• Title/Summary/Keyword: Standardized protocol

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The Relationship between Depressive Symptoms and Modifiable Lifestyle Risk Factors in Office Workers

  • Jin, Youngyun;Ha, Changduk;Hong, Hyeryun;Kang, Hyunsik
    • Journal of Obesity & Metabolic Syndrome
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    • v.26 no.1
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    • pp.52-60
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    • 2017
  • Background: This study investigated the relationship between depressive symptoms and physical fitness, obesity indices, and vitamin D status in office workers. Methods: The subjects were 514 adults with more 30 years of experience as office workers in the city of Seoul. Lifestyle risk factors, obesity indices, physical fitness, and serum vitamin D levels were assessed with a standardized protocol. The Beck Depression Inventory (BDI) was used to assess depression status. Vitamin D status was assessed by measuring serum 25-hydroxyvitamin D concentrations. Based on the BDI scores, participants were classified into no depression (ND, $BDI{\leq}9$), mild depression (MiD, $10{\leq}BDI{\leq}15$), and moderate depression (MoD, $16{\leq}BDI{\leq}23$) groups. Results: Compared with the high cardiorespriatory fitness group, the low cardiorespiratory fitness (men OR=2.618, women OR=1.596) an middle cardiorespiratory fitness group (men OR=1.256, women OR=1.110) had significantly higher odds ratio for having depressive symptoms, even after adjustment for age, hypertension, diabetes, hyperlipidemia, cardiovascular disease, alcohol intake, smoking, body mass index (BMI), percent body fat (%BF), and waist circumference (WC). Compared with the insufficient or deficient vitamin D group , the sufficient vitamin D group had significantly lower odds ratios for having depressive symptoms (men OR=0.121, women OR=0.114), even after adjustment for age, hypertension, diabetes, hyperlipidemia, cardiovascular disease, alcohol intake, smoking, BMI, %BF, and WC. Conclusion: Vitamin D supplementation and outdoor activities should be key components of a lifestyle intervention against office workers' depression.

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.

Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis

  • Mangkuliguna, Ghea;Glenardi, Glenardi;Natalia, Natalia;Pramono, Laurentius A.
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.299-316
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    • 2021
  • Background: The lack of effective medications for coronavirus disease 2019 (COVID-19) has led to a trend of drug repurposing such as the case of azithromycin which shows immunomodulatory and anti-viral effect. Several clinical trials have shown conflicting results. It is currently unclear whether the available evidence is in favor or against the use of azithromycin in COVID-19 patients. Thus, the aim of this study was to investigate the efficacy and safety of azithromycin in COVID-19 patients. Methods: Four independent reviewers selected relevant studies from PubMed, ScienceDirect, EBSCO, and ProQuest published prior to March 2021. The protocol used in this study has been registered in PROSPERO (CRD42020224967). Results: We included 17 studies and found that the mortality rate (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.76-1.19), need of respiratory support (OR, 1.30; 95% CI, 0.98-1.73), hospitalization rate (standardized mean difference, 0.12; 95% CI, -0.02 to 0.27), and intensive care unit transfer (OR, 1.21; 95% CI, 0.79-1.86) of azithromycin-treated group did not differ significantly (p>0.05) from those of the control group. Azithromycin treatment did not significantly increase the risk of getting secondary infection (OR, 1.23; 95% CI, 0.83-1.82), hypoglycemia (OR, 0.73; 95% CI, 0.38-1.40), gastrointestinal problems (OR, 1.03; 95% CI, 0.73-1.45) or electrocardiogram abnormalities (OR, 1.16; 95% CI, 0.94-1.42). The overall quality of evidence ranged from low to very low. Conclusion: Azithromycin did not result in a superior clinical improvement in COVID-19 patients, although it was well-tolerated and safe to use.

Efficacy of Computerized Cognitive Behavioral Therapy in Individuals with Non-Cardiac Chest Discomfort : Review and Suggestions for a New Protocol (비심인성 흉부 불편감을 가진 대상자에서 컴퓨터 기반 인지행동치료의 효과성 : 문헌 검토와 새로운 프로토콜 제안)

