Mohamad Y. Fares;Jaspal Singh;Amar S. Vadhera;Jonathan Koa;Peter Boufadel;Joseph A. Abboud
Clinics in Shoulder and Elbow
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제26권3호
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pp.238-244
/
2023
Background: Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. Methods: An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). Results: Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages. Conclusions: Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV.
Objectives: This study aims to contribute to the prevention of dental diseases and health care in the elderly by investigating the relationship among the experiences of chronic diseases, dental health status, and the behaviors in the Korean elderly people. Methods: A total of 2,856 elderly people aged 65 or older were selected as the final analysis subjects using data from the 6th National Health and Nutrition Examination Survey (2013-2014). Chronic diseases were defined as 'cardiocerebrovascular diseases', 'diabetes', 'chronic respiratory diseases', and 'cancer' diagnosed by the doctors. For the statistical analysis, SPSS 21.0 for Windows was used. Descriptive analysis and a Chi-square test were conducted to investigate the relationship among the experiences of chronic diseases, general characteristics, dental health status, and the behaviors in the Korean elderly. Finally, logistic regression analysis was performed to investigate the relationship among the experiences of chronic diseases, dental health status, and the behaviors. Results:The prevalence of Cardiocerebrovascular diseases was significantly higher in the 3-4 group of community periodontal index with the score of 1.36 (95% CI 1.03-1.00) than in the 0-2 group. The prevalence of Cardiocerebrovascular diseases was significantly higher in the group without dental examination during the past one year with the score of 1.29 (95% CI 1.00-1.66). The prevalence of diabetes was significantly higher in the uncomfortable speaking state group with the score 1.46 (95% CI 1.12-1.91). The prevalence of cancer was significantly higher in the partial denture needs group with the score 1.67 (95% CI 0.98-2.83). Conclusions: Regular dental examinations and dental health care for the elderly with chronic diseases showed that periodontal health and residual teeth could be maintained and managed. Therefore, continuous customized dental health services should be implemented for the elderly with chronic diseases.
This paper diagnoses the financial knowledge of the college students and their values on financial situation. Another emphasis is given to the classification of surveyed college students based on their financial knowledge and values and the financial traits of each classified group is also analyzed. Statistical analysis was conducted using Cronbach's ${\partial}$, factor analysis, t-test, one-way ANOVA, and Duncan's multiple range test with total number of 733 questionnaires. Primary results of the research are as follows: First, overall score of financial knowledge was 62.65 points, showing the highest points in spending while lowest in savings and investment. Senior classes, students majoring in liberal arts, students with financial education and media experiences scored high points. Second, overall score of college students on financial values was 3.92, resulting in high points on credit and frugality but points on sharing with others were low. Thirdly, all surveyed students were classified into 4 types based on the mean scores on financial knowledges and values. Total 31.7% of students belonged to Type 1 where students scored high points on financial knowledge and values. Type 2 had about 22.4 % of students whose financial score was high but value score was low. Type 3 occupied 24.2% and this group scored low points on financial knowledge but high points on financial values. Type 4 occupied 21.8% and was a group of students whose scores for financial knowledge and values were low. Finally, Type 1 and 3 groups showed better desirable behaviors for financial management and expressed higher satisfaction status for finance than Type 2 and 4. Type 1 is a group of students whose subjective financial level was high. Monthly income was highest in Type 2 and financial stress was lowest in Type 1.
