Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.
Purpose: This study was done to assess the effects of a self-help intervention on clinical, lifestyle and psycho-social outcomes in patients with Type II diabetes. Methods: Eligible adults with Type II diabetes were randomly assigned to either the intervention group receiving the diabetes self-help or the control group receiving usual care. Of the 36 patients who completed the study, 15 were in the intervention group and 21 were in the control group. The self-help group consisted of six weekly sessions covering aspects of diabetes self-care and using continuing education, discussion, and structured social activities. Outcomes included changes in glycemic control, knowledge, self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. Analysis of covariance was used to compare outcomes between the groups, adjusting for baseline measures. Results: After the six week intervention, significant improvements from the baseline were observed in the measurements of self-management behaviors, diabetes-related self-efficacy, and health-related quality of life for the intervention group. Conclusion: The findings provide preliminary evidence that a diabetes self-help group intervention can benefit diabetes patients in self-management behaviors, diabetes-related self-efficacy, and health-related quality of life. However, larger longitudinal studies are needed to determine the most efficacious self-management methods to sustain long-term glycemic control and psychological well-being.
KSII Transactions on Internet and Information Systems (TIIS)
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v.18
no.2
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pp.284-310
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2024
Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.
Kim, Han-Joong;Park, Eun-Cheol;Choi, Yoon-Jung;Kang, Hyung-Gon
Journal of Preventive Medicine and Public Health
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v.34
no.2
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pp.175-181
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2001
Objectives : To compare the multiple outcomes of patients with cataract surgery at perioperative time,3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). Methods : For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was peformed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was 'conducted at 4 stages' : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. Results : The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 mouths. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom sure were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(09.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. Conclusions : In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.
Quentin Durand-Moreau;Tanya Jackson;Danika Deibert;Charl Els;Janice Y. Kung;Sebastian Straube
Safety and Health at Work
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v.14
no.3
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pp.250-258
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2023
The effectiveness of mindfulness techniques in addressing mental health conditions in workers is uncertain. However, it could represent a therapeutic tool for workers presenting with such conditions. Our objective was to assess the effects of mindfulness-based practices for workers diagnosed with mental health conditions. We conducted a systematic review of randomized controlled trials. Participants included were workers with a mental health condition. Interventions included any mindfulness technique, compared to any nonmindfulness interventions. Outcomes were scores on validated psychiatric rating scales. A total of 4,407 records were screened; 202 were included for full-text analysis; 2 studies were included. The first study (Finnes et al., 2017) used Acceptance and Commitment Therapy (ACT) associated or not with Workplace Dialogue Intervention (WDI), compared to treatment as usual. At 9 months follow-up, for the ACT group, depression scores improved marginally (standardized mean difference [SMD]: -0.06, p = 0.021), but anxiety scores were worse (SMD: 0.15, p = 0.036). Changes in mental health outcomes were not statistically significant for the ACT + WDI group. In the second study (Grensman et al., 2018), no statistically significant change in mental health scales has been observed after completion of mindfulness-based cognitive therapy compared to cognitive behavioral therapy. Substantial heterogeneity precluded meta-analysis. This systematic review did not find evidence that mindfulness-based practices provide a durable and substantial improvement of mental health outcomes in workers diagnosed with mental health conditions.
Journal of The Korea Institute of Healthcare Architecture
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v.17
no.2
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pp.35-44
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2011
The aim of this study is to review the literature addressed the methodology to measure and evaluate the health outcomes as evidences for health benefits through the study on the healing environment, garden, therapeutic garden and viewing landscape and so forth. The research methods and measures used to assess health effects in the reviewed studies have applied in a different way ranged from quantitative methods (physical measures or quantitative observations) to qualitative methods (qualitative observations and surveys). In a literature review of research articles on the health outcomes have been found various research methods and measures used to assess health effects. This study will be concentrated mainly on methodological considerations in order to find the significant evidences related to evidence-based design (EBD). Future research should build the body of methodological knowledge to find more empirical evidences as sound scientific data and to improve the effectiveness of design interventions.
Lee, Yu Jin;Hwang, Seung-sik;Shin, Sang Do;Lee, Seung Chul;Song, Kyoung Jun
Journal of Korean Medical Science
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v.33
no.51
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pp.328.1-328.12
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2018
Background: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. Methods: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. Results: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1-3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3-2.9 [1.6%]; 1.4-1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. Conclusion: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.
Purpose: The purpose of this study was to identify the effects of applying jigsaw cooperative learning to basic nursing practicums on self-directed learning ability, self-efficacy, and learning outcomes. Methods: This study was based on a non-equivalent control group design, and the subjects were nursing students. The study allocated 30 people in the experimental group and 30 people in the control group, and jigsaw cooperative learning was applied to the experimental group for 2 hours every week for a total of 8 weeks. The traditional educational method was applied to the control group. The collected data were analyzed using SPSS v26.0. Results: The experimental group to which jigsaw cooperative learning was applied showed statistically significant differences in self-directed learning ability (F=4.49, p=.038), self-efficacy (F=6.15, p=.016), and learning outcomes (F=19.48, p<.001) compared to the control group. Conclusion: By applying jigsaw cooperative learning to basic nursing practicums, this study confirmed its effect not only on the effective domain such as self-directed learning ability and self-efficacy, but also on learning outcomes in the practical domain. We propose future studies apply jigsaw cooperative learning to various practice classes to achieve learning outcomes that focus on cultivating students' practical capabilities.
Journal of Korean Academy of Nursing Administration
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v.6
no.2
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pp.245-257
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2000
The purpose of this study was to validate caregiver outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 73 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not at all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. Eight outcome label were considered to be 'supporting' and three outcome label were considered to be 'nonsupporting'. 2. 'Caregiver-Patient Relationship' attained an OCV score of 0.64 and the highest OCV score among caregiver outcomes.. 3. 'Caregiver Emotional Health' attained an OCV score of 0.54 and the lowest OCV score among caregiver outcomes. Replication study will be needed and outcomes sensitive to Korean culture need to be developed.
Purpose: This study was done to test a structural equation modeling of case management outcomes in order to identify parameters affecting case management outcomes for the community-dwelling vulnerable elders. Methods: Data were collected from 309 nurses (case managers) and community-dwelling vulnerable elders (clients) from public health centers. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and covariance structure analysis were performed using SPSS Version 18.0 for Windows and Amos 16.0. Results: The hypothetical model had an acceptable fit: GFI=.97, CFI=.95, RMSEA=.02, SRMR=.05. The factor "case managers' singularity" had the greatest impact on case management outcomes in this model. In addition, the factor "case management practice" influenced case management outcomes; however, client characteristics did not. Case managers' singularity affected case management outcomes directly and indirectly, with case management practice mediating the latter effect. Conclusion: These results suggest that the causal relationship between case management outcomes and factors influencing these outcomes should be clarified through longitudinal research including a variety of client characteristics. In addition, in future studies, analysis of the effects of programs to improve manpower quality and examine the relationships among case management outcomes should be done.
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