Kim, Sun-Young;Kim, Eun-Jin;Jeon, Sang-Won;Shin, Dong-Won;Shin, Young-Chul;Oh, Kang-Seob
Anxiety and mood
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v.15
no.1
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pp.20-28
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2019
Objective : The purpose of this study was to compare and analyze effectiveness of various psychotherapies of depressive symptoms in patients with anxiety disorders by means of a systemic review. Methods : A systematic search using key words was conducted using EMBASE, MEDLINE and CENTRAL. Results : Five studies were included in this systematic review. The Scottish Intercollegiate Guidelines Network (SIGN) was used for quality assessment. Diagnostic-specific cognitive behavioral therapies for various anxiety disorders (ds CBT) were also effective in reducing comorbid depression. Transdiagnostic cognitive behavioral therapies targeting anxiety and depression (tCBT-AD) were not superior than ds CBT for anxiety disorders. Mindfulness-based stress reduction (MBSR) was more effective than traditional cognitive behavioral therapy. Conclusion : ds CBT relieves anxiety symptoms as well as depressive symptoms comorbid with anxiety disorders effectively. In addition, MBSR is more successful for anxiety disorders with co-occurring depression by focusing broadly on the shifting relationship to internal experience rather than focusing narrowly on specific symptoms.
This study is designed to verify the actual effect on the prevention of the elderly suicide of the integrated crisis intervention service which has been widely provided across all local communities in Gyeonggi-province focusing on the integrated crisis intervention model developed for the prevention of elderly suicide. The integrated crisis intervention model for the local communities and its manual were developed for the prevention of elderly suicide by integrating the crisis intervention theory which contains local community's integrated system approach and the stress vulnerability theory. For the analysis of the effect, the geriatric depression and suicidal ideation scale was adopted and the data was collected as follows; The data was collected from 258 people in the first preliminary test. Then, it was collected from the secondary test of 184 people after the integrated crisis intervention service was performed for 6 months. The third collection of data was made from 124 people after 2 or 3 years later using the backward tracing method. As for the analysis, the researcher used the R Statistics computing to conduct the test equating, and the vertical scaling between measuring points. Then, the researcher conducted descriptive statistics analysis and univariate analysis of variance, and performed multi-level modeling analysis using Bayesian estimation. As a result of the study, it was found out that the integrated crisis intervention model which has been developed for the elderly suicide prevention has a statistically significant effect on the reduction of elderly suicide in terms of elderly depression and suicide ideation in the follow-up measurement after the implementation of crisis intervention rather than in the first preliminary scores. The integrated crisis intervention model for the prevention of elderly suicide was found to be effective to the extent of 0.56 for the reduction of depression and 0.39 for the reduction of suicidal ideation. However, it was found out in the backward tracing test conducted 2-3 years after the first crisis intervention that the improved values returned to its original state, thus showing that the effect of the intervention is not maintained for long. Multilevel analysis was conducted to find out the factors such as the service type(professional counseling, medication, peer counseling), characteristics of the client (sex, age), the characteristics of the counselor(age, career, major) and the interaction between the characteristics of the counselor and intervention which affect depression and suicidal ideation. It was found that only medication can significantly reduce suicidal ideation and that if the counselor's major is counseling, it significantly further reduces suicidal ideation by interacting with professional counseling. Furthermore, as the characteristics of the suicide prevention experts are found to regulate the intervention effect on elderly suicide prevention in applying integrated crisis intervention model, the primary consideration should be given to the counseling ability of these experts.
Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using porous hydroxyapatite for intraarticular calcaneal fracture of joint depression type. Materials and Methods: Twenty patients with intraarticular calcaneal fracture were followed up for more than 1 year. The period to union was calculated to evaluate the osteoconductivity of porous hydroxyapatite used as bone graft substitute. The measurement of Bohler angle, Gissane angle and the degree of articular surface depression was performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: Bohler angle and Gissane angle had improved significantly from preoperative average $10.4^{\circ}$, $117.8^{\circ}$ to average $22.6^{\circ}$, $113.5^{\circ}$ immediate postoperatively, and had maintained to average $21.2^{\circ}$ and $114.4^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 4.8 mm to 1.5 mm at the last follow-up. All cases achieved bone union, and the interval to union was average 12.8 weeks. AOFAS score was average 85.2 points at last follow-up. There were 7 excellent, 10 good, and 3 fair results according to the CNHF scale. Therefore, 17 cases (85%) achieved satisfactory results. Conclusion: Plate fixation using porous hydroxyapatite seems to be one of effective treatment methods for intraarticular calcaneal fracture of joint depression type, because of supporting the reduction of subtalar articulation by augmenting bony defect and facilitating bone formation. Further evaluation about long-term radiological changes and histological analysis on hydroxyapatite implantation site should be required.
This research examines the participation experience of a Focusing group program dealing with elderly depression, with the aim of providing a groundwork for developing and improving such programs. Qualitative analysis is performed based interviews conducted with 9 elderly clients with depression symptoms that participated in a 10 week Focusing group program. The results summarize into 3 themes, 3 categories per theme, and 3 sub-categories per category. The first theme is "program effectiveness" with three associated categories: Category 1) The reduction effect of the depression ; Category 2) Increased self-awareness, self-respect and acceptance experience; Category 3) Everyday life changes. The second theme is "expectation and difficulties of the program", with 3 related categories: Category 1) Expectation of program; Category 2) Difficulties of program; Category 3) Personal difficulties. The third theme is "program enhancement methods" with 3 affiliated categories: Category 1) Differentiation with other programs; Category 2) Improvement of program; Category 3) Post program direction. Based on the results of the analysis, the effectiveness of the Focusing group program for elderly depression is examined and suggestions are provided for further program improvements and applications.
Background: The need to study the effects of concert oriented music therapy (COMT) on a diverse range of subjects. Purpose: This study aimed to verify the effectiveness of Concert Oriented Music Therapy (COMT), a technique based on active music activities, in alleviating depression among the elderly in a nursing home. Methods: COMT program was prepared, which was designed to enable participants to express and explore emotions through music in a creative environment, being divided into 'Therapeutic music making' and 'Concert activities,' The 70 elderly residents in a nursing facility were randomly assigned to either an experimental (n=35) or a control group (n=35). The 3 participants withdrew, and a total of 67 completed the COMT intervention program. Results: The experimental group receiving COMT intervention showed a significant reduction in the average GDS-K score from 20.34 to 15.18 (p<.001), with notable decreases observed in the cognitive function and depression factors. Conclusion: The COMT was found to effectively reduce depression, particularly, related to cognitive function, for the elderly residents in a nursing facilities. The COMT intervention program is expected to be beneficial in improving the quality of life for the elderly in a nursing home, susceptible to depression
Calcaneus is largest tarsal bone and the fracture of calcaneus is most common tarsal fractures. Calcaneal fractures are divided into extra-articular and intra-articular fractures. Intra-articular calcaneal fractures could be classified as tongue type and joint depression type using simple lateral radiograph (Essex-Lopresti classification), but Sanders suggested new classification according to involving the posterior facet of calcaneus using computed tomography. The involvement of posterior facet was revealed as more complicated than Essex-Lopresti classification. The principle purpose of treatment of calcaneal fractures are restoration of calcaneal height (B$\ddot{o}$hler angle), width, axis, anatomical reduction of joint and restoration of function through the stable fixation. Good visualization of joint and anatomical reduction could be achieved by extended lateral approach. But, skin problem could be occurred after of extended lateral approach.
Jo, Deok-Jun;Kim, Myoung-Su;Lee, Jung-Ho;Park, Moo-Jong;Kim, Joong-Hoon
Proceedings of the Korea Water Resources Association Conference
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2005.05b
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pp.1199-1203
/
2005
Combined sewer overflows(CSOs) are themselves a significant source of water pollution. Therefore, the control of urban drainage for CSOs reduction and receiving water quality protection is needed. Examples in combined sewer systems include downstream storage facilities that detain runoff during periods of high flow and allow the detained water to be conveyed by an interceptor sewer to a centralized treatment plant during periods of low flow. The design of such facilities as stormwater detention storage is highly dependant on the temporal variability of storage capacity available(which is influenced by the duration of interevent dry periods) as well as the infiltration capacity of soil and recovery of depression storage. As a result, a contiunous approach is required to adequately size such facilities. This study for the continuous long-term analysis of urban dranage system used analytical Probabilistic model based on derived probability distribution theory. As an alternative to the modeling of urban drainage system for planning or screening level analysis of runoff control alternatives, this model have evolved that offer much ease and flexibility in terms of computation while considering long-term meteorology. This study presented rainfall and runoff characteristics or the subject area using analytical Probabilistic model. Runoff characteristics manifasted the unique characteristics of the subject area with the infiltration capacity of soil and recovery of depression storage and was examined appropriately by sensitivity analysis. This study presented the average annual COSs and number of COSs when the interceptor capacity is in the range 3xDWF(dry weather flow). Also, calculated the average annual mass of pollutant lost in CSOs using Event Mean Concentration. Finally, this study presented a dicision of storage volume for CSOs reduction and water quality protection.
Purpose: There is limited data on the use of perampanel in children under 12 years of age. We evaluated the efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy. Methods: This retrospective observational study was performed in Kyungpook National University Hospital from July 2016 to March 2018. A responder was defined as a patient with ${\geq}50%$ reduction in monthly seizure frequency compared with the baseline. Adverse events and discontinuation data were obtained to evaluate tolerability. Results: Twenty-two patients (8 males, 14 females) aged 3.1-11.4 years (mean, $8.0{\pm}2.5years$) were included in this study. After an average of 9.2 months (range, 0.5-19 months) of follow-up, 15 patients (68%) showed a reduction in seizure frequency, including 5 patients (23%) with seizure freedom. The age at epilepsy onset was significantly lower (P=0.048), and the duration of epilepsy was significantly longer (P=0.019) in responders than in nonresponders. Nine patients (41%) experienced adverse events, including somnolence (23%), respiratory depression (9%), violence (4.5%), and seizure aggravation (4.5%). The most serious adverse event was respiratory depression, which required mechanical ventilation in 2 patients (9%). Eight patients (36%) discontinued perampanel due to lack of efficacy or adverse events. Three out of 4 patients (75%) who discontinued perampanel due to adverse events had an underlying medical condition. Conclusion: Perampanel offers a treatment option for refractory epilepsy in children. Adjunctive treatment with perampanel requires special consideration in those with underlying medical conditions to prevent serious adverse events.
Park, Han-Kyul;Lee, Jae-Yeol;Song, Jae-Min;Kim, Tae-Seup;Shin, Sang-Hun
Maxillofacial Plastic and Reconstructive Surgery
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v.36
no.6
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pp.266-272
/
2014
Purpose: This study was conducted in order to investigate the therapeutic effect of closed reduction according to a classification in patients with nasal bone fracture. Methods: The study was conducted retrospectively on 186 patients with a mean age of 38 years (range: 7 to 80 years). All patients were diagnosed by clinical and radiologic examination, and then classified according to Hwang's classification by computed tomography. The patients were further classified by their age, gender, causes of fracture, operation timing after fracture, concurrent facial bone fracture, and complications. All patients underwent the same reduction and treatment protocol and were then followed up regularly for at least three months. Results: The cause of the fracture was slip down, and the highest prevalence was shown in the 20s. The mean operation timing after fracture was 4.1 days (range: 1 to 14 days), and it tended to be longer in the case of defected septal bone or more severe fracture. The most common concurrent facial bone fracture was orbital blow-out fracture, and zygomaticomaxillary complex and maxillary fracture occured frequently. The largest number of complications occurred in class III and IIBs patients, and the main complication was postoperative pain. Conclusion: Results of nasal bone closed reduction on the 186 patients showed that serious complications rarely occurred. Closed reduction is generally an effective treatment for nasal bone fracture. However, in the case of severe concurrent septal bone fracture or comminuted fracture with depression, open reduction should be considered. Further study with a larger number of patients and further classification is required.
Kim, Dong Hyuck;Kim, Rae Hyong;Lee, Jun;Chee, Young Deok;Kwon, Kyoung-Hwan
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.40
no.3
/
pp.103-110
/
2014
Objectives: In this study, we assessed soft tissue asymmetry that occurred after open reduction of unilateral zygomaticomaxillary complex (ZMC) fractures. We proposed a simple method to assess soft tissue asymmetry after reduction surgery by evaluating the symmetry between the affected and the unaffected sides. The factors affecting soft tissue contour after surgery were also analyzed. Materials and Methods: Subjects included patients admitted to Wonkwang University Dental Hospital from 2008 to 2013. Cone-beam computed tomography (CBCT) images of asymmetric patients who underwent open reduction at least 3 months prior were compared with healthy patients. Results: The degree of asymmetry was measured in both the open reduction and control groups. Landmarks that showed a statistically significant difference between the two groups were zygion ($1.73{\pm}0.24mm$), bucclae ($1.08{\pm}0.26mm$), point of cheek ($2.05{\pm}0.33mm$) and frontozygomatic point ($1.30{\pm}0.31mm$). Conclusion: When compared with the normal group, asymmetry can occur in the affected side, which usually shows depression of overlying soft tissue and is statistically significantly different. Evaluation of soft tissue asymmetry with CBCT images after open reduction of ZMC fracture is useful.
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