Purpose: Breast cancer is second most common cancer in women. Almost of patients with breast cancer treated with mastectomy undergoes breast reconstruction. Nipple reconstruction is an important step in breast reconstruction. Many surgeons have investigated of nipple reconstruction using the flap technique after breast reconstruction with the autologous tissue. The objective of this study is to evaluate the results of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. Methods: From April 2006 to May 2008, the authors treated 17 patients of nipple reconstruction using C - V flap technique, who were received breast reconstruction with the only breast expander. We have predicted decrease of the size of reconstructed nipple and designed flap a little larger than wanted nipple size. Nipple splint was applied for 4 - 6 months for minimizing decrease of the size of reconstructed nipple. The diameter and height of the reconstructed nipple were measured and patient's satisfaction score was assessed. Results: Mean follow-up duration was 12.5 months. Among the 17 patients, the average absorption rate by height of nipple was 47.0%. Partial necrosis was noted in 1 case, and treated well with conservative management. There was no other significant complications noted. Patient's satisfactory score was assessed by the height, design and location of the nipple. The average of satisfaction score was 85%, 68%, 62% and total average was 83%. Conclusion: The authors experienced 17 patients of nipple reconstruction using the C - V flap technique after breast reconstruction with the only breast expander. The absorption rate of the size of the nipple, complications and patient's satisfactory score of this study were similar to those of nipple reconstruction after breast reconstruction with the autologous tissue. It is expected that nipple reconstruction after breast reconstruction with the only breast expander is safe and reliable. It is considered that a long - term study is necessary.
Objective : This study aims to investigate the relationship between addictive mobile phone use and post-traumatic stress disorder (PTSD) symptoms in bullies who experienced school violence. Methods : The study subjects consisted of 97 adolescents in The Foundation for Preventing Youth Violence after school violence. The participants conducted self-report questionnaire for addictive mobile phone use and Impacted Event Scale-revised-Korean version (IES-R-K). Partial correlation and multiple logistic regressions were performed. Results : The scores related to addictive mobile phone use were correlated with total score (r=0.21, p=0.04), avoidance score (r=0.21, p=0.04) and intrusive score (r=0.26, p=0.01) related to PTSD symptoms on the IES-R-K. Intrusive score related to PTSD symptoms on the IES-R-K were significant risk factor for addictive mobile phone use (O.R=1.25, 95% CI=1.12-1.39). Conclusion : This data supports that PTSD intrusive symptoms could be predictable factor of addictive mobile phone use. An appropriate intervention about PTSD symptoms might play a useful role in preventing addictive mobile phone use in bullies of school violence.
Kim, Jung-Han;Min, Young-Kyoung;Park, Man-Jun;Huh, Jung-Wook;Park, Jun-Ho
Clinics in Shoulder and Elbow
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제25권2호
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pp.93-100
/
2022
Background: Subscapularis tendon insertion at the first facet has separate layers (deep and superficial). The purpose of this study is to evaluate postoperative clinical outcomes and radiological healing according to each layer of detachment in the first facet involving subscapularis tendon tear. Methods: Eighty-three patients who underwent arthroscopic repair due to First facet involving the scapularis tendon tear accompanying small to medium sized posterosuperior cuff tear were classified into three groups (group A: deep layer partial detachment, group B: deep layer complete detachment, but no superficial layer detachment, and group C: deep layer and superficial layer complete detachment). Subscapularis tendon healing was evaluated using computed tomography arthrogram and clinical result was evaluated using American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant score and University of California Los Angeles (UCLA) shoulder score. Results: Retear rate of the subscapularis tendon was 2.2%, 18.2%, and 33.3% in group A, group B, and group C, respectively. These rates showed statistically significant difference among the three groups, which were classified by deep and superficial layer detachment in the first facet (p=0.003). Group A showed significant difference in subscapularis tendon healing compared with group B and group C (p=0.018 and p<0.001, respectively), but there was no statistical difference between group B and group C (p=0.292). Regarding clinical outcomes, there was no significant difference among three groups in ASES and UCLA score at final follow-up (p=0.070 and p=0.106, respectively). Conclusions: Complete detachment of deep layer may be related with retear occurrence regardless with detachment of superficial layer, but clinical outcome may not be related with each layer detachment in the first facet involving subscapularis tendon tear.
