• Journal of Korean Critical Care Nursing
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• v.15 no.2
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• pp.50-63
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• 2022

Purpose : This study aimed to identify intensive care units (ICU) nurses' experience of traumatic events, deliberate rumination, self-disclosure, social support, and post-traumatic growth (PTG), and to explore relationships among the variables. Methods : Participants were 157 nurses who have provided direct patient care for six months or more in ICUs at a university hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVAs, Pearson correlations, and multiple linear regressions using the SPSS/WIN version 23.0. Results : The PTG was found to be significantly associated with deliberate rumination (r=0.36, p<.001), self-disclosure (r=0.39, p<.001), and social support (r=0.54, p<.001). Factors that affect PTG significantly were found in the order of social support (𝛽=0.40, p<.001), self-disclosure (𝛽=0.25, p<.001), and deliberate rumination (𝛽=0.24, p<.001). The final regression model explained 40.1% of the variance of PTG (F=26.33, p<.001). Conclusion : The influencing factors identified in this study on PTG, including social support, self-disclosure, and deliberate rumination should be included in programs to promote PTG for ICU nurses who may experience traumatic events repeatedly.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.165-174
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• 2022

Background: One goal of the End tuberculosis (TB) Strategy is to see no TB-affected households experiencing catastrophic costs. Therefore, it is crucial for TB-elimination programs to identify catastrophic costs and their main drivers in order to establish appropriate health and social measures. This study aimed to measure the percent of catastrophic costs experienced by Egyptian TB patients and to identify its determinants. Methods: We conducted a prospective cohort study with 151 Egyptian TB patients recruited from two chest dispensaries from the Cairo governate from May 2019 to May 2020. We used a validated World Health Organization TB patient-cost tool to collect data on patients' demographic information, household income, and direct and indirect expense of seeking TB treatment. We considered catastrophic TB costs to be total costs exceeding 20% of the household's annual income. Results: Of the patients, 33% experienced catastrophic costs. The highest proportion of the total came in the pre-treatment stage. Being the main breadwinner, experiencing job loss, selling property, and the occurrence of early coronavirus disease 2019 lockdown were independent determinants of the incidence of catastrophic costs. Borrowing money and selling property were the most-often reported coping strategies adopted. Conclusion: Despite the availability of free TB care under the Egyptian National TB Program, nearly a third of the TB patients incurred catastrophic costs. Job loss and being the main breadwinner were among the significant predictors of catastrophic costs. Social protection mechanisms, including cash assistance and insurance coverage, are necessary to achieve the goal of the End TB Strategy.

• Journal of the Korea Society of Computer and Information
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• v.27 no.5
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• pp.21-28
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• 2022

All health problems that occur in the circulatory system are refer to cardiovascular illness, such as heart and vascular diseases. Deaths from cardiovascular disorders are recorded one third of in total deaths in 2019 worldwide, and the number of deaths continues to rise. Therefore, if it is possible to predict diseases that has high mortality rate with patient's data and AI system, they would enable them to be detected and be treated in advance. In this study, models are produced to predict heart disease, which is one of the cardiovascular diseases, and compare the performance of models with Accuracy, Precision, and Recall, with description of the way of improving the performance of the Decision Tree(Decision Tree, KNN (K-Nearest Neighbor), SVM (Support Vector Machine), and DNN (Deep Neural Network) are used in this study.). Experiments were conducted using scikit-learn, Keras, and TensorFlow libraries using Python as Jupyter Notebook in macOS Big Sur. As a result of comparing the performance of the models, the Decision Tree demonstrates the highest performance, thus, it is recommended to use the Decision Tree in this study.

• Archives of Craniofacial Surgery
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• v.23 no.2
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• pp.59-63
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• 2022

Background: Deformational plagiocephaly is usually managed conservatively, as it tends to improve over time and with the use of conservative measures. However, before the year 2017 we operated on patients with severe plagiocephaly and neurological symptoms at the Helsinki Cleft Palate and Craniofacial Center. Methods: Of the 20 infants with severe deformational plagiocephaly and neurological symptoms referred to us between 2014 and 2016, 10 underwent cranioplasty open reshaping of the posterior cranial vault. The parents of the last 10 patients were given information on the natural history of the condition and the patients were followed up with an outpatient protocol. The aim of this study was to gain information on the brain electrophysiology and recovery of patients after total cranial vault reconstruction by measuring the electroencephalogram (EEG) somatosensory evoked potentials (SEP; median nerve). Results: Of the 10 participants in the operation arm, six had abnormal SEP at least on the affected cerebral hemisphere and all SEPs were recorded as normal when controlled postoperatively. In the follow-up arm, eight out of 10 participants had abnormal SEP at the age of approximately 24 months, and all had normalized SEPs at control visits. Conclusion: Our data suggest that cranioplasty open reshaping of the posterior cranial vault did not affect abnormal SEP-EEG recordings. We have abandoned the operations in deformational plagiocephaly patients due to findings suggesting that expanding cranioplasty is not beneficial for brain function in this patient group.

