• Title/Summary/Keyword: mixed outcomes

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Geographic Disparities in Prostate Cancer Outcomes - Review of International Patterns

  • Baade, Peter D.;Yu, Xue Qin;Smith, David P.;Dunn, Jeff;Chambers, Suzanne K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1259-1275
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    • 2015
  • Background: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. Materials and Methods: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. Results: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Conclusions: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.

The Prognostic Factors of Selective Transforaminal Epidural Block in Patients with Low Back Pain (요하지통 환자에서 선택적 경추간공 경막외강 블록의 예후 인자)

  • Choi, Byung In;Han, Jeong Mi;Kweon, Tae Dong;Lee, Youn-Woo
    • The Korean Journal of Pain
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    • v.20 no.1
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    • pp.54-59
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    • 2007
  • Background: Selective transforaminal epidural block (STEB) has showen effectiveness as a diagnostic and therapeutic option for the management of patients with low back pain or sciatica. This study was carried out in order to determine the short-term effects and prognostic factors associated with STEB in patients with low back pain or sciatica. Methods: Ninety-seven patients were selectedfor participation in this study. Their diagnosis were based werewason the clinical symptoms and MRI findings. We performed STEB under fluoroscopic guidance and injected 3 ml of radio opaque dye in order to confirm the technical success of the procedure. We then injected 20 mg of triamcinolone mixed into 3 ml of 0.5% mepivacaine. One month later, we classified the patient outcomes as excellent, good, moderate or poor, according to the degree of reduction in VAS score from baseline. The independent variables assessed included symptom duration, block level, number of blocks, primary diagnosis, prior caudal block, anterior epidural space filling of dye, medication history, demographic data, radiating pain, back surgery and spondylolisthesis. Results: At a mean follow-up period of 1 month after STEB, excellent results were noted in the patients diagnosed with herniated lumbar disc (70%), non-specific spondylosis (54%), spinal stenosis (44%), and failed back syndrome (28%). The patients with epidural adhesion and combined spondylolisthesis were associated with poorer outcomes. Combined caudal block, symptom duration and the extent of epidural spread of the drug were not related to the effectiveness of the treatment. Conclusions: Selective transforaminal epidural block is effective in treating patients with radiculopathy, such as herniated lumbar disc, but it isrelatively ineffective in treating patients with structural deformities, such as failed back syndrome and spondylolisthesis.

Liver Transplantation for Acute Toxic Hepatitis due to Herbal Medicines and Preparations (식물 제제와 연관된 급성 독성 간염으로 인한 간이식 : 원인 제제와 손상 유형에 대한 후향적 분석)

  • Sohn, Chang-Hwan;Cha, Myung-Il;Oh, Bum-Jin;Yeo, Woon-Hyung;Lee, Jae-Ho;Kim, Won;Lim, Kyoung-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.110-116
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    • 2008
  • Purpose: Acute toxic hepatitis is a common cause of acute liver failure (ALF). We investigated the causes, clinical manifestation, and outcomes of ALF patients who underwent liver transplantation due to acute toxic hepatitis caused by herbal medicines and preparations. Methods: Between January 1992 and May 2008, we retrospectively reviewed the medical records of 24 patients who were transplanted due to acute toxic hepatitis caused by herbal medicines and preparations. We applied the RUCAM score to patients with acute toxic hepatitis and assessed the relationship between herbal preparations and liver injury. We studied the patients' medication history, liver function tests, and clinical outcomes. Results: The type of liver injury was divided into three groups: hepatocellular type, 14 patients (58.3%); cholestatic type, 4 patients (16.7%); and mixed type, 6 patients (25%). Polygonum multiflorum Thunberg (3 cases) was the most common cause of acute toxic hepatitis, followed by Acanthopanax senticosus (2 cases), pumpkin juice (2 cases), Dictamnus dasycarpus Turcz (2 cases), Hovenia dulcis (1 case), Phellinus linteus (1 case), and Artemisia capillaries (1 case). One year survival after liver transplantation was 76%. Conclusion: We identified the herbal preparations leading to acute liver failure. Many patients consider herbal remedies to be completely free of unwanted side effects. However, we found that many herbal products have biological activities that can lead to severe hepatotoxicity.

