• Title/Summary/Keyword: Quality Outcomes

Search Result 1,256, Processing Time 0.097 seconds

The Effect of Hounsfield Unit Value with Conventional Computed Tomography and Intraoperative Distraction on Postoperative Intervertebral Height Reduction in Patients Following Stand-Alone Anterior Cervical Discectomy and Fusion

  • Lee, Jun Seok;Son, Dong Wuk;Lee, Su Hun;Ki, Sung Soon;Lee, Sang Weon;Song, Geun Sung;Woo, Joon Bum;Kim, Young Ha
    • Journal of Korean Neurosurgical Society
    • /
    • v.65 no.1
    • /
    • pp.96-106
    • /
    • 2022
  • Objective : The most common complication of anterior cervical discectomy and fusion (ACDF) is cage subsidence and maintenance of disc height affects postoperative clinical outcomes. We considered cage subsidence as an inappropriate indicator for evaluating preservation of disc height. Thus, this study aimed to consider patients with complications such as reduced total disc height compared to that before surgery and evaluate the relevance of several factors before ACDF. Methods : We retrospectively reviewed the medical records of 40 patients who underwent stand-alone single-level ACDF using a polyetheretherketone (PEEK) cage at our institution between January 2012 and December 2018. Our study population comprised 19 male and 21 female patients aged 24-70 years. The minimum follow-up period was 1 year. Twenty-seven patients had preoperative bone mineral density (BMD) data on dual-energy X-ray absorptiometry. Clinical parameters included sex, age, body mass index, smoking history, and prior medical history. Radiologic parameters included the C2-7 cobb angle, segmental angle, sagittal vertical axis, disc height, and total intervertebral height (TIH) at the preoperative and postoperative periods. Cage decrement was defined as the reduction in TIH at the 6-month follow-up compared to preoperative TIH. To evaluate the bone quality, Hounsfield unit (HU) value was calculated in the axial and sagittal images of conventional computed tomography. Results : Lumbar BMD values and cervical HU values were significantly correlated (r=0.733, p<0.001). We divided the patients into two groups based on cage decrement, and 47.5% of the total patients were regarded as cage decrement. There were statistically significant differences in the parameters of measuring the HU value of the vertebra and intraoperative distraction between the two groups. Using these identified factors, we performed a receiver operating characteristic (ROC) curve analysis. Based on the ROC curve, the cut-off point was 530 at the HU value of the upper cortical and cancellous vertebrae (p=0.014; area under the curve [AUC], 0.727; sensitivity, 94.7%; specificity, 42.9%) and 22.41 at intraoperative distraction (p=0.017; AUC, 0.722; sensitivity, 85.7%; specificity, 57.9%). Using this value, we converted these parameters into a bifurcated variable and assessed the multinomial regression analysis to evaluate the risk factors for cage decrement in ACDF. Intraoperative distraction and HU value of the upper vertebral body were independent factors of postoperative subsidence. Conclusion : Insufficient intraoperative distraction and low HU value showed a strong relationship with postoperative intervertebral height reduction following single stand-alone PEEK cage ACDF.

A Comparative Clinical Study on an Electronic Moxibustion with Acupuncture for Dry Eye Syndrome (건성안 증후군에 대한 전자뜸과 침의 효과 비교 임상연구)

  • Ji-Shik Park;Ji-Hoon Song;Min-Yeong Jung;Jung-Hwa Choi;Soo-Yeon Park
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.36 no.1
    • /
    • pp.64-77
    • /
    • 2023
  • Objectives : Recently, the number of patients with dry eye syndrome has been steadily increasing. However, established treatment for it does not yet exist. This study compared electronic moxibustion with acupuncture for patients with dry eye in terms of efficacy and safety. Methods : This trial was designed as an investigator-initiated, single-blinded, comparative, randomized controlled trial. Thirty patients with dry eye were randomized to the electronic moxibustion treatment group(EMG) or the acupuncture treatment group(AG) in equal proportion. The participants who assigned to the EMG were treated with electronic moxibustion to ten acupoints including both sides of BL2, GB14, TE23, and LI4 for 12 minutes. The participants who were assigned to the AG were treated with acupuncture to the same acupoints for 15 minutes. Over 4 weeks, each intervention was carried out twelve times in total. The primary outcome was the ocular surface disease index(OSDI). The secondary outcomes were the subjective symptoms visual analog scale(VAS), quality of life(QoL), Schirmer I test(SIT), and general assessment. Adverse events and vital signs were also investigated for safety assessment. Results : In intragroup comparisons, both the EMG and the AG significantly improved the OSDI scores, the subjective symptoms VAS scores, the QoL scores, and the SIT results after 4 weeks of the trial. However, there were no statistical differences in intergroup comparisons between the two groups after 4 weeks. The safety of electronic moxibustion and acupuncture was confirmed by no occurrence of serious adverse events. Conclusions : Both electronic moxibustion and acupuncture were effective for dry eye syndrome, and they were safe. Electronic moxibustion and acupuncture can be used for dry eye syndrome as equivalent treatments.

Study on the Place Image Factors for Place Branding of Public Libraries (공공도서관의 장소브랜딩을 위한 장소이미지요인에 관한 연구)

  • Yu Jeong, Kang;Jee Yeon, Lee
    • Journal of the Korean Society for Library and Information Science
    • /
    • v.56 no.4
    • /
    • pp.129-159
    • /
    • 2022
  • This study generated primary data for supporting the place branding as a part of the library advertising and marketing strategies to increase public library visits. The literature review enabled the use of the place branding concepts to discover the relationships among the constituent parts, factors, expected outcomes, and loyalty, then to develop the research model and the hypothesis, which were verified using the Structural Equation Model. There were 34 research hypotheses, of which 21 were adopted. The place image factors such as library reliability, library reciprocity, and library safety were found to be significant. This study derived social contribution value as new place value and place image factors as the potential brand image of public libraries. It helped select the place image factors that best fit the local library's core values (i.e., place value). This study is meaningful because it is a fundamental study to introduce place branding in public libraries as an advertising and marketing strategy. And it is expected that public libraries will grow into high-quality brands with high awareness, loyalty, and secure leadership in the local community.

The Effectiveness and Safety of Dokwhalkisaeng-tang Combined with the Medication on Rheumatoid Arthritis: A Study Protocol for Systematic Review and Meta-analysis (류마티스 관절염 치료제와 병용한 독활기생탕의 효과 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Chae, Soo-Yeon;Jung, Chan-Yung;Kim, Joo-Hee;Kim, Eun-Jung;Seo, Byung-Kwan;Hwang, Min-Seop;Park, Seong-Sik;Kim, Kyung-Ho;Yoon, Jong-hwa;Sung, Won-Suk
    • Herbal Formula Science
    • /
    • v.30 no.2
    • /
    • pp.95-100
    • /
    • 2022
  • Objectives : Recent studies reported that Dokwhalkisaeng-tang (DHJST) could relieve the clinical rheumatoid arthritis (RA) symptoms and the level of RA-related blood test. However, evidence-based review on effectiveness and safety of DHJST with medication on RA was not yet provided. Methods : Searching randomized controlled trials on the use of DHJST for RA will be performed using multiple electronic databases, manual search, and contact to author. Studies will be selected according to the pre-defined criteria and collected data on study participants, interventions, control groups, outcome measurements, the results, adverse events, and risk of bias will be summarized. Primary outcome will be the disease activity score (including effective rate, swollen joint count, tender joint count, and morning stiffness), and the secondary outcomes will be RA-related blood test and adverse events. We will use Review Manager software to perform a meta-analysis, Cochrane Collaboration "risk of bias" tool for assessing the risk of bias, and Grades of Recommendation, Assessment, Development and Evaluation for the determination of quality of evidence. Results : We are going to investigate the effectiveness and safety of DHJST with medication for RA. Conclusion : This study will provide reliable evidence on whether DHJST combined with medicine is more effective on RA than medicine monotherapy.

Comparison of the Voice Outcome After Injection Laryngoplasty: Unilateral Vocal Fold Paralysis Due to Cancer Nerve Invasion and Iatrogenic Injury (성대주입술 후 음향학적 분석결과 비교: 암의 신경 침윤으로 인한 일측성 성대마비 환자와 수술 후 발생한 일측성 성대마비 환자)

  • Yongmin, Cho;Hyunseok, Choi;Kyoung Ho, Oh;Seung-Kuk, Baek;Jeong-Soo, Woo;Soon Young, Kwon;Kwang-Yoon, Jung;Jae-Gu, Cho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
    • /
    • v.33 no.3
    • /
    • pp.172-178
    • /
    • 2022
  • Background and Objectives Injection laryngoplasty is a common method for treatment of unilateral vocal fold paralysis. Unilateral vocal fold paralysis has various causes, including idiopathic, infection, stroke, neurologic condition, surgery and nerve invasion by cancer. To the knowledge of the authors, there was no study on the relationship between the causes of vocal cord paralysis and the outcome of injection laryngoplasty. Therefore, we tried to investigate the difference in the outcomes of injection laryngoplasty between vocal cord paralysis after surgery group and nerve invasion by cancer group. Materials and Method A retrospective analysis was performed for 24 patients who underwent vocal cord injection due to unilateral vocal cord paralysis caused by surgery or nerve invasion by cancer. The objective quality of the voice was assessed by acoustic voice analysis with the Multi-Dimensional Voice Program. Results Both group showed an improvement of fundamental frequemcy (F0), jitter percent, shimmer (percent), and noise to hearmonic ratio (NHR) after injection laryngoplasty. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of F0, shimmer percent and NHR than the vocal cord paralysis due to surgery group, but there was not statistically significant. Conclusion Our study did not show a statistically significant difference in outcome between vocal cord paralysis due to cancer invasion group and surgery group, but statistically tendency was suggested. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of acoustic voice analysis than surgery group.

