Although periodic health examination has been one of the most common practices of preventive medicine, its effect on modification of risk behavior has been seldom assessed. Thus, this study attempted to demonstrate the influence of a health examination on modification of cardiovascular disease related health risk behaviors such as smoking, physical inactivity, and obesity. Data of 893 adults were derived from two types of a popular and highly acclaimed health examination program. With a conceptual model constructed using Persuasive Communication variables, McNemar tests examined Source-Outcome association, hypothesizing that different health examination programs would yield different levels of behavior change in smoking, physical inactivity, and obesity. No significant behavior change was found in any of the two health examination programs. Instead, previously established Receiver-Outcome relationship was reconfirmed by logistic regression modeling where gender was the most prominent predictor of all three behaviors. Men were more likely to be current smokers (OR=0.029), exercisers (OR=2.629), and obese (OR=0.237). The importance of followups after health examination is highly stressed as well as that of gender-specific health education strategies. This study recommends applying the social-ecological approaches in health examination, which emphasizes the support and collaboration at individual, family, organizations, community, and policy level to improve health. Long term and qualitative evaluation of health examination may provide more foundation for increasing the effectiveness of health education and communication in health examinations.
Temporal lobe epilepsy (TLE) is the most common type of medically intractable epilepsy in adults and children, and mesial temporal sclerosis is the most common underlying cause of TLE. Unlike in the case of adults, TLE in infants and young children often has etiologies other than mesial temporal sclerosis, such as tumors, cortical dysplasia, trauma, and vascular malformations. Differences in seizure semiology have also been reported. Motor manifestations are prominent in infants and young children, but they become less obvious with increasing age. Further, automatisms tend to become increasingly complex with age. However, in childhood and especially in adolescence, the clinical manifestations are similar to those of the adult population. Selective amygdalohippocampectomy can lead to excellent postoperative seizure outcome in adults, but favorable results have been seen in children as well. Anterior temporal lobectomy may prove to be a more successful surgery than amygdalohippocampectomy in children with intractable TLE. The presence of a focal brain lesion on magnetic resonance imaging is one of the most reliable independent predictors of a good postoperative seizure outcome. Seizure-free status is the most important predictor of improved psychosocial outcome with advanced quality of life and a lower proportion of disability among adults and children. Since the brain is more plastic during infancy and early childhood, recovery is promoted. In contrast, long epilepsy duration is an important risk factor for surgically refractory seizures. Therefore, patients with medically intractable TLE should undergo surgery as early as possible.
Objective : To evaluate the efficacy of balloon guiding catheter (BGC) during thrombectomy in anterior circulation ischemic stroke. Methods : Sixty-two patients with acute anterior circulation ischemic stroke were treated with thrombectomy using a Solitaire stent from 2011 to 2016. Patients were divided into the BGC group (n=24, 39%) and the non-BGC group (n=38, 61%). The number of retrievals, procedure time, thrombolysis in cerebral infarction (TICI) grade, presence of distal emboli, and clinical outcomes at 3 months were evaluated. Results : Successful recanalization was more frequent in BGC than in non-BGC (83% vs. 66%, p=0.13). Distal emboli occurred less in BGC than in non-BGC (23.1% vs. 57.1%, p=0.02). Good clinical outcome was more frequent in BGC than in non-BGC (50% vs. 16%, p=0.03). The multivariate analysis showed that use of BGC was the only independent predictor of good clinical outcome (odds ratio, 5.19 : 95% confidence interval, 1.07-25.11). More patients in BGC were successfully recanalized in internal carotid artery (ICA) occlusion with small retrieval numbers (<3) than those in non-BGC (70% vs. 24%, p=0.005). In successfully recanalized ICA occlusion, distal emboli did not occur in BGC, whereas nine patients had distal emboli in non-BGC (0% vs. 75%, p=0.001) and good clinical outcome was superior in BGC than in non-BGC (55.6% vs. 8.3%, p=0.01). Conclusion : A BGC significantly reduces the number of retrievals and the occurrence of distal emboli, thereby resulting in better clinical outcomes in patients with anterior circulation ischemic stroke, particularly with ICA occlusion.
