• Title/Summary/Keyword: Standardized patients

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A Comparison Study of Pulmonary Tuberculosis Patients Between those with Previous History of Treatment and Those Without it before Registration to Health Center (보건소(保健所) 등록이전(登錄以前) 결핵치료역(結核治療歷) 유무(有無)와 치료효과와의 관련성(關聯性) 연구(硏究))

  • Kim, Han-Joong;Park, Dong-Chul
    • Journal of Preventive Medicine and Public Health
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    • v.16 no.1
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    • pp.129-134
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    • 1983
  • The records for the tuberculosis patients who discharged from the health center during 1982 in Kangwha county were analized in order to study the characteristics and the patterns of treatments for the pulmonary tuberculosis patients with the history of previous treatment before registration and also the relationship between the previos history of treatment and the outcome at the time of discharge from the health center. The major findings are as follows. 1. Those who have a history of previous treatment were 58, 22.5% of those 258 patients who were studied. 2. There is no difference in sex however the rate of previous history of treatment was higher among middle age group (20-59) than young and old age group (under 19 or over 60). 3. The rate of previous treatment was rather higher in those lived in remote area from Eup. 4. As for the reationship with occupation, students and civil servants who easily exposured to the public relations of government's tuberculosis control program experienced lower previous treatment before registration than farmers or unemployed. 5. A total of 62.1% were previously treated less than 6 months, 29.3% between 6 and 12 months, and only 8.6% more than 12 months before registration to health center. 6. The most common used anti-tuberculosis drugs were isoniazid and ethambutol but only 13.8% used government-standardized precription and 69.0% used secondary drugs from its beginning. 7. There was no statistical difference between the previous history of treatment and the outcome at the time of discharge from the health center. However the longer the duration of treatment before registration was the lower the cure rate at health center was.

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Speech Rate and Pause Characteristics in Speaker with Flaccid Dysarthria (이완형 마비말장애 화자의 말속도와 쉼 특성)

  • Hong, Saemi;Byeon, Haewon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.2930-2936
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    • 2014
  • The purposes of this study were to investigate the characteristics of speech rate and pause in patients with flaccid dysarthria. For this purpose, 15 patients with flaccid dysarthria and 15 normal speakers matched in gender and age participated as subjects. The overall speech rate, the articulation rate, the inter-sentence and the intra-sentence pause duration and pause frequency were measured during reading the standardized passage "Autumn"(Kim, 1996). As a result, the overall speech rate and articulation rate of patients with flaccid dysarthria were significantly slower than normal speakers and intra-sentence pause duration and frequency of patients with flaccid dysarthria were significantly higher than normal speakers, but those of inter-sentence weren't. The results from this study provides the speech rate index of flaccid dysarthria and indicates that to control the speech rate of flaccid dysarthria have regard to not only the overall speech rate and the articulation rate but also the intra-sentence pause duration and the frequency.

The Effects of Sling Bridging Exercise to Pain Scale and Trunk Muscle Activity in Low Back Pain Patients

  • Jeong, Eun Dong;Chae, Chang Woo;Yun, Hong Kyu;Woo, Kwang Seog;Kim, Dong Hyun;Kim, Seung Min
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.1
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    • pp.523-531
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    • 2013
  • Most patients with chronic low back pain experience functional disability of trunk muscle, and limitations in physical activity. While there are many types of exercise programs available, in recent years sling exercise has been emerging as the exercise program for spinal stabilization. It has been supported by a great amount of research with positive findings on its effectiveness. This research studies the effects of bridging exercise, conducted on a sling, on pain level and trunk muscle activation in supine, sidelying, and prone positions during a 4 weeks period. 10 healthy people(normal group, n=10) and 28 patients with low back pain participated in this study. 28 patients were divided into two groups; one group participated in exercise with the sling(experimental group, n=14) and the other group exercised without the sling(control group, n=14). They were asked to use the Numerical Rating Scale(NRS) to answer to the level of their pain they felt (no pain: 0 point, severe pain: 10 points). During sling bridging exercises, the muscle activity level in each muscle measured in each position was standardized as three seconds of EMG signals during five seconds MVIC. In conclusion, the experimental group with four weeks of sling bridging exercise experienced a statistically significant reduction in the pain level(p<.05) and increase in the muscle activities of erector spinae when in supine position, internal oblique when in sidelying position, and rectus abdominis in prone position(p<.05). Regular sling bridging exercise reduces the low back pain and enhances other trunk muscle activation, thereby positively affect spinal stabilization.