Busan Tourism Industry applying OECD Tourism Policy and ICT Convergence Platform (OECD 관광정책과 ICT 융합 플랫폼을 적용한 부산관광산업)

  • Lim, Yong-Suk;Jung, Ho-Jin;Lee, Jung-Won
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
    • /
    • v.7 no.12
    • /
    • pp.871-879
    • /
    • 2017
  • The purpose of this study is to propose a Busan tourism industry in which the 2016 OECD Tourism policy and ICT convergence platform are applied. OECD proposed 3 policies to promote the tourism industry: First, to maintain the competitiveness of the tourism industry as well as improve its efficiency and sustainability, second, to establish a seamless traffic system, and third, to build a response to the sharing economy. Centering on the OECD's three policies, we propose the developmental possibilities of tourism in Busan. At the same time, we suggest the necessity to build an ICT convergence platform that will help foster the industry. In building an ICT convergence platform, we especially focus on the necessity of: 1. Sharing and creating experience-based interactive contents on the software side, and 2. Developing high quality user experience (UX) and providing a data analysis-based customized service on the hardware side. In addition, we insist on the establishment of the Tourism Promotion Agency for the continuous performance and management of Busan tourism industry. The study ultimately suggests that the construction of ICT convergence platform based on OECD tourism policy can result in the expected outcomes of high effects with low cost for both consumers and suppliers related to the tourism industry.

Improving Tuberculosis Medication Adherence: The Potential of Integrating Digital Technology and Health Belief Model

  • Mohd Fazeli Sazali;Syed Sharizman Syed Abdul Rahim;Ahmad Hazim Mohammad;Fairrul Kadir;Alvin Oliver Payus;Richard Avoi;Mohammad Saffree Jeffree;Azizan Omar;Mohd Yusof Ibrahim;Azman Atil;Nooralisa Mohd Tuah;Rahmat Dapari;Meryl Grace Lansing;Ahmad Asyraf Abdul Rahim;Zahir Izuan Azhar
    • Tuberculosis and Respiratory Diseases
    • /
    • v.86 no.2
    • /
    • pp.82-93
    • /
    • 2023
  • Tuberculosis (TB) is a significant public health concern. Globally, TB is among the top 10 and the leading cause of death due to a single infectious agent. Providing standard anti-TB therapy for at least 6 months is recommended as one of the crucial strategies to control the TB epidemic. However, the long duration of TB treatment raised the issue of non-adherence. Non-adherence to TB therapy could negatively affect clinical and public health outcomes. Thus, directly observed therapy (DOT) has been introduced as a standard strategy to improve anti-TB medication adherence. Nonetheless, the DOT approach has been criticized due to inconvenience, stigma, reduced economic productivity, and reduced quality of life, which ultimately could complicate adherence issues. Apart from that, its effectiveness in improving anti-TB adherence is debatable. Therefore, digital technology could be an essential tool to enhance the implementation of DOT. Incorporating the health belief model (HBM) into digital technology can further increase its effectiveness in changing behavior and improving medication adherence. This article aimed to review the latest evidence regarding TB medication non-adherence, its associated factors, DOT's efficacy and its alternatives, and the use of digital technology and HBM in improving medication adherence. This paper used the narrative review methodology to analyze related articles to address the study objectives. Conventional DOT has several disadvantages in TB management. Integrating HBM in digital technology development is potentially effective in improving medication adherence. Digital technology provides an opportunity to improve medication adherence to overcome various issues related to DOT implementation.

