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Factors Influencing Sleep Disturbances among Older Adults Living within a Community (재가노인의 수면 관련요인)

  • Jeon, Bo Min;Choi-Kwon, Smi
    • Korean Journal of Adult Nursing
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    • v.29 no.3
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    • pp.235-245
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    • 2017
  • Purpose: Reported insomnia and decreased sleep quality are common among older adults. The purpose of this study was to identify factors contributing to insomnia and decreased sleep quality among elderly persons living within a community. The data will be verified with Actigraph which is a non-invasive measurement of rest/activity cycles. Methods: 137 participants over 65 years old were recruited from a senior welfare center. Their mean age was $74.07{\pm}5.18years$ old and majority was women (69.3%). The quality and quantity of nighttime sleep were assessed using Varren-synder-Halper Sleep Scale and a sleep log. Depression and fatigue were assessed using Geriatric Depression Scale Short Form and Fatigue Severity Scale, respectively. Pain was assessed using 11-point Numeric rating scale. An actigraph was used to verify the self-reported sleep. Results: Ninety-two participants (67.2%) reported insomnia. Sixty-eight subjects (49.6%) reported good sleep. Of the participants, 56.2% reported depression and 33.6% reported fatigue. In logistic regression, depression was related to insomnia (OR=3.09, p=.003). Sleep quality was related to depression (OR=2.13, p=.045) and fatigue (OR=2.24, p=.044). The data from the Sleep logs correlated with data obtained from the actigraph. Conclusion: Depression significantly influenced insomnia and sleep quality whereas fatigue only influenced sleep quality. Thus, depression and fatigue should be closely monitored among elderly persons with sleep disturbances.

The Effect of Arm Training in Standing Position on Balance and Walking Ability in Patients with Chronic Stroke (선 자세에서 상지 훈련이 만성 뇌졸중 환자의 균형과 보행 능력에 미치는 영향)

  • Bang, Dae-Hyouk;Cho, Hyuk-Shin
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.2
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    • pp.75-82
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    • 2017
  • PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant between-group difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.

Verification of the Reliability and Validity of the Short Form 36 Scale in Indonesian Middle-aged and Older Adults

  • Arovah, Novita Intan;Heesch, Kristiann C.
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.3
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    • pp.180-188
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    • 2020
  • Objectives: The Short Form 36 (SF-36) questionnaire is increasingly being used to measure health-related quality of life (HRQoL) in Indonesia. However, evidence that it is valid for use in Indonesian adults is lacking. This study assessed the validity and reliability of the SF-36 in Indonesian middle-aged and older adults. Methods: Adults aged 46-81 years (n=206) in Yogyakarta, Indonesia completed the SF-36, another measure of HRQoL (the EuroQoL visual analogue scale [EQ-VAS]), and measures assessing their demographic characteristics. Fifty-four percent (n=121) completed the SF-36 measure again 1 week later. Confirmatory factor analysis was conducted to confirm the factor structure of the SF-36. Internal consistency reliability was estimated using Cronbach's alpha, and test-retest reliability was assessed using intraclass correlations. Convergent and discriminant validity were assessed by computing correlations among SF-36 subscales, between subscales and the 2 component scores, and between component scores and EQ-VAS scores. Results: Most scaling assumptions were met. The hypothetical factor structure fit the data poorly (root mean square error of approximation [RMSEA]=0.108) and modification was required for a good fit (RMSEA=0.060). Scores on all subscales demonstrated acceptable internal consistency (α>0.70) and test-retest reliability (r>0.70). Divergent validity was supported by weak to moderate interscale correlations (r=0.19 to 0.64). As expected, the 2 summary scores were moderately to strongly correlated with the EQ-VAS (r>0.60). Conclusions: The findings adequately support the use of SF-36 in Indonesian middle-aged and older adults, although the optimal algorithm for computing component scores in Indonesia warrants further investigation.

Validation of the International Classification of Diseases l0th Edition Based Injury Severity Score(ICISS) - Agreement of ICISS Survival Probability with Professional Judgment on Preventable Death - (외상환자 중증도 평가도구의 타당도 평가 - ICISS 사망확률과 전문가의 예방가능한 사망에 대한 판단간의 일치도 -)

  • Kim, Yoon;Ah, Hyeong-Sik;Lee, Young-Sung
    • Health Policy and Management
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    • v.11 no.1
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    • pp.1-18
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    • 2001
  • The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.