The aim of this study was to determine the predictors of desirable pregnancy outcomes. The subjects were 795 pregnant women participating in the 2007 Mom and Baby Expo. They were grouped by gestational age: group I (3-12 wk: n = 95), group II (13-25 wks: n = 263) and group III (26-42 wks: n = 437). We collected data for general characteristics, sociocultural factors, life styles and nutrient intakes. We also collected pregnancy outcome data of 634 pregnant women including birth weight, maternal weight gain and gestational age. Dietary intakes of the subjects were estimated by Food Frequency Questionnaire. folate, iron and calcium intakes from foods of pregnant women were 88%, 79% and 58% of KDRIs, respectively. Bivariate analysis showed that birth weight was significantly associated with pre-pregnancy BMI, maternal weight gain, maternal age, gestational age and intakes of iron, potassium, $vitaminB_1$, $B_6$, fatty acids, MUFA. And also, bivariate analysis showed that maternal weight gain was significantly associated with pre-pregnancy BMI, maternal age, gestational age and intakes of energy, potassium. Further multivariate analyses suggest that vitaminB6 may be a significant predictor for low birth weight and energy intake and maternal age for maternal weight gain. Our findings suggest that dietary and lifestyle interventions during pregnancy can improve maternal and infant pregnancy outcomes. Prepregnancy weight control and intakes of energy and vitamin $B_6$ need to be taken into considerations in developing strategic prenatal care programs to promote desirable pregnancy outcome.
Kose, Selin Guven;Kose, Halil Cihan;Celikel, Feyza;Akkaya, Omer Taylan
The Korean Journal of Pain
/
v.35
no.4
/
pp.447-457
/
2022
Background: Ultrasound-guided genicular nerve radiofrequency (RF) procedures are of interest in the management of chronic knee pain. A wide variety of demographic, clinical, and procedural characteristics can affect treatment success. This study aimed to determine predictive factors to provide superior treatment outcomes. Methods: The demographic, clinical, and technical data of patients who received genicular nerve RF for knee pain between September 2016 and September 2021 were evaluated. A positive outcome was defined as at least 50% pain relief on a pain score for at least 6 months. Logistic regression analysis was performed to determine the factors associated with a successful response to genicular RF. Results: Among 206 patients who underwent genicular RF, 62% of the patients reported successful outcomes at 6 months. In the multivariate model, targeting 5 nerves (odds ratio [OR], 6.184; 95% confidence interval [CI], 2.291-16.690; P < 0.001) was the most significant predictor of successful outcomes. Multivariable logistic regression analysis showed that prognostic genicular nerve block with a 50% cut-off value (OR, 2.109; 95% CI, 1.038-4.287; P = 0.039), no opioid use (OR, 2.753; 95% CI, 1.405-5.393; P = 0.003), and depression (OR, 0.297; 95% CI, 0.124-0.713; P = 0.007) were the predictive factors significantly associated with response to genicular RF. Conclusions: Clinical and technical factors associated with better treatment outcomes were ultimately targeting more nerves, performing prognostic block, no opioid use, and no depression. These results are expected to be considered when selecting patients for genicular RF.
Purpose: This study systematically reviewed the research literature on nurse job satisfaction to suggest directions for further research. Methods: A total of 98 articles published in the journals registered in National Research Foundation of Korea (NRF) from January 2000 to August 2013 were included for the final analysis. Results: The number of published papers related to nurse job satisfaction has increased annually. The most frequently used instrument to measure nurse job satisfaction was 'The Index of Work Satisfaction'developed by Slavitt et al. (1978). 'Personal Perception/Attitude' was the strongest predictor influencing on nurse job satisfaction (41 times, 38.0%). Organizational commitment, turnover intention, nursing performance, job stress, and organizational performance were commonly used as outcome variables related to nurse job satisfaction. Conclusion: Further research is needed to analyze diverse influential factors on nurse job satisfaction. In addition, it is also needed to develop an intervention program which can improve nurse job satisfaction.
