Background Breast augmentation with implants is the most commonly performed cosmetic plastic surgery in Brazil and worldwide. The aim of this study was to assess patient satisfaction and quality of life following subpectoral breast augmentation with either microtextured or macrotextured implants, using the BREAST-Q. Methods A prospective study was conducted with 40 women with hypomastia undergoing subpectoral breast augmentation. The patients were randomly allocated to two groups to receive either microtextured or macrotextured breast implants. All participants were assessed preoperatively (baseline) and after 2 and 4 months of surgery for quality of life and patient satisfaction with the surgical results, using the BREAST-Q augmentation module, a patient-reported outcome measure. Results The patients had a mean age of 28.9 ± 6.45 years. The microtextured (n = 20) and macrotextured (n = 20) groups were homogeneous for sex, age, education level, marital status, and number of children (p > 0.05). Both groups showed significant improvement in satisfaction with breasts (p < 0.001), psychosocial well-being (p < 0.001), and sexual well-being (p < 0.001) at the 2- and 4-month follow-up visits compared with baseline. The observed improvements were associated with high effect size values of 5.09, 3.44, and 3.90, respectively. In contrast, significant decreases from baseline in physical well-being scores (p = 0.001) were found 2 and 4 weeks after surgery in both groups. Conclusion Subpectoral breast augmentation with either microtextured or macrotextured breast implants improved satisfaction with breasts and quality of life in patients with hypomastia.
Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection-related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.
Work-related musculoskeletal injuries and disorders (WMSD) are a significant issue in the health care sector. Allied Health professionals (AHP) in this sector are exposed to physical and psychosocial factors associated with increased risk of developing a WMSD. Clarification of relevant hazard and risk factors for AHP is needed to improve understanding and inform WMSD risk management. A systematic analysis of the literature was undertaken to determine prevalence and risk factors for WMSD in AHP. Databases of Ovid MEDLINE, CINAHL (EBSCO), EMBASE and the Cochrane Database of Systematic Reviews were reviewed. This quality of articles was low. Outcome measures were varied, with prevalence rates of WMSD reported from 28% to 96% over a one-year time period. The lower back was the most commonly affected body part. Relevant factors identified with the development of WMSD included inexperience in the role and area of employment. Future research needs to focus on undertaking high quality prospective studies to determine the factors associated with WMSD development in AHP.
Purpose: This study was to analyze research reports published in Korea on cardiac rehabilitation for patients with cardiovascular disease. Methods: Based on inclusion criteria, 19 research reports were included in this review. Published year of selected articles was between 1996 and 2008. Nineteen studies were analyzed by guidelines of the cardiac rehabilitation programs done by the American Heart Association(AHA) and Scottish Intercollegiate Guidelines Network(SIGN). Results: The characteristics of patients were mostly of ischemic heart disease, 50-59 yr old, and male. Educational sessions were administered twice, and each lesson lasted less than 30 min. Exercise was done 3 times per week for 6 weeks. Most educational content were about risk factors, but there was no information, such as coping with feelings. Most exercise was performed as ROM, treadmill, and cycle ergometer. A large percentage of outcome indicators were health behavior, hemodynamic changes, and exercise capacity. There was more 'no effect' than 'positive effect' in trait anxiety and depression, whereas similar in physiologic domain. Conclusion: Various types of cardiac rehabilitation in Korea were performed by researchers. Therefore, we need to develop the standard protocol, to add psychosocial intervention, and to study cost effectiveness of cardiac rehabilitation.
The prevalence of insomnia and the degree of impairment due to insomnia is greater than in the of young. The cause for insomnia in the elderly are various factors among the elderly is known to be high including medical, psychiatric, drug issues, circadian rhythm changes, sleep disorders, and psychosocial. So the careful evaluation to find the cause of insomnia is needed for the eldery. Treatment options for insomnia include behavior modification and pharmacotherapy. Outcome data from previous studies indicate that behavioral approaches produce reliable and durable therapeutic benefits, as evidenced by improved sleep efficiency and continuity and enhanced satisfaction with sleep patterns. Treatment methods such as stimulus control and sleep restriction, which target maladaptive sleep habits, are especially beneficial for older insomniacs, whereas relaxation-based interventions aimed at decreasing arousal, produce more limited effects. Cognitive and educational interventions are instrumental in altering age-related dysfunctional beliefs and attitudes about sleep. The choice of hypnotics is based on matching the nature of the insomnia to the hypnotic agent. The ideal agent has rapid onset, duration of action that lasts through the night but no residual daytime effects, and no adverse effects. The key for the healthcare professional is finding the appropriate treatment or treatment combination, including behavioral modification and pharmacotherapy. When hypnotics are indicated, the most appropriate short-acting agent should be considered.
