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Does oral doxycycline treatment affect eradication of urine vancomycin-resistant Enterococcus? A tertiary hospital study

  • Kim, Yoonjung;Bae, Sohyun;Hwang, Soyoon;Kwon, Ki Tae;Chang, Hyun-Ha;Kim, Su-Jeong;Park, Han-Ki;Lee, Jong-Myung;Kim, Shin-Woo
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.112-121
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    • 2020
  • Background: Vancomycin-resistant Enterococcus (VRE) has become more common in nosocomial infections, especially in urine samples. However, until now, no treatment regimen has been proven to effectively eradicate urine VRE colonization. Therefore, to evaluate the efficacy of doxycycline in eradicating urine VRE and shortening VRE isolation period, we compared VRE colony detection period between doxycycline-treated and untreated patients. Methods: A retrospective cohort study of 83 patients with VRE colonization in urine cultures was conducted at a tertiary academic hospital from January 2011 to February 2018. Kaplan-Meier survival analysis was used to evaluate eradication rates in the treatment and non-treatment groups. Factors affecting urine VRE colonization persistence were analyzed by multiple logistic regression analysis. Results: The overall rate of VRE eradication during the entire hospital stay was higher in the doxycycline treatment group (90.5%) than in the non-treatment group (58.1%, p=0.014). Survival analysis showed that the 5-, 10-, and 20-day cumulative eradication rates were 78.3%, 100%, and 100% in the doxycycline treatment group, and 18.5%, 45.7%, and 67.8% in the non-treatment group, respectively, thereby indicating that eradication rates were higher in the doxycycline treatment group than in the non-treatment group (p<0.001). Only doxycycline treatment was shown to affect urine VRE colonization persistence in multivariate logistic regression analysis. Conclusion: Doxycycline treatment enhanced the eradication rate of urine VRE colonization and appeared to be useful in shortening VRE isolation period.

Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • v.12 no.6
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

Effects of an Abdominal Obesity Management Program on Physiological Bio-markers of Middle-aged Women in Korea: A Meta-analysis (국내 중년기 비만 여성의 생리적 지표에 대한 복부비만관리프로그램의 효과: 메타분석)

  • Kim, KyengJin;Hong, HaeSook;Park, WanJu;Ko, SangJin;Na, YeonKyung
    • Journal of Obesity & Metabolic Syndrome
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    • v.25 no.3
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    • pp.138-148
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    • 2016
  • Background: The purpose of this study is to analyze the effects of an abdominal obesity management program in middle-aged women in Korea. Methods: Examination of databases, including the Research Information Sharing Service, Database Periodical Information Academic, and Korean Studies Information, resulted in identification of 772 studies performed up to 2014, of which 43 satisfied the inclusion data. Data analysis was performed using R version 3.2 to calculate the effect sizes, explore possible causes of heterogeneity, and check for publication bias, using a funnel plot and its trim-and-fill analysis. Results: The mean effect size of the management program was small (g=0.22), along with the anthropometric index (g=0.18), metabolism index (g=0.21), fat-distribution (g=0.36), and inflammatory index (g=0.36). Moderator analysis was performed to determine heterogeneity, but no significant differences were found between the randomized controlled trial (RCT) group and non-RCT group. In addition, the length of the session was found to be statistically significant after performing a meta-regression. Finally, a funnel plot with a trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, the abdominal obesity management program affects middle-aged women in Korea. Further research is needed to target other age groups with abdominal obesity.

Association between Participation in Social Activities and Mortality (중고령층 집단의 사회활동 참여와 사망률의 연관성 분석)

  • Kim, Young Guen;Yang, Jeong Min;Kim, Jae Hyun
    • Health Policy and Management
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    • v.31 no.4
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    • pp.462-471
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    • 2021
  • Background: The purpose of this study was to identify the association between participation in social activities and mortality rates for those aged 45 aged and older in Korea. Methods: In this study, the 1st to 6th Korea Longitude Study of Aging was used to analyze 10,217 people excluding missing values among middle and old age groups aged 45 or older. The scope of social activities was classified into "religious gatherings," "religious gatherings," "leisure/cultural/sports-related organizations," and "clubs/hometowns/religious associations," and analyzed using a chi-square test and Cox proportional risk model. Results: In the case of non-participating groups in religious activities, the mortality rate was 1.24 times higher (hazard ratio [HR], 1.24; p=0.000) than those of the participating group. The non-participating group of social gatherings had a 1.27 times higher mortality rate (HR, 1.27; p<0.0001) than the participating group. In addition, the mortality rate of non-participating groups related to leisure/cultural/sports was 1.79 times higher (HR, 1.79; p=0.000). The mortality rate of the group that did not participate in the alumni association/festival/folklore society was 1.51 times higher than that of the participating group (HR, 1.51; p<0.0001). As a result of correcting the control variable to analyze the relationship between the number of participants in social activities and the mortality rate, the mortality rate of the group participating in one or less social activities was 2.26 times higher (HR, 2.26; p<0.0001) compared to the four or more social activity participating groups, and the mortality rate of the 1-3 social activities was 1.64 times higher (HR, 1.64; p<0.0001). Conclusion: As a result of the study, it was found that participation in social activities of the middle-aged and elderly groups was effective in reducing mortality, and in particular, it was found that there was a strong relationship with mortality in less than one social activity group. Therefore, it is intended to provide an academic basis for lowering the mortality rate of the group in line with the continuous improvement of domestic social activity participation conditions, and through this, this study can be expected to serve as a policy and institutional basis for lowering the mortality rate of the group.

The Smart Phone Taxi Application Using State, Value Perception and Satisfaction among Chinese Consumers (중국 소비자들의 스마트폰 택시 앱 이용실태, 가치속성에 대한 지각과 만족도)

  • Yang, Zhen;Wang, Da Woon;Choi, Hye Kyong
    • International Area Studies Review
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    • v.22 no.1
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    • pp.141-159
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    • 2018
  • The study aims to explore the factors that affect the value perception, satisfaction, and frequency of smart phone taxi applications in Shanghai, China, and commuters. According to a survey conducted on the actual use of taxi application, the majority of the customers responded that they have been using taxi apps for more than one or two years, and the results showed that they use taxi apps once or twice a week. It also showed that the actual use of taxi apps varies depending on their age and academic background. Among the value attributes of smart phone taxi applications, the respondents perceived ease of use as the highest at 4.41 points out of 5 point scale, while the risk perception was the lowest at 3.34 points. Finally, when social demographic characteristics and the nature of taxi app use were controlled, the value perception variables had a significant influence on taxi application satisfaction. The higher the perception of service quality, usefulness, and system usability, the higher the satisfaction levels were. In particular, the impact of perceived usefulness and system usability perception was high.

The Effects of Elderly's Socio-economic Deprivation Experience on Suicidal Ideation (사회경제적 박탈 경험이 노인의 자살생각에 미치는 영향: 6가지 박탈 유형을 중심으로)

  • Kang, Dong Hoon;Kim, Yun Tae
    • 한국노년학
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    • v.38 no.2
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    • pp.271-290
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    • 2018
  • The study aims to analyze the effects of socio-economic deprivation on suicidal ideation. The analysis data were used as a guide for Korea Welfare Panel Study 9. the frequency analysis, mean difference analysis, correlation analysis, and logistic regression were performed by SPSS programs. The results of analysis are as follows. First, The results of frequency analysis by deprivation type showed a high frequency of deprivation in the following order. Experience of not receiving a public pension, experience of being able to work but unemployed, experience of not being able to eat a balanced diet due to financial difficulties, and experience where you had nothing to eat but no more money to buy. Second, the average difference analysis shows that when a person does not have a spouse, the lower the academic background and the income level, the higher the likelihood of suicide. Third, regression analysis shows that the following deprivation patterns have a statistically significant effect on older adults' thoughts of suicide. Experience in which the respondents or their family could not go to hospital because they had no money, experience that move house because is back rent more than 2 months or can not pay rent, experience that they could not afford to buy food and eat well-balanced meals, experience of failing to pay your bills on time, experience of being able to work but not having a job, and experience in which financial difficulties left them short of food and no money to live. Based on such research results, some policy measures, such as the expanding management of medical care benefits cases, the improvement of elderly housing, residential conditions and the diet survey for the elderly, and the expansion of measures to support elderly people's tax rates, were proposed.

Influence of Recognition for Health Care Accreditation on Patient Safety Managing Activities of Nursing Staffs in Geriatric Hospital (의료기관 인증제에 대한 인식이 요양병원 간호인력의 환자안전관리 활동에 미치는 영향)

  • Kweon, Myeung Sook;Jo, Hyun Sook
    • 한국노년학
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    • v.38 no.1
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    • pp.15-26
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    • 2018
  • This study was aimed to investigate the influencing level of nursing staff's recognition for the health care accreditation on patient safety managing activities by identifying the relationship between them and other factors affecting on patient safety managing activities. Subjects of this study were 182 nursing staffs working in six geriatric hospitals accredited for health care in Seoul metropolitan area. Data was collected during April, 2016 by structured questionnaires. And SPSS/WIN 15.0 program with t-test, ANOVA, Pearson's correlation, and stepwise multiple regression analysis were employed for analyzing them. 96.2% of the subjects have recognized the accreditation and 31.8% of them have acknowledge it in detail. The average level of recognition for the health care accreditation and patient safety managing activity were 3.60 and 4.39 point (max.5.0) respectively. Correlation between them was positive(r=.339, p<.001). Significant factors influencing patient safety managing activity were internal service quality promotion (t=5.292, p<.001) and academic background (t=2.836, p=.005). Education program or information on health care accreditation system, and action plans for promoting internal service quality for the nursing staffs including job standardization of the jobs are recommended for the better patient safety managing activities.

A Systematic Study of Computer-Based Driving Intervention Program for Elderly Drivers (노인 운전자에게 적용한 컴퓨터 기반 운전중재 프로그램에 관한 체계적 고찰)

  • Kim, Deok Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.293-302
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    • 2019
  • This study systematically analyzed computer-based driving intervention programs for seniors, to provide the academic background for driving intervention for seniors. Articles published from January 2009 till December 2018 were researched and analyzed. 'PubMed, Google Scholar, and Science Direct' were used to search articles published overseas, and 'RISS, KERIS, and KISS' searched for articles published in Korea. Based on the inclusion and exclusion criteria, totally 359 papers were retrieved, and 10 articles were finally analyzed; 8 articles (80%) were evidence level I, and 2 articles (20%) were evidence level III. Amongst the computer-based interventions, driving simulators (70%) were the most common, followed by two video image training (20%) and one Nintendo Wii program (10%). In most studies, driving simulators trained the cognitive and visual abilities of seniors and enhanced their abilities to cope with risk situations under various simulated circumstances. Other interventions were also reported to have a positive effect. For evaluating elderly drivers, the driving performance evaluation using a driving simulator was the most common; in addition, evaluations of attention, space-time ability, cognitive function, risk perception, depression and anxiety were also commonly used. We believe that it is appropriate to employ computer-based driving intervention programs for seniors to train and evaluate various domains. We expect that these interventions can be used as an effective tool for safe driving.

A Study on the Use of the Media for Positive Perception and Attitude towards People with Mental Illness: Focusing on Depression, Obsessive-Compulsive Disorder, and Panic Disorder (정신질환자에 대한 태도와 인식 개선을 위한 대중매체 활용 방안 연구 : 우울증, 강박증, 공황장애를 중심으로)

  • Park, Jong-Ho;Lee, Hyun-Sim
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.250-263
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    • 2019
  • This study aimed to improve the public perception of people with mental illness by suggesting the need for public efforts and proposing specific plans. Demographic differences in the attitudes towards mental illness, the need of public service announcements to improve public perception of mental illness, and the current and expected situation of each advertising medium were analyzed, and plans to improve the advertising were proposed. Three mental illnesses that are possible to recover from through treatment-depression, obsessive-compulsive disorder(OCD), and panic disorder-were examined primarily, and the general public residing in Seoul and the capital area were surveyed. A comparison of the respondents' attitudes towards people with mental illness showed that there were significant differences in their attitudes with respect to gender, marital status, age, and family history. On the other hand, there was no significant difference with respect to religion, monthly income, or academic background. Most of the respondents recognized that public efforts to improve the public perceptions of mental illness, i.e., efforts through the mass media, were necessary and should be intensified though television, Internet, radio, billboard, and transport advertising. Based on the above findings, this study highlights the necessity for advertising through mass media for positive public perceptions of people with mental illness and proposes plans to intensify the advertising, focusing on social, organizational, and individual levels.

Analysing the Use of Test Tools in Science-Related Affective Domain and its Improvements (과학 관련 정의적 영역 검사 도구 활용 및 개선 내용 분석)

  • Chung, Sue-Im;Shin, Donghee
    • Journal of The Korean Association For Science Education
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    • v.39 no.2
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    • pp.263-277
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    • 2019
  • This study analyzed the current use of science-related test tools in affective area in Korean academic journals for the last 30 years since 1989 and the cases of modification of the original tools related to the tools. This provides practical information on the development and improvement of test tools in the future and offers the basis for developing valid test tools. The study was conducted in two stages. We analyzed the status of 88 domestic science education researches dealing with testing tools related affective characteristics and 57 domestic and foreign resource tools referenced by them. After that, we compared the characteristics of the five cases in which the original tool was revised and the concrete item correction examples. The results were analyzed as follows: topics that have emerged continuously or that have recently begun to appear in domestic research, the research situations according to their purpose and measurement methods used by the tool, and use state of original tools. The background and key points of revision were analyzed for the five tools, TOSRA, SAI, PISA items, STEBI-A/B, SMQ, whose revision process were disclosed. In addition, the changes of the items were analyzed by comparing the four test items with the questions before and after the revision. As a result of item analysis, item improvement was proceeding in the direction of enhancing readability, clarifying meaning, and changing items according to change of sub constructs. The implications of this study are as follows: notes on interpreting the results obtained from the tool with multiple mixed constructs, the possibility of the testing tool that broadens the horizon of the research, error recognition in the subjective self-report, and notes when applying test tools from other disciplines to science.