Management of complex surgical wounds of the back: identifying an evidence-based approach

  • Zolper, Elizabeth G.;Saleem, Meher A.;Kim, Kevin G.;Mishu, Mark D.;Sher, Sarah R.;Attinger, Christopher E.;Fan, Kenneth L.;Evans, Karen K.
    • Archives of Plastic Surgery
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    • v.48 no.6
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    • pp.599-606
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    • 2021
  • Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

Effects on Turnover Intention due to Terminal Care Stress of Nurses Working in Long-term Care Hospitals (요양병원 간호사의 임종간호 스트레스가 이직의도에 미치는 영향)

  • Ha, Shin-young;Song, Jun-Ah
    • Journal of Korean Gerontological Nursing
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    • v.20 no.3
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    • pp.217-228
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    • 2018
  • Purpose: This study was done to examine the effect on turnover intention (TI) of terminal care stress (TCS) on nurses working in long-term care hospitals (LCH). Methods: Participants were 182 nurses from 6 Seoul LCH. Data were collected from October to December, 2017. Self-report questionnaires were used to collect data on general characteristics, TCS, and TI. Results: Subjective satisfaction on the job (r=.52, p<.001), number of monthly terminal care elders (r=.16, p=.043), TCS (r=.16, p=.027), and sub-categories of TCS, 'difficulty for assigning timetable to care for terminally ill patients' (r=.17, p=.025), 'feeling a burden of caring for terminally ill patients' (r=.23, p=.002), and 'conflict with terminally patients' (r=.16, p=.034) showed statistically significant correlation with TI. Multiple regression analysis showed significant influence of subjective satisfaction with job (${\beta}=.52$, p<.001) and TCS (${\beta}=.23$, p=.001) with a 30.3% explanatory power. When sub-categories of TCS were entered, subjective satisfaction with the job (${\beta}=.50$, p<.001) and 'feeling burden of terminally ill patients' (${\beta}=.28$, p<.001) were factors significantly influencing TI with explanatory power of 32.8%. Conclusion: Findings of this study suggest that it is needed to develop standardized practice guidelines and educational programs for terminal care in LCH as well as stress healing programs for nurses.

Evaluation of Muscular Atrophy and Fatty Infiltration Using Time-zero Magnetic Resonance Imaging as Baseline Data, After Rotator Cuff Repair

  • Kim, Hyoung Bok;Yoo, Jae Chul;Jeong, Jeung Yeol
    • Clinics in Shoulder and Elbow
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    • v.22 no.2
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    • pp.70-78
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    • 2019
  • Background: This study evaluated postoperative changes in the supraspinatus from time-zero to 6 months, using magnetic resonance imaging (MRI). We hypothesized that restoration of the musculotendinous unit of the rotator cuff by tendon repair immediately improves the rotator cuff muscle status, and maintains it months after surgery. Methods: Totally, 76 patients (29 men, 47 women) with rotator cuff tears involving the supraspinatus tendon who underwent arthroscopic rotator cuff repairs were examined. MRI evaluation showed complete repair with intact integrity of the torn tendon at both time-zero and at 6 months follow-up. All patients underwent standardized MRI at our institution preoperatively, at 1 or 2 days postoperative, and at 6 months after surgery. Supraspinatus muscular (SSP) atrophy (Thomazeau grade) and fatty infiltrations (Goutallier stage) were evaluated by MRI. The cross-sectional area of SSP in the fossa was also measured. Results: As determined by MRI, the cross-sectional area of SSP significantly decreased 11.41% from time-zero (immediate repair) to 6 months post-surgery, whereas the Goutallier stage and Thomazeau grade showed no significant changes (p<0.01). Furthermore, compared to the preoperative MRI, the postoperative MRI at 6 months showed a no statistically significant increase of 8.03% in the cross-sectional area. In addition, morphological improvements were observed in patients with high grade Goutallier and Thomazeau at time-zero, whereas morphology of patients with low grade factors were almost similar to before surgery. Conclusions: Our results indicate that cross-sectional area of the initial repair appears to decrease after a few months postoperatively, possibly due to medial retraction or strained muscle.

A Study on the Characteristics of Lower Extremity Muscle Activation according to the Variable Weight Shift on the Affected Side in Hemiplegic Patients (편마비 환자의 마비측으로의 다양한 중심이동에 따른 하지 근육 활성도 특성에 관한 연구)

  • Kim, Kyung-Hwan;Park, Sung-Hun;Pak, Noh-Wook;Lee, Hye-Jin
    • PNF and Movement
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    • v.17 no.1
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    • pp.93-101
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    • 2019
  • Purpose: This study aimed to investigate lower extremity muscle activation to the variable weight shift on the affected side of patients with hemiplegia. Methods: Eighteen patients with chronic hemiplegia volunteered to participate in this study. All participants performed three types of weight shift (sideways, forward, and backward) in limits of stability on the affected side. Muscle activation in a paralyzed leg was measured with electromyography on the gluteus medius, tensor fasciae latae, rectus femoris, and biceps femoris; furthermore, the attached area was recommended by SENIAM projects. Each weight shift was performed three times, and then the mean value of the three measurements was analyzed. The data were analyzed by measuring the symmetrically standing position with the reference voluntary contraction (RVC) and was standardized with the percentage of RVC method. Results: No significant difference in lower extremity muscle activation occurred according to the three types of variable weight shift. However, significant differences in lower extremity muscle activation did occur with each weight shift position. In addition, activation increased at the rectus femoris and decreased at the gluteus medius and tensor fasciae latae. Conclusion: Hip abductor muscle strength training and variable weight shifts on the affected side must increase to improve patients'balance and limits of stability.

Comparison of factors among the regional oral health center for the disabled in Korea (우리나라 권역 장애인구강진료센터 이용자 만족요인 비교)

  • Jung, Yun-Sook;Choi, Yeong-Ae;Kang, Jae-Min;Lee, Young-Eun;Song, Keun-Bae
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.2
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    • pp.183-191
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    • 2021
  • Objectives: The purpose of this study was to identify the factors of satisfaction with regional oral health centers for people with disabilities in Korea. Methods: A survey was conducted with 784 patients who visited regional oral health care centers in Korea. A self-developed questionnaire (29 items) was adapted with a consent form and IRB (Institutional Review Board). All collected data were analyzed for statistics using SPSS version 25.0. Results: The study participants were 452 (57.7%) male patients, 207 (26.4%) aged 20-29 years old, and mostly had physical, developmental, and mental disabilities. The patients were introduced by their acquaintances, and the major reason for visit was specific dental care for the disabled. Most patients used their cars and took half to one hour to commute. The common factor affecting the comprehensive satisfaction was the facility satisfaction. Conclusions: A more comprehensive and standardized questionnaire should be developed for the annual evaluation of all centers. This study presents the basic data that can aid to activate the operation of the four oral health care centers for the disabled, which are scheduled to be implemented in the future, as well as 10 currently operated centers.

Effects of Bojungikgi-tang and its modifications for Anemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (빈혈에 대한 보중익기탕 및 그 가미방의 효과: 체계적 문헌고찰과 메타분석)

  • Mikyung Kim;Chang-ho Han
    • The Journal of Korean Medicine
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    • v.44 no.2
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    • pp.181-200
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    • 2023
  • Objectives: This study aimed to evaluate the efficacy and safety of Bojungikgi-tang (BJIG) and its modifications for patients with anemia. Methods: The subject of analysis of this study was a parallel design randomized controlled trial in which BJIG or its modifications was administered orally to patients who met the World Health Organization's anemia criteria and the efficacy and safety were prospectively measured. Electronic databases were searched to retrieve eligible literature published from 1 January 2000 to 12 February 2023. A meta-analysis was conducted, and the risk of bias (RoB) and level of evidence of the included studies was assessed using the Cochrane RoB 2 tool and GRADE method, respectively. Results: Five studies were included in the meta-analysis. When BJIG or its modifications was administered to anemia patients receiving conventional treatment, additional benefits compared to the non-administered group were found in terms of an increase in red blood cell count (mean difference (MD) 0.46 × 1012/L, 95% confidence interval (CI) 0.17 to 0.74), hemoglobin concentration (MD 9.28 g/L, 95% CI 6.06 to 12.51), hematocrit (MD 2.57%, 95% CI 1.76 to 3.38), total effective rate (odds ratio 5.29, 95% CI 2.05 to 13.68), and traditional Chinese medicine symptom scores (standardized MD -1.51, 95% CI -2.79 to -0.24). Conclusions: This study demonstrated the clinical potential of BJIG and its modifications to provide additional benefits to patients with anemia receiving conventional treatment.

Radiologic and clinical outcomes of an arthroscopic bridging graft for irreparable rotator cuff tears with a modified Mason-Allen stitch using a plantaris tendon autograft: a case series with minimum 2-year outcomes

  • Hyun-Gyu Seok;Sam-Guk Park
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.406-415
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    • 2023
  • Background: Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT. Methods: Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon. Results: A statistically significant improvement at the final follow-up was evident in scores for the VAS (-3.0, P=0.003), ASES (24.9, P=0.002), D ASH (-20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported. Conclusions: An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients. Level of evidence: IV.