Purpose: The purpose of this study was to examine the levels of burnout experienced by Korean hospital nurses (N=198), and to identify predictors of their nursing outcomes such as job performance, work satisfaction, and productivity. Method: Hierarchical multiple regression was used to identify predictors of each nursing outcomes. Included predictors were nurses' general characteristics, work- related characteristics (role stress and perceived control), and burnout. Results: Korean nurses experienced higher levels of burnout compared to the cutoffs suggested by Maslach and Jackson (1986) and to those in the USA. For each nursing outcome, predictor variables explained 39% of the variance in role performance, 30% of the variance in work satisfaction, and 38% of variance in productivity. Higher personal accomplishment, lower role ambiguity, being staff nurses, and lower emotional exhaustion were related to higher job performance, and higher productivity. Lower role conflict and role ambiguity were also related to higher work satisfaction. Conclusion: Based on the findings of this study, managemental interventions for nurses to reduce their burnout experience are needed. Further study in this area is warranted.
Yu, Tosol;Kim, Hak Jae;Wu, Hong-Gyun;Ha, Sung Whan;Song, Yong-Sang;Park, Noh-Hyun;Kim, Jae-Won
Radiation Oncology Journal
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v.33
no.1
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pp.29-35
/
2015
Purpose: To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery. Materials and Methods: We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months). Results: The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure. Conclusion: The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.
Kim, Ah Lim;Kwon, Jae Choon;Park, In;Kim, Ji Na;Kim, Jong Min;Jeong, Bi Na;Yu, Sung Ken;Lee, Byung Ki;Kim, Yeon Jae
Tuberculosis and Respiratory Diseases
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v.76
no.6
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pp.269-275
/
2014
Background: The six-minute walk test has been widely used in people with chronic cardiopulmonary disorders as an outcome assessment with regards to therapeutic or prognostic determinants. This study was undertaken to determine the six-minute walk distance (6MWD) in a sample of healthy Koreans and to create a reference equation. We also compared the 6MWD of our cohort with previously published equations. Methods: Two hundred fifty-nine healthy subjects (95 males) aged 22-59 years performed two walking tests using a standardized protocol. 6MWD was defined as the greatest distance achieved from the two tests. The effect of anthropometrics on the 6MWD was also investigated. Results: The average 6MWD was $598.5{\pm}57.92m$, with significantly longer distances by males ($628.9{\pm}59.51m$) than females ($580.9{\pm}47.80m$) (p<0.001). Age, height, weight, and body mass index were significantly correlated with 6MWD in univariate analysis. Stepwise multiple regression showed height to be single independent predictor of 6MWD ($r^2$=0.205, p<0.001). The reference equations derived in Caucasian and North African populations tend to overestimate the distance walked by Korean subjects, while Asian equations underestimate it. Conclusion: The average 6MWD in these Korean populations was 600 m. The regression equation revealed that individual's height was the most significant predictor of distance, explaining 20.5% of the distance variance.
Background: To determine the predictive value of the baseline stimulated thyroglobulin (STg) level for ablation outcome in patients undergoing adjuvant remnant radioiodine ablation (RRA) for differentiated thyroid carcinoma (DTC). Materials and Methods: This retrospective study accrued 64 patients (23 male and 41 female; mean age of $40{\pm}14$ years) who had total thyroidectomy followed by RRA for DTC from January 2012 till April 2014. Patients with positive anti-Tg antibodies and distant metastasis on post-ablative whole body iodine scans (TWBIS) were excluded. Baseline STg was used to predict successful ablation (follow-up STg <2 ng/ml, negative diagnostic WBIS and negative ultrasound neck) at 7-12 months follow-up. Results: Overall, successful ablation was noted in 37 (58%) patients while ablation failed in 27 (42%). Using the ROC curve, a cut-off level of baseline STg level of ${\leq}14.5ng/ml$ was found to be most sensitive and specific for predicting successful ablation. Successful ablation was thus noted in 25/28 (89%) of patients with baseline STg ${\leq}14.5ng/ml$ and 12/36 (33%) patients with baseline STg >14.5 ng/ml ((p value <0.05). Age >40 years, female gender, PTS >2 cm, papillary histopathology, positive cervical nodes and positive TWBIS were significant predictors of ablation failure. Conclusions: We conclude that in patients with total thyroidectomy followed by I-131 ablation for DTC, the baseline STg level is a good predictor of successful ablation based on a stringent triple negative criteria (i.e. follow-up STg < 2 ng/ml, a negative DWBIS and a negative US neck).
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