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Beyond the clinical walls: registered dietitian nutritionists providing medical nutrition therapy in the home setting

  • Hicks-Roof, Kristen;Xu, Jing;Fults, Amanda K.;Latortue, Krista Yoder
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.789-797
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    • 2021
  • BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m2. Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.

Long-term Survival Outcomes of Laparoscopic Gastrectomy for Advanced Gastric Cancer: Five-year Results of a Phase II Prospective Clinical Trial

  • Ahn, Sang-Hoon;Kang, So Hyun;Lee, Yoontaek;Min, Sa-Hong;Park, Young Suk;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.102-110
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    • 2019
  • Purpose: Despite an increased acceptance of laparoscopic gastrectomy (LG) in early gastric cancer (EGC), there is insufficient evidence for its oncological safety in advanced gastric cancer (AGC). This is a prospective phase II clinical trial to evaluate the feasibility of LG with D2 lymph node dissection (LND) in AGC. Materials and Methods: The primary endpoint was set as 3-year disease-free survival (DFS). The eligibility criteria were as follows: 20-80 years of age, cT2N0-cT4aN3, American Society of Anesthesiologists score of 3 or less, and no other malignancy. Patients were enrolled in this single-arm study between November 2008 and May 2012. Exclusion criteria included cT4b or M1, or having final pathologic results as EGC. All patients underwent D2 lymphadenectomy. Three-year DFS rates were estimated by the Kaplan-Meier method. Results: A total of 157 patients were enrolled. The overall local complication rate was 10.2%. Conversion to open surgery occurred in 11 patients (7.0%). The mean follow-up period was $55.0{\pm}20.4months$ (1-81 months). The cumulative 3-year DFS rates were 76.3% for all stages, and 100%, 89.3%, 100%, 88.0%, 71.4%, and 35.3% for stage IB, IIA, IIB, IIIA, IIIB, and IIIC, respectively. Recurrence was observed in 37 patients (23.6%), including hematogenous (n=6), peritoneal (n=13), locoregional (n=1), distant node (n=8), and mixed recurrence (n=9). Conclusions: In addition to being technically feasible for treatment of AGC in terms of morbidity, LG with D2 LND for locally advanced gastric cancer showed acceptable 3-year DFS outcomes.

Research on the Value of Korean Neologism Education and the Method of Building Data (한국어 신조어 교육의 가치와 자료 구축을 위한시론)

  • Kim, Deok-shin
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.1
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    • pp.371-377
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    • 2022
  • This study examines whether there are subjects and learners to pay attention to as 'processes' that have not been dealt with in Korean vocabulary education due to prioritizing learning outcomes, educational outcomes, and objects. In addition, the purpose of this study was to examine the educational value of the neologism and to suggest data construction method for it. Proposal to create a 'single-level list' of neologisms as a preliminary work to create a dictionary as a learning material to teach new words to academic purpose learners, taking neologism as the vocabulary in the blind spot and foreign academic purpose learners as learners in the blind spot stage. did The 'single-layered list' is to divide new words by period into coined words, meanings, culture, etc. and construct them as data. Through this study, we will help systematically teach Korean vocabulary by adding vocabulary to be learned as a 'process' to the results of Korean vocabulary education so far.