The pregnancy and postpartum period appear to be a time of heightened vulnerability for the development of major depression in some women. Postpartum depression affects 10% of women within a few weeks immediately postpartum. Postpartum depression is associated with disturbances in the mother-infant relationship, which in turn have an adverse impact on the course of child cognitive and emotional development. Depression during pregnancy is also common, although it has been relatively neglected. Psychopathological symptoms during pregnancy have physiological consequences for the fetus. Understanding the aetiology of perinatal depression requires integrating of multiple psychosocial and biological risk factors. The treatment of depressed pregnant women requires skilled decision making by psychiatrists. Risk-benefit analysis is appropriate method for intervention fur depression in pregnancy. Effective treatments for depression in pregnancy include psychotherapy, antidepressant medication and electroconvulsive therapy. In treatment of postpartum depression, the biological, psychological, and social interventions are included. Prescribing antidepressants(such as fluoxetine), estrogen in severe and chronic cases, and counselling can be effective for improving maternal mood and aspects of infant outcome. Ongoing research is directed to further elucidating neurohormonal and psychosocial contributions to depression during pregnancy or postpartum. Screening for risk factors and symptoms for depression need to be incorporated into antenatal and pediatric clinics.
The Journal of Korean Academic Society of Nursing Education
/
v.22
no.4
/
pp.549-558
/
2016
Purpose: The purpose of this study was to develop and validate a Nursing Competency Scale in Simulation (NCSS) for nursing students. Methods: A preliminary version of the NCSS of 14 items was derived from the literature. A panel of seven experts reviewed the preliminary version for content validation and developed 15 items scale. A convenient sample of 195 nursing students completed the survey and two evaluators measured the performances of nine teams in a simulation scenario with NCSS. The data were analyzed using exploratory factor analysis, descriptive statistics, independent t-test and Cronbach's alpha. Intraclass correlation coefficient (ICC) was used in order to estimate the degree of inter-rater reliability. Results: An exploratory factor analysis demonstrated that two factor structures of the NCSS explained 51.1% of the total variance. Two factors were named psychosocial skills and cognitive and psychomotor skills. The mean scores of NCSS between third and 4th grade were significantly different providing support for its known-group validity. Cronbach's alpha was .90 and ranged from .79 to .88. The overall ICC for inter-rater agreement was 0.89 (95% CI 0.03 to 0.98). Conclusion: This scale shows preliminary evidence for validity and reliability. It could be a useful instrument for measuring learning outcome in simulation for nursing students' clinical competency.
Background: Cross-culturally adapted questionnaires may not be comparable to their original version. Objects: To examine concurrent validity of two health-related quality of life (HRQOL) instruments for the Korean versions of EuroQOL-5 Dimension (EQ-5D) and the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) instrument. Methods: A total of 139 cancer survivors from two rehabilitation institutes was recruited. All participants were registered for palliative rehabilitation care. Both instruments were concurrently administered by health care providers following the second bout of the rehabilitation cares. Rasch partial credit model and Spearman's correlation analysis were used to investigate: 1) dimensionality, 2) hierarchical item difficulty, and 3) concurrent validity using correlations between two instruments. Results: For the WHOQOL-BREF, all items except negative feeling, pain, dependence of medical aid, were found to be acceptable, while all items of EQ-5D were acceptable. There was an evidence of negative correlations between EQ-5D and 4 domains of WHOQOL-BREF. Two correlations were strong (EQ-5D vs. physical health domain, ρ = -0.610, 95% CI = -0.716 to -0.475) and moderate (EQ-5D vs. psychosocial domain, ρ = -0.402, 95% CI = -0.546 to -0.236). Other two correlations were weak (EQ-5D vs. social relationship and environmental domains, ρ = -0.242, 95% CI = -0.401 to -0.075 and ρ = -0.364, 95% CI = -0.514 to -0.207, respectively). Item difficulty calibrations of the two measurements were ranged from -0.84 to 0.86 for the EQ-5D and -1.07 to 1.06 for the WHOQOL-BREF. Conclusion: The study provides some supports for the concurrent validity of the two Korean versions of HRQOL instrument, with evidences of weak to strong correlations between the EQ-5D and four domains of the WHOQOL-BREF applied to various cancer survivors. Additionally, the cancer survivors appeared to have more of a tendency to view the EQ-5D items as being slightly more challenging than the WHOQOL-BREF items.
Manrique, Oscar J.;Ciudad, Pedro;Doscher, Matthew;Torto, Federico Lo;Liebling, Ralph;Galan, Ricardo
Archives of Plastic Surgery
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v.44
no.2
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pp.150-156
/
2017
Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.
The purpose of this study was to investigate the effects and characteristics of program on health promotion with foreign worker in Korea. The study was conducted using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Group. The final selected literature was varied in program and outcome variables. Therefore, it was difficult to quantitatively synthesize and it was analyzed through qualitative review. The findings indicate that health promotion programs for foreign workers reduced acculturation stress, depression and anxiety, and increased self-esteem. These findings provide scientific evidence for developing and using health promotion program of foreign workers. Futher development of a variety of health promotion programs and studies of effectiveness review for foreign workers in Korea.
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