Using Eeclaimed Land for Potato Cultivation in Saemangeum, South Korea: Determining the Optimal Nitrogen Fertilization Rate with the Giant Miscanthus used as a Source of Soil Organic Matter (새만금간척지에서 거대억새 투입 후 분해 특성 및 감자 재배를 위한 적정 질소시비수준 평가)

  • Yang-Yeol, Oh;Kang-Ho, Jeong;Su-Hwan, Lee;Kwang-Seung, Lee;Bo-Seong, Seo;Kil-Yong, Kim
    • Journal of Environmental Science International
    • /
    • v.31 no.11
    • /
    • pp.911-922
    • /
    • 2022
  • To restore reclaimed land, it needs to be supplemented with organic matter; this is especially true for Korea, where organic matter constitutes only one-tenth of conventional agricultural soils. The giant Miscanthus, a perennial grass known for its extensive biomass, shows signs of being an excellent source of organic matter for restoring reclaimed land. Therefore, the objectives of this study were to (i) evaluate the feasibility of using the giant miscanthus as an organic resource within the context of re-using reclaimed land for agricultural purposes (i.e., potato cultivation), and (ii) determine the optimum fertilization rate for the potatoes while the giant miscanthus is being used as an organic resource. Our results show that after 180 days, giant miscanthus lost 23-47% of its original dry weight, with the extent of the loss dependent on soil salinity. Nutrient concentrations (Mg2+, Na+) continued to increase until the end of the study period. In contrast, potassium (K+) and the ratio of carbon to nitrogen (C/N) decreased until the end of the study period. Specifically, after 180 days, low salinity topsoil treatments had the lowest C/N ratio. In the first year, 150 % of standard N rates were required for the potatoes to achieve maximum productivity; however in the 2nd year, standard rates were sufficient to achieve maximum productivity. Overall, this implies that even though the application of giant miscanthus did eventually improve soil quality, increasing crop yields, N fertilization is still necessary for the best outcomes.

Different Abortion Approaches in Europe and Women's Health: Implications for Korean Abortion Debates (유럽 각국의 낙태 접근과 여성건강 - 한국 낙태논쟁에 대한 함의 -)

  • Chung, Jin-Joo
    • Issues in Feminism
    • /
    • v.10 no.1
    • /
    • pp.123-158
    • /
    • 2010
  • For the last several months, abortion debates have sparkled in Korea. The government has escalated the need of active punishment of illegal abortions to solve low fertility problems, while some obstetricians and gynecologist have proclaimed stoppage of illegal abortions suing colleague doctors who has conducted illegal abortions. Women's rights groups and researchers have also responded to the abortion debate claiming that women's decisions over their pregnancy are important in making of abortion policies. To contribute to Korean abortion debates, his paper aims to analyze European experiences of abortion polices in relation to the consequences on women's health. For the analysis of European abortion experiences, three countries - Ireland, U.K, and Netherland -are chosen. These three countries are selected since their legal and social acceptance of abortion and the level of safe abortion system are different. Each country is reviewed by national abortion policy, legal regulation, medical system and the role of civil society. The analysis shows several implications for abortion debates occurring in Korea. Various systematic policy mechanisms - abortion on women' request, abortions without complicated doctor's referrals, transparent and anonymous counseling and information provision regarding abortion, training and education for medical professionals to guarantee high quality abortion, abortions funded publicly for women to improve their access to abortions, steady monitoring and auditing abortion procedures and outcomes for safe abortion and so on - are required in Korean society. Two track procedures - safe abortion on women's request and prevention of unwanted pregnancy - are needed for reproduction of healthy women and society.

A Study on Social Network Characteristics, Social Support, Functional Recovery, and Life Satisfaction of People with Mental Illness (정신질환자의 사회관계망 특성, 사회적 지지 그리고 삶의 만족도에 관한 연구)

  • Kim, Jin-Mi;Shin, Hyo-Jin
    • The Journal of the Convergence on Culture Technology
    • /
    • v.9 no.6
    • /
    • pp.85-96
    • /
    • 2023
  • In a reality where negative perceptions and social prejudices towards individuals with mental illnesses persist, the absence and lack of social support systems acquired through personal intimate social networks can be considered a significant hindrance to the quality of life for those with mental disorders. Therefore, this study examined the impact of the characteristics of social networks and social support on the life satisfaction of individuals with mental illnesses. A survey was conducted with 180 patients from seven mental health treatment facilities in the Daegu area. The data were analyzed using MANOVA, hierarchical multiple regression analysis, and Sobel test for mediation analysis with SPSS 25 software. The key findings of the study revealed that the intimacy aspect of social networks had a positive and significant effect on social support and life satisfaction. On the other hand, the size of the social network showed a negative influence on social support. Furthermore, social support partially mediated the relationship between the intimacy of social networks and life satisfaction, and it fully mediated the relationship between the size of social networks and life satisfaction. Based on these research outcomes, practical and policy-related recommendations are provided to enhance life satisfaction through increased social support for this population.