Effect of the Tai Chi Exercise Program on Physical Function, Cognitive Function, and Quality of Life among Older Adults in the Community: A Preliminary Study (타이치운동 프로그램이 지역사회 거주 노인의 신체기능, 인지기능 및 삶의 질에 미치는 효과: 인지기능을 중심으로-예비조사 연구)

  • Song, Rhayun;Jang, Taejeong
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.30 no.3
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    • pp.252-263
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    • 2023
  • Purpose: To assess the feasibility, safety, and preliminary estimates of effectiveness of Tai Chi on the functional outcomes of older adults in the community. Methods: This was a mixed-method study that employed a single-group repeated measure design and in-depth interviews. Nine older adults were recruited from the community were recruited to participate in a Tai Chi program, conducted twice weekly for 6 months. Research outcomes included physical function, cognitive function, and quality of life, measured at intervals of 3 and 6 months. Findings: Tai Chi exercises were gradually conducted based on the health status of the older adults. All participants actively participated in the program with an average attendance of 90%. Consequently, the participants showed significant improvements in mobility and their memory recall ability at both 3 and 6 months. Additionally, the results of the Stroop test exhibited improvement 3 months after the commencement of the study program. Quality of life of the participants improved according to the mild cognitive impairment questionnaire, but it did not show significant improvement in health-related quality of life. Conclusion: The Tai Chi exercise program was a safe and, feasible program to improve the physical function, cognitive function, quality of life among the older adults in the community.

The Role of Pharmacists' Interventions in Increasing Medication Adherence of Patients With Epilepsy: A Scoping Review

  • Iin Ernawati;Nanang Munif Yasin;Ismail Setyopranoto;Zullies Ikawati
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.3
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    • pp.212-222
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    • 2024
  • Objectives: Epilepsy is a chronic disease that requires long-term treatment and intervention from health workers. Medication adherence is a factor that influences the success of therapy for patients with epilepsy. Therefore, this study aimed to analyze the role of pharmacists in improving the clinical outcomes of epilepsy patients, focusing on medication adherence. Methods: A scoping literature search was conducted through the ScienceDirect, PubMed, and Google Scholar databases. The literature search included all original articles published in English until August 2023 for which the full text was available. This scoping review was carried out by a team consisting of pharmacists and neurologists following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews and the Joanna Briggs Institute guidelines, including 5 steps: identifying research questions, finding relevant articles, selecting articles, presenting data, and compiling the results. Results: The literature search yielded 10 studies that discussed pharmacist interventions for patients with epilepsy. Five articles described educational interventions involving drug-related counseling with pharmacists. Two articles focused on similar pharmacist interventions through patient education, both verbal and written. Three articles discussed an epilepsy review service, a multidisciplinary intervention program involving pharmacists and other health workers, and a mixed intervention combining education and training with therapy-based behavioral interventions. Conclusions: Pharmacist interventions have been shown to be effective in improving medication adherence in patients with epilepsy. Furthermore, these interventions play a crucial role in improving other therapeutic outcomes, including patients' knowledge of self-management, perceptions of illness, the efficacy of antiepileptic drugs in controlling seizures, and overall quality of life.

The Impact of Urban Space Structure on Commercial Real Estate Markets (물리적 도시공간구조가 상업용 부동산시장에 미치는 영향)

  • Kim, Kyung-Min;Shin, Sang-Mook
    • Journal of the Economic Geographical Society of Korea
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    • v.16 no.1
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    • pp.71-85
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    • 2013
  • This paper examines the impact of urban space structure on real estate markets, especially on commercial real estate markets. Based on a large scale of GIS dataset, volumes of each land use type are examined. This vast dataset enables 3-dimensional analysis of land use in the entire Seoul area, overcoming the limits of previous research relying on simple 2-dimensional analysis. After then, the Herfindahl index is used to calculate the level of mixed-uses. It analyzes whether a building price is influenced by circumjacent commercial buildings and its residential development pattern. The regression outcomes verify that a nearby area's development patterns make an impact on an office building price. It shows the possibility that a new-urbanism's argument can be actualized.

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Facial Soft Tissue Augmentation using Autologous Fat Mixed with Stromal Vascular Fraction

  • Lee, Sang Kyun;Kim, Deok-Woo;Dhong, Eun-Sang;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.39 no.5
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    • pp.534-539
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    • 2012
  • Background Autologous fat grafting evolved over the twentieth century to become a quick, safe, and reliable method for restoring volume. However, autologous fