구 (K-OEE-2)의 타당도와 신뢰도)

  • Choi, Mona;Jung, Dukyoo
    • Korean Journal of Adult Nursing
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    • v.24 no.6
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    • pp.580-587
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    • 2012
  • Purpose: To develop and test the validity and reliability of the Korean version of outcome expectations-2 for exercise. Methods: The Korean version of outcome expectations for exercise-2 was developed through forward-backward translation techniques. Content, criterion, and construct validity using confirmatory factor analysis and an internal consistency reliability were conducted. Survey data were collected from 200 older adults living in a community. Results: The Korean version of outcome expectations for exercise-2 had factor loadings of the 13 items ranged from .20 to .76, and was validated by confirmatory factor analysis (CFI=.829, NFI=.754, RMSEA=.086). Also there was a reliable internal consistency with a Cronbach's ${\alpha}$ for the positive domain of outcome expectations for exercise scale-2 of .73. Negative domain, however, reported slightly low Cronbach's ${\alpha}$ of .63. Conclusion: The findings of this study demonstrated that the Korean version of outcome expectations for exercise-2 had satisfactory validity to measure expectations regarding exercise among older adults in Korea. Negative domain, however, should be retested to verify reliability for the further study.

Perception on Optimal Diet, Diet Problems and Factors Related to Optimal Diet Among Young Adult Women Using Focus Group Interviews - Based on Social Cognitive Theory - (포커스 그룹 인터뷰를 이용한 젊은 성인 여성의 식생활 실태 및 관련 요인 - 사회인지론에 근거하여 -)

  • Kim, Hye Jin;Lee, A Reum;Kim, Kyung Won
    • Korean Journal of Community Nutrition
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    • v.21 no.4
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    • pp.332-343
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    • 2016
  • Objectives: Study purpose was to investigate perception on diet, diet problems and related factors among young adult women using focus group interviews (FGI) based on the Social Cognitive Theory (SCT). Methods: Eight groups of FGI were conducted with 47 female undergraduate or graduate students. Guide for FGI included questions regarding perception on optimal diet, diet problems and cognitive, behavioral, and environmental factors of SCT. FGI were video, audio-taped, transcribed and analyzed by themes and sub-themes. Results: Subjects showed irregular eating habits (skipping breakfast, irregular meal time) and selection of unhealthy foods as the main diet problems. Regarding cognitive factors related to optimal diet, subjects mentioned positive outcome expectations (e.g., health promotion, skin health, improvement in eating habits, etc.) and negative outcome expectations (e.g., annoying, hungry, expensive, taste). Factors that promoted optimal diet were mainly received from information from mobile or internet and access to menu or recipes. Factors that prevented optimal diet included influence from friends, lack of time and cooking skills. Behavioral factors for optimal diet included behavioral capability regarding snacks, healthy eating and smart food selection. Subjects mentioned mass media (mobile, internet, TV) as the influential physical environment, and significant others (parents, friends, grandparents) as the influential social environment in optimal diet. For education topics, subjects wanted to learn about healthy meals, basic nutrition, disease and nutrition, and weight control. They wanted to learn those aspects by using mobile or internet, lectures (cooking classes), campaign and events. Conclusions: Study results might be used for planning education regarding optimal diet for young adult women. Education programs need to focus on increasing positive outcome expectations (e.g., health) and behavioral capability for healthy eating and food selection, reducing negative outcome expectations (e.g., cost, taste) and barriers, making supportive environments for optimal diet, and incorporating topics and methods found in this study.

Effects of the Continuity of Care on Hospital Utilization : Convergence A Propensity Score Matching Analysis (진료지속성이 의료이용에 미치는 영향 : 융복합 성향점수매칭 방법 적용)

  • Ahn, Lee-Su
    • Journal of Digital Convergence
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    • v.13 no.9
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    • pp.323-332
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    • 2015
  • This paper examines the level of the primary care continuity for patients with high blood pressure and the effects of the primary care continuity on their convergence health outcomes. We conducted a retrospective cohort study. A total of 315,791 patients who had received new diagnoses of hypertension. We determined standard indices of continuity of care-MFPC, MMCI, and COC and evaluated their association with study outcomes over three years of follow-up. Outcome measures included hospitalization and emergency room visits. The result of the primary care continuity levels and hazard ratios of health outcome showed that, comparing continuity group, non-continuity group had higher rates of hospitalization by 1.655(95% CI: 1.547-1.771) and emergency room visits by 1.669(95% CI: 1.465-1.903). This paper argues that medical costs of chronic diseases will reduce if low continuity of care turns into high continuity of care.

Long-term outcomes after peri-implantitis treatment and their influencing factors: a retrospective study

  • Lee, Sung-Bae;Lee, Bo-Ah;Choi, Seong-Ho;Kim, Young-Taek
    • Journal of Periodontal and Implant Science
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    • v.52 no.3
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    • pp.194-205
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    • 2022
  • Purpose: This study aimed to determine the long-term outcomes after peri-implantitis treatment and the factors affecting these outcomes. Methods: This study included 92 implants in 45 patients who had been treated for peri-implantitis. Clinical data on the characteristics of patients and their implants were collected retrospectively. The change in the marginal bone level was calculated by comparing the baseline and the most recently obtained (≥3 years after treatment) radiographs. The primary outcome variable was progression of the disease after the treatment at the implant level, which was defined as further bone loss of >1.0 mm or implant removal. A 2-level binary logistic regression analysis was used to identify the effects of possible factors on the primary outcome. Results: The mean age of the patients was 58.7 years (range, 22-79 years). Progression of peri-implantitis was observed in 64.4% of patients and 63.0% of implants during an observation period of 6.4±2.7 years (mean±standard deviation). Multivariable regression analysis revealed that full compliance to recall visits (P=0.019), smoking (P=0.023), placement of 4 or more implants (P=0.022), and marginal bone loss ≥4 mm at baseline (P=0.027) significantly influenced the treatment outcome. Conclusions: The long-term results of peri-implantitis treatment can be improved by full compliance on the part of patients, whereas it is impaired by smoking, placement of multiple implants, and severe bone loss at baseline. Encouraging patients to stop smoking and to receive supportive care is recommended before treatment.

Outcome of a Pilot Project on Case Management Service for Medical Aid Clients (의료급여텔레케어사업 효과 - 일 시범지역을 대상으로 -)

  • Oh, Jin-Joo
    • Journal of Korean Public Health Nursing
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    • v.24 no.1
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    • pp.61-70
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    • 2010
  • Purpose: This study analyzed outcomes of a Telecare case management service pilot project for Korean Medicaid Program Clients in Seoul. Outcome data for provided services and medical aid cost data were analyzed. Methods: Case management services were delivered by 10 medical aid managers. The period of the project was from July to December 2007. Results: The total number of the objects was 9714, representing 43.4% of the total medical aid clients in the area. The average number of consults was 2.58. Consults were most frequently via letter and telephone, with in- person visits being least common. Of the total, 213 cases were referred to community services, 87.8% were transacted successfully. The medical expenditure was less than that from January-June, 2007. Conclusion: Telecare service via mail or telephone allows contact with many clients in a short time which can enable the discover and monitoring of high risk clients. This can be accomplished at a cost savings to the Korean Medicaid Program.

Effects of Home-Based Intervention Program to Prevent Child Abuse for Parents: A Meta Analysis (부모를 위한 아동학대 예방 가정방문 프로그램 효과 메타분석)

  • Park, Hyun-Jung;Kim, Hyun Kyoung
    • Child Health Nursing Research
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    • v.23 no.4
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    • pp.479-493
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    • 2017
  • Purpose: This study was done to conduct a meta-analysis of articles describing randomized controlled trials which showed substantiated effects for home-based child abuse prevention programs for all parents. Methods: The articles regarding child abuse prevention programs for parents were investigated using the systematic review method. A literature search was conducted in PubMed, CINAHL, PsycINFO, Cochrane central library, Eric, and RISS on material published. Article searches and quality appraisal through RoB (Risk of Bias) yielded 14 records. Results: The total random effect size was 0.344 (Parents outcome, 0.333; Child outcome, 0.310; Environment, 0.275). The home based intervention for parents was effective for prevention of potential child abuse. Conclusion: This study supports the effectiveness of health care professional directing child abuse prevention programs for all parents whose children are in the early years of life including during the period of pregnancy.