  • Lyoo, In Kyoon;Kim, Jungyoon;Kim, Jieun E.
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.1-7
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    • 2019
  • Since non-cardiac chest discomfort (NCCD) can result in substantial healthcare burden and lower quality of life, interventions such as cognitive behavioral therapy (CBT) have been investigated for the relief of NCCD. In this review, we aimed to summarize the evidence on the efficacy of the CBT for the treatment of NCCD while introducing a newly-developed computerized CBT program for NCCD. Studies applying CBT to individuals with NCCD were searched for from both English and Korean electronic databases. Among 37 studies, 11 randomized controlled trials, 4 case-control studies, 1 case series, and 2 review articles were eligible for this review. Efficacy of conventional CBT for NCCD was shown in a series of studies as most of them reported improved symptom severity of NCCD or NCCD-related anxiety. However, a substantial variability existed among these studies in participants, treatment procedures and durations. High attrition rates were also reported in these studies on conventional CBT. Computerized CBT could be an alternative to the conventional CBT as it can be standardized and more easily accessible, but it was only reported in one previous study. In addition to the literature review, we presented a newly-developed computerized CBT program for NCCD which may overcome some of the limitations of conventional CBT. A computerized CBT could be an alternative treatment of NCCD, however, need further studies on its usefulness.

Measurement of Uncertainty Using Standardized Protocol of Hand Grip Strength Measurement in Patients with Sarcopenia

  • Ha, Yong-Chan;Yoo, Jun-Il;Park, Young-Jin;Lee, Chang Han;Park, Ki-Soo
    • Journal of Bone Metabolism
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    • v.25 no.4
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    • pp.243-249
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    • 2018
  • Background: The aim of this study was to determine the accuracy and error range of hand grip strength measurement using various methods. Methods: Methods used for measurement of hand grip strength in 34 epidemiologic studies on sarcopenia were analyzed. Maximum grip strength was measured in a sitting position with the elbow flexed at 90 degrees, the shoulder in 0 degrees flexion, and the wrist in neutral position (0 degrees). Maximum grip strength in standing position was measured with the shoulder in 180 degrees flexion, the elbow fully extended, and the wrist in neutral position (0 degrees). Three measurements were taken on each side at 30 sec intervals. The uncertainty of measurement was calculated. Results: The combined uncertainty in sitting position on the right and left sides was 1.14% and 0.38%, respectively, and the combined uncertainty in standing position on the right and left sides was 0.35 and 1.20, respectively. The expanded uncertainty in sitting position on the right and left sides was 2.28 and 0.79, respectively, and the expanded uncertainty in standing position on the right and left sides was 0.71 and 2.41, respectively (k=2). Conclusions: Uncertainty of hand grip strength measurement was identified in this study, and a significant difference was observed between measurement. For more precise diagnosis of sarcopenia, dynamometers need to be corrected to overcome uncertainty.

A Study on the Weavigation Service for Smart Devices that Reflects the Real-Time Weather Conditions in Vulnerable Area (취약지역 실시간 기상상황을 반영한 스마트기기용 웨비게이션 서비스 연구)

  • Bae, Kwang Yong;Lee, Jae Eun;Kim, Young Beom
    • Journal of Climate Change Research
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    • v.4 no.4
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    • pp.385-395
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    • 2013
  • In this paper, we target to develop weather platform and services to use in smart devices which is in real-time mobility environment. The existing TPEG-based navigation service requires a dedicated terminal, DMB communication method, and service scalability, so there are limits. In this paper, we analyze, processing and storage the real-time weather information suitable for navigation on the end user's smart devices by weather information service platform has been developed that can provide a standardized. In addition, we develop weavigation services and API for the developer to develop weather services easily. And we introduce system for serving information of dangerous district forecast based on natural disaster dangerous district data.

Utility of Spinal Injury Diagnosis Using C-Spine Lateral X-Ray and Chest, Abdomen and Pelvis Computed Tomography in Major Trauma Patients with Impaired Consciousness

  • Jang, Yoon Soo;So, Byung Hak;Jeong, Won Jung;Cha, Kyung Man;Kim, Hyung Min
    • Journal of Trauma and Injury
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    • v.31 no.3
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    • pp.151-158
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    • 2018
  • Purpose: The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness. Methods: The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods. Results: One hundred patients with Glasgow coma scale ${\leq}13$ underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures. Conclusions: C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

A Comparison between Importance of Nursing Management Clinical Practicum and Practical Experience recognized by Nursing Students (간호대학생이 인식한 간호관리학 실습 중요도와 실습경험도 비교)

  • Hwang, Sung-Woo;Koo, Ok-Hee
    • Journal of the Korea Convergence Society
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    • v.10 no.9
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    • pp.351-361
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    • 2019
  • Importance recognition of the nursing management(N. M.) clinical practice contents and the actual practical experience were studied against 289 students of 3 nursing schools who had undergone the senior N. M clinical practice. The most important item they considered from the practical evaluation was responsibility followed by interpersonal relationship, trust, communication, and ethic. For the importance of the N. M. contents, nursing unit management was considered as the most important(4.37/5). Abilities they could actually experience from the clinical practice were nursing unit management(22.0%), understanding of nursing management(20.7%), and human resource management(19.8%). And, abilities they could never experience were marketing(52.4%) and financial management(44.0%). Since there was an inconsistency between the importance of contents students recognized and the actual experience, I suggest a completion of standardized protocol of N. M. clinical training and implementation of management training exclusive preceptor system.