• The Journal of Korean Society for School & Community Health Education
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• v.23 no.4
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• pp.29-39
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• 2022

Objectives: The purpose of this study was to assess the incidence of delivery and puerperium complications in South Korea and analyze the correlations between the patient's characteristics and delivery and complications before and after 10 years. Methods: This study used the data from an Korean National Hospital Discharge In-depth Injury Survey. Cases of which the principal diagnosis and second diagnoses were disease classification ICD code O00-O99(Pregnancy, childbirth and the puerperium) were defined as the study subjects, and the first study group was divided as the year of discharge from 2005 to 2007, and the second study group from 2015 to 2017. Results: The number of patients discharged whose principal diagnosis or second diagnoses was O00-O99 was 21,598(Weighted 423,306) from 2005 to 2007 and 19,028(Weighted 364,384) from 2015 to 2017, which decreased by 13.9% compared to 10 years ago. The average age of discharged patients increased by about 2 years and was statistically significant (p<.0001). Factors associating spontaneous delivery, caesarean section and puerperium complication were hospitalization route, bed size, maternal age, length of hospital stay, and the year of discharge. Conclusion: Based on the results of this study, health and education policies and economic support for medical care for high-risk pregnancy and delivery management would be necessary continuously. In addition, policies to strengthen the medical system for high-risk pregnancy management in non-metropolitan areas with high fertility rates would also be needed.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.685-690
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• 2021

Background Human immunodeficiency virus (HIV)-associated lipodystrophy is a known consequence of long-term highly active antiretroviral therapy (HAART). However, a significant number of patients on HAART therapy were left with the stigmata of complications, including fat redistribution. Few studies have described the successful removal of focal areas of lipohypertrophy with successful outcomes. This manuscript reviews the outcomes of excisional lipectomy versus liposuction for HIV-associated cervicodorsal lipodystrophy. Methods We performed a 15-year retrospective review of HIV-positive patients with lipodystrophy. Patients were identified by query of secure operative logs. Data collected included demographics, medications, comorbidities, duration of HIV, surgical intervention type, pertinent laboratory values, and the amount of tissue removed. Results Nine male patients with HIV-associated lipodystrophy underwent a total of 17 procedures. Of the patients who underwent liposuction initially (n=5), 60% (n=3) experienced a recurrence. There were a total of three cases of primary liposuction followed by excisional lipectomy. One hundred percent of these cases were noted to have a recurrence postoperatively, and there was one case of seroma formation. Of the subjects who underwent excisional lipectomy (n=4), there were no documented recurrences; however, one patient's postoperative course was complicated by seroma formation. Conclusions HIV-associated lipodystrophy is a disfiguring complication of HAART therapy with significant morbidity. Given the limitations of liposuction alone as the primary intervention, excisional lipectomy is recommended as the primary treatment. Liposuction may be used for better contouring and for subsequent procedures. While there is a slightly higher risk for complications, adjunctive techniques such as quilting sutures and placement of drains may be used in conjunction with excisional lipectomy.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.3
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• pp.67-72
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• 2022

Objectives: This study investigated the reliability and validity of the Korean version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 2 Cross-Cutting Symptom Measure-Patient-Reported Outcomes Measurement Information System (PROMIS)-Depression and the Irritability for parents of children aged 6-17 years. Methods: Participants were 190 children diagnosed with depressive disorder (n=14), anxiety disorder (n=21), attention-deficit/hyperactivity disorder (ADHD; n=111), ADHD with anxious depression (n=13), and tic disorder with somatic symptoms (n=31). Patients were 8-15 years of age. The participants' mothers completed the Korean versions of the DSM-5 Level 2 Cross-Cutting Symptom Measure-PROMIS Depression and Irritability (Affective Reactivity Index, ARI), and the Korean Child Behavior Checklist (K-CBCL). Using these data, we calculated the reliability coefficient and examined the concurrent and discriminant validity of the PROMIS Depression and the Irritability (ARI) scales for assessing depression and irritability in children. Results: The reliability coefficient of the PROMIS Depression scale (Cronbach's α) was 0.93. The correlation coefficient with the K-CBCL DSM emotional problem score was 0.71. The PROMIS Depression scale significantly discriminated children with depressive disorders from those with other conditions. The reliability coefficient of the Irritability (ARI) scale was 0.91, suggesting its high reliability. Conclusion: Our results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure for Depression and Irritability Scales for parents of children aged 6-17 years is reliable and valid and may be an efficient alternative to the K-CBCL.

• Clinical and Experimental Pediatrics
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• v.65 no.4
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• pp.194-200
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• 2022

Background: Injury is the leading cause of death or disability in children and adolescents. Rates of deaths from injuries have recently declined, but studies of the occurrence of nonfatal injuries are lacking. Purpose: This study aimed to investigate nonfatal injuries in children and adolescents younger than 20 years based on data from the Korean National Health and Nutrition Survey, 2007-2018. Methods: A questionnaire survey was conducted to determine whether children and adolescents had experienced an injury requiring a hospital visit in the previous year. We investigated each injury's risk factors and characteristics. Results: Of a total of 21,598 children and adolescents, 1,748 (weighted percentage, 8.1%) experienced one or more injuries in the previous year. There was no yearly difference in the proportion of injuries experienced. Among the male subjects, 10.0% had an injury experience; among the female participants, 6.1% had an injury experience (P<0.001). The highest rate was 9.0% in children aged 1-4 years. In multivariate logistic regression analysis, male sex; having an urban residence; having restricted activity due to visual, hearing, or developmental impairment; and attention deficit/hyperactivity disorder were significant risk factors for injury experience. The characteristics of up to 3 injuries per patient were investigated, and 1,951 injuries were analyzed. Falls and slips accounted for 34.9%, collisions for 34.1%, and motor vehicle accidents for 11.3% of the total injuries. Ninety-six percent of injuries were unintentional, 20% caused school absences, and 10% required hospitalization. Conclusion: Among Korean children and adolescents, 8.1% experienced injuries at least once a year with no significant differences in incidence over the past 12 years. Greater attention and effort to prevent injuries are needed.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.71-81
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• 2022

Purpose : This study aimed to present evidence by analyzing the characteristics and effectiveness of group art therapy interventions through an examination of domestic studies on group art therapy for older people with dementia. Methods : The database used DBpia, Riss, and Google Scholar, and the research period was from 2016 to November 2021. For the selected studies, the level of evidence was analyzed, bias evaluation was performed, and patient, intervention, comparison, and outcome were analyzed. For the evaluation of bias, the risk of bias assessment tool for non-randomized study (RoBANS) and Cochrane's risk of bias (RoB) were used. Results : As for the level of evidence of the included studies, level I consisted of five studies, and levels II and III each had one article. As a result of the bias evaluation of five studies through RoB, a "low risk of bias" was found for incomplete result data, selective result reporting, and others, except for four unclear evaluation areas. The "low risk of bias" ratio was 0~25 % in the evaluation of bias in two studies through RoBANS. For the evaluation tool, cognitive evaluation tool was used the most while mini-mental state examination-Korea was used the most frequently. For the intervention method, the most frequently used was group art therapy that employed recall in three studies, while collage, Korean painting, use of paper media, and procedural memory were used in each of the other studies. Each intervention was found to be significantly effective overall. Conclusion : This study provided clinical evidence by systematically reporting research on group art therapy for older people with dementia. In the future, it is necessary to check the effect of group art therapy on various areas other than cognition for older people with dementia. Moreover, the study should be conducted with the risk of bias sufficiently taken into consideration.

• Archives of Plastic Surgery
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• v.49 no.2
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• pp.166-173
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• 2022

The introduction of acellular dermal matrix (ADM) to breast reconstruction has allowed surgeons to reexplore the prepectoral implant placement technique in postmastectomy breast reconstruction. Our institution adopted a novel approach using meshed ADM to lessen the financial burden of increased ADM utilization with the prepectoral breast reconstruction. This is a retrospective, single-center review of two-stage prepectoral breast reconstruction using meshed human-derived ADM for anterior prosthesis coverage. Patient demographics, oncologic data, perioperative characteristics, and complications were examined and reported as means with standard deviations. Cost-saving with the meshed technique was evaluated. Forty-eight patients (72 breasts) with a mean age of 48.5 ± 15.0 years (range 26-70 years) were included in the study. The mean follow-up time was 13.2 ± 4.4 months (range 4.1-25.8 months). Nineteen breasts (24.6%) experienced complications, with seromas being the most common complication (12.5%, n = 9). Expander removal and reoperation occurred at a rate of 8.3 and 9.7%, respectively. The average time to drain removal was 18.8 ± 6.6 days (range 8-32 days). Meshed ADM provided an average cost savings of $6,601 for unilateral and $13,202 for bilateral reconstructions. Our study found that human-derived meshed ADM can be safely used in two-staged prepectoral tissue expander-based breast reconstruction and can result in significant cost savings.