Purpose: The purpose of the study was to shorten the KPCS-1 (Korean Patient Classification System-1) for predicting nursing care need level and to explore whether the patients can be clustered by their acuity and dependency. Methods: The participants were inpatients in two surgical wards and two internal medicine wards at a teritory hospital during 14 days investigations. The KPCS-1 was evaluated once a day for all inpatients and 2,082 cases of data from a total of 411 patients were analyzed. Results: The items were reducted from 50 items to 26 items by partial least squares analysis and expert review. Through factor analysis, it was confirmed that hygiene, diet, elimination, and exercise were categorized as dependence factors. Patients were clustered with low acuity/low dependency (average score: 7.68±2.81/1.05±1.33), high acuity/low dependency (average score: 17.20±4.15/1.94±2.40), medium acuity/high dependency (average score: 13.56±5.30/9.66±2.64) through cluster analysis. The total score of the three groups for their nursing care needs was 8.73±3.36, 19.14±5.74, and 23.24±6.31 in order, and the results showed a statistically significant difference (F=1712.12, p<.001). Conclusion: The shortening of the KPCS-1 and the new criteria for categorizing patients according to acuity and dependence will increase clinical utility and be useful for manpower assignment criteria in detail.
Efficient use of limited blood products is becoming very important in terms of socioeconomic status and patient recovery. To predict the appropriateness of patient-specific transfusions for the intensive care unit (ICU) patients who require real-time monitoring, we evaluated a model to predict the possibility of transfusion dynamically by using the Medical Information Mart for Intensive Care III (MIMIC-III), an ICU admission record at Harvard Medical School. In this study, we developed an explainable machine learning to predict the possibility of red blood cell transfusion for major medical diseases in the ICU. Target disease groups that received packed red blood cell transfusions at high frequency were selected and 16,222 patients were finally extracted. The prediction model achieved an area under the ROC curve of 0.9070 and an F1-score of 0.8166 (LightGBM). To explain the performance of the machine learning model, feature importance analysis and a partial dependence plot were used. The results of our study can be used as basic data for recommendations related to the adequacy of blood transfusions and are expected to ultimately contribute to the recovery of patients and prevention of excessive consumption of blood products.
Near-infrared spectra of methanol-water mixtures and acetonitrile-water mixtures were acquired to find interactions between solvents widely used for reverse-phase liquid chromatography. Mixtures were prepared to give a series of increasing mole fractions of methanol or acetonitrile in water. Data matrices of acquired spectra were analyzed to determine the proper number of principal components of each mixture system using Malinowski's factor indicator function. Initial guess of score matrix and loading matrix were calculated by nonlinear iterative partial least squares (NIPALS) algorithm for faster computation. Iterative target transform factor analysis (ITTFA) was applied to convert the initial estimation of score matrix to true concentration profile and loading matrix to pure spectra of pure components of the mixtures. In case of methanol-water the number of principal components was found to be 4 and those initial guess of factors were converted to the pure spectra of water methanol and two kinds of complexes. In case of acetonitrile-water the number of pure components of the mixtures was found to be 3 and the pure spectrum of acetonitrile-water complex was found. The nonlinear characteristics of concentration profiles of complexes in the solvent mixtures may give a good criteria in understanding their elution characteristics in reverse-phase liquid chromatogrsphy.
Purpose: This study is part of questionnaire survey concerned with the views of nursing staff for cancer patients. This study was done to describe cancer pain management problem, pain management knowledge. Methods: The participants were 188 nurses at cancer ward. Data were collected from July 2003 to August 2003. Data were collected with multiple-choice items and one open-ended question, which were constructed structured questionnaire. The data were analyzed by means of SPSS statistical software and content analysis. Results: Experiences of pain education are 53.7%, pain assessment sheet not use 86%, pain management status are partial. Education need of pain management was 87.8% patients in pain were very often(23.9%) or rather often (35.1%) cancer patients. The nurses are respond to open question. Pain management problems as assessed by nurses are categorized 11 item. The health professional problems are Knowledge deficit pain management, Incontrollable pain, Doctor's busy. The patient problems afraid of narcotics for addiction, side effect, distinguishing between physical and suffering, economical problem. The scores of knowledge about pain was average 16.7 score. The pain knowledge showed significant correlation education need(r=.180, p=.013). The effective variable was need of $education({\beta}=.163)$. Conclusion: It was found that pain knowledge was middle score and pain management problem was multiple. The study highlights the need to increase pain education for health professional. Therefore, This study suggest that health professionals education should be done to improve pain management problem.
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