Effects of Herbal Medicines on Osteoporosis in Rheumatoid Arthritis: Study Protocol for a Systematic Review and Meta-Analysis (한약이 류마티스 관절염 환자의 골다공증에 미치는 영향: 체계적 문헌 고찰 및 메타분석을 위한 프로토콜)

  • Kwon, Do Young;Gu, Ji Hyang;Lee, Eun Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.77-84
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    • 2022
  • Objectives This study is designed to identify the effectiveness of herbal medicine for osteoporosis in rheumatoid arthritis. Methods We will investigate 10 databases, 4 Korean databases (KoreaMed, KMBASE, Koreanstudies Information Service System [KISS], ScienceOn) and 6 of abroad (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], WanFang, Citation Information by NII [CiNii]) without publication date, language limitation for clinical study of herbal medicine for osteoporosis in rheumatoid arthritis. Type, dose, duration, frequency of herb medicine will be analyzed. Results Randomized controlled trials about herbal medicine or herb extract for osteoporosis in rheumatoid arthritis should be included in the study. Cochrane's risk of bias tools will be used to assess quality of the study. Mean differences or standardized mean differences of 95% confidence intervals will calculated and data synthesis will be conducted using Review Manager (RevMan, ver.5.3; The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Conclusions It is expected to provide basic data for the active use of herb medicine by systematically synthesizing and analyzing the actual situation, effectiveness, and safety of herb medicine for osteoporosis in rheumatoid arthritis.

Effect of feeding fermented soybean meal on broiler chickens' performance: a meta-analysis

  • Irawan, Agung;Ratriyanto, Adi;Respati, Adib Norma;Ningsih, Niati;Fitriastuti, Rahma;Suprayogi, Wara Pratitis Sabar;Hadi, Rendi Fathoni;Setyono, Wahyu;Akhirini, Novi;Jayanegara, Anuraga
    • Animal Bioscience
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    • v.35 no.12
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    • pp.1881-1891
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    • 2022
  • Objective: The present study aimed to quantify the effects of fermented soybean meal (FSBM) on broiler chickens' performance by employing a meta-analysis approach. Methods: A total of 16 studies were included in the database after being systematically selected using a PRISMA protocol. Hedges' g effect size was used to quantify pooled standardized mean difference (SMD) using random-effects models at 95% confidence intervals (95% CI). Publication bias among studies was computed with Egger's test and visualized using funnel plots. Results: Results indicated that dietary FSBM inclusion increased final body weight (BW) (SMD = 0.586, 95% CI: 0.221 to 0.951, p = 0.002) of broiler chickens, particularly in starter period (SMD = 0.691, 95% CL: 0.149 to 1.233, p = 0.013) while in the finisher period, the effect was weaker (SMD = 0.509, 95% CI: 0.015 to 1.004, p = 0.043). Average daily gain (ADG), feed intake (FI), and feed conversion ratio (FCR) were not affected with FSBM inclusion when compared to control. Subgroup analysis revealed that FI increased in starter period (SMD = 0.582, 95% CI: 0.037 to 1.128, p = 0.036). When considering types of microorganism as moderating variables in the subgroup analysis, we found that Aspergillus oryzae, mixed probiotics+bromelain protease, Bacillus subtilis, and Lactobacillus bacteria significantly increased ADG and FI (p<0.01). Additionally, either Bacillus subtilis+protease or Bacillus subtilis alone decreased FCR (p<0.001). However, meta-regression analysis showed that levels of FSBM inclusion had no effects on final BW (p = 0.502), ADG (p = 0.588), FI (p = 0.861), and FCR (p = 0.462). Conclusion: Substituting SBM in broiler chickens' diet with FSBM improved BW of broiler chickens, especially in the starter period whereas the effects on ADG, FI, and FCR were mostly dependent on microbial strains used for fermentation.