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Effects of Extracorporeal Shock Wave Therapy with Myofascial Release Techniques on Pain, Movement, and Function in Patients with Myofascial Pain Syndrome (근막통증 증후군 환자에게 체외충격파와 근막이완술 병행 치료가 통증, 움직임, 기능에 미치는 영향)

  • Choi, Won-Jae;Nam, Eun-Jung;Kim, Hyun-Joong;Lee, Seung-Won
    • PNF and Movement
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    • v.18 no.2
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    • pp.245-254
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    • 2020
  • Purpose: The study investigated the effects of extracorporeal shock wave therapy with myofascial release techniques (ESWT+MFR) on pain, movement, and function in patients with myofascial pain syndrome. Methods: Forty participants with upper trapezius trigger points were recruited and randomly allocated to two groups: an experimental group (n = 20) and a control group (n = 20). The experimental group performed the ESWT+MFR, and the control group performed only myofascial release techniques. Each group was treated for 15 minutes, twice a week for four weeks. Pain was assessed using a visual analogue scale and a pressure pain threshold measure. Movement was assessed by cervical range of motion, and cervical and shoulder function were assessed on the Constant-Murley Scale and the Neck Disability Index before and after treatment. Results: The results indicate statistically significant improvements in the two groups on all parameters after intervention as compared to baseline (p < 0.05). As compared to the control group, the experimental group showed statistically significant improvements on the visual analogue scale and pressure pain threshold, cervical range of motion (except rotation), and on the Neck Disability Index (p < 0.05). Conclusion: The ESWT+MFR is more effective than myofascial release techniques for pain, movement, and function in patients with myofascial pain syndrome and would be clinically useful for physical therapists treating myofascial pain syndrome.

Evaluation of Ceramics, Alumina and Silicone Carbide Added Concrete Surface Protecting Agent (세라믹스, 알루미나 및 실리콘 카바이드 혼합물이 첨가된 콘크리트 표면보호재의 성능 평가)

  • Kong, Jin-Hee;Kim, Young-Geun;Oh, Sang-Keun
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2009.11a
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    • pp.43-46
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    • 2009
  • The purpose of this study is to enhance durability of concrete structures that uses this surface protecting material by carrying out the performance test of the surface protecting material of concrete, and as s result, we reached out the conclusion as follow. 1. As a result of the test measuring the stability and adhesive power of conductive film against ultraviolet, freezing & thawing, and damage from seawater that deteriorate the surface protecting material, it was turned out to meet the performance criteria specifying in the KS standard enough to gain a good evaluation to use as a surface protecting material. 2. As a result of the test identifying the neutralization-furtherance, it was assessed to be capable of protecting effectively concrete structures from carbonic acid gas by a very low depth of 0.1mm of neutralization. 3. As a result of the test identifying Penetrated Resistance Properties of chloride ion, as it was turned out to have a very low value of 819 Coulombs, it was assessed that even in the environment where the corrosion by chloride such sea environment is very affective, the film can effectively protect the concrete structure. 4. As a result of the test identifying freezing & thawing, as there was no change in reduction of mass after 400 cycle, it was assessed that the film has a good resistance against freezing & thawing. According to the results of study above, it is expected that this technology can extend its durability of concrete structure and be widely used for concrete structure through means (methods) to prevent the neutralization and damage from seawater as original purposes of the surface protecting material.

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Effects of Lumbar Mobilization for Lower Limb Strength in Healthy Individuals: A Protocol for Systematic Review and Meta-Analysis

  • Choi, Wansuk;Choi, Taeseok;An, Hojung;Kim, Jisung;Heo, Seoyoon
    • Journal of International Academy of Physical Therapy Research
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    • v.11 no.2
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    • pp.2096-2101
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    • 2020
  • Background: The effect of mobilization on lumbar back pain has been fully described in several clinical aspects, but evidence for muscle strength would be still less clear. Objective: To assess the effect of lumbar mobilization on lower limb strength in healthy individuals. Methods and Analysis: Healthy people aged 18-65 will be included regardless of race or sex. Original peer-reviewed primary reporting randomized controlled trials (RCTs) will be included. Electronic databases, such as MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Pedro, CINAHL, ClinicalTrials.gov will be searched from inception until July 30. Only studies published in English will be included in this review. Two reviewers will complete the screening for eligibility independently, and the other two reviewers will also complete the risks of data extraction and bias assessment independently. Lower Limb strength will be assessed as primary outcome, and particular intervention or participant characteristics will be assessed as the secondary outcomes. Meta-analysis will be conducted using Review Manager 5.3.3, and evidence level will be assessed using the method for Grading of Recommendations Assessment, Development and Evaluation. Outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. If I2 ≤ 50%, P>.1, the fixed effect model will be used, otherwise, random-effects model will be used. Ethics and dissemination: This review might not be necessary ethical approval because it does not require individual patient's data; these findings will be published in conference presentations or peer-reviewed journal articles. PROSPERO registration number: CRD42020150144.

Integrity of human sperm DNA assessed by the neutral comet assay and its relationship to semen parameters and clinical outcomes for the IVF-ET program

  • Chi, Hee-Jun;Chung, Da-Yeon;Choi, Soon-Young;Kim, Jong-Hyun;Kim, Gi-Young;Lee, Jae-Seok;Lee, Hee-Sun;Kim, Myung-Hee;Roh, Sung-Il
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.1
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    • pp.10-17
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    • 2011
  • Objective: To explore potential relationships between sperm DNA integrity and both semen parameters and clinical outcomes. Methods: Semen analysis of 498 samples was performed according to the 2010 criteria of the World Health Organization. The sperm DNA fragmentation Index (DFI) of the semen samples was assessed using a neutral comet assay. Results: Sperm DFI showed a significant correlation with semen parameters, including the patient's age, sperm viability, motility, morphology, and number of leukocytes (p<0.05). The sperm DFI values for asthenozoospermic (15.2%), oligoteratozoospermic (18.3%), asthenoteratozoospermic (17.5%), and oligoasthenoteratozoospermic semen samples (21.3%) were significantly higher than that observed in normozoospermic semen samples (10.5%, p<0.05). A sperm DFI value of 14% was used as a threshold of sperm DFI in assessing whether DNA was highly damaged. In 114 IVF-ET cycles, the fertilization rate of the sperm DFI <14% group (70 cycles, 61.7%) was significantly higher than that observed for the ${\geq}14%$ group (44 cycles, 55.3%), but there was no difference in the other clinical outcomes between the two groups. In the ${\geq}14%$ group, the pregnancy rates of the ICSI cycles (40.0%) and half-ICSI (44.0%) were higher than conventional IVF cycles (30.7%), but the difference was not statistically significant. Conclusion: Along with the conventional semen analysis, the sperm DFI assessed using the comet assay was shown to improve the quality of the semen evaluation. To evaluate the precise effect of ICSI on pregnancy rates in the patients who demonstrate high sperm DFI values, further study is necessary.

A Study on Nutritional Status after Gastrectomy of Gastric Cancer Patients in Jeonbuk Province (전북지역 위암환자의 위절제술 전.후 영양상태 평가)

  • Jeong, Mi-Jin;Kim, Chan-Young;Kim, Sook-Bae
    • Korean Journal of Community Nutrition
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    • v.11 no.6
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    • pp.785-792
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    • 2006
  • The purpose of this study was to investigate the nutritional status before and after gastrectomy of gastric cancer patients in Jeonbuk Province. The subjects were 136 patients with gastrectomy of gastric cancer. We assessed the nutritional status before and after an operation by general characteristics (age, clinicopathological stage, type of operation, method of reconstruction), anthropometric characteristics (height, weight, skeletal muscle mass, body fat mass, body mass index (BMI), percent body fat, arm muscle circumference AMC, arm circumference AC) and biochemical characteristics (hemoglobin Hb, hematocrit Hct, mein corpuscular volume MCV, mean corpuscular hemoglobin MCH, total lymphocyte count TLC, serum albumin, serum transferrin). Mean ages were 60.0 yrs in males and 58.8 yrs in females. Age, clinicopathological stage, types of operation and reconstruction methods were not significantly different between males and females. Weight, skeletal muscle mass, body fat mass, BMI, percent body fat, AMC and AC significantly deteriorated by gastrectomy. There were severe weight losses in males and females after gastrectomy. Hemoglobin, Hct, MCV, MCH, TLC, albumin and transferrin significantly deteriorated by gastrectomy. After gastrectomy, subjects who were assessed as malnounrished in Hb and Hct were increased in male and those who were assessed as malnounrished in Hb were increased in females. These results suggest that a nutrition intervention, specially for energy, protein and iron, is necessary to improve the nutritional status of gastric cancer patients with gastrectomy.

A Pilot Study to Evaluate the Efficacy and Safety of Treatment with Botulinum Toxin in Patients with Recalcitrant and Persistent Erythematotelangiectatic Rosacea

  • Park, Kui Young;Kwon, Hyun Jung;Kim, Jae Min;Jeong, Guk Jin;Kim, Beom Joon;Seo, Seong Jun;Kim, Myeong Nam
    • Annals of dermatology
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    • v.30 no.6
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    • pp.688-693
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    • 2018
  • Background: There are few pharmacologic options to reduce erythema and flushing in patients with recalcitrant erythematotelangiectatic rosacea (ETR). We previously reported two cases of refractory flushing and erythema of rosacea that were successfully treated with intradermal botulinum toxin injection, and additional research is needed to prove the efficacy and safety of this treatment. Objective: To report the efficacy and safety of botulinum toxin injection as an aid in persistent erythema of rosacea patients. Methods: A total of 20 Korean patients with recalcitrant ETR were enrolled to receive treatment by injection of botulinum toxin. Patients received one treatment of intradermal botulinum toxin injection and were assessed 1, 2, 4, and 8 weeks after treatment. The severity of erythema and telangiectasia was investigated by a non-treating physician, and the Erythema Index (EI) was assessed by mexameter at each visit. Patient satisfaction and any adverse events were also assessed at each visit. Results: 17 patients completed all follow-up visits and were included in the analysis. Intradermal injection of botulinum toxin significantly reduced erythema severity and EI in ETR patients. Patients reported a satisfaction score of $2.94{\pm}0.56$ at 8 weeks after treatment. Except for three patients who discontinued the study early due to inconvenience of facial muscle paralysis, 17 patients participating in the final analysis did not report side effects except injection pain at the time of the procedure. Conclusion: Intradermal injection of botulinum toxin can be used as an effective and relatively safe adjuvant agent for recalcitrant and persistent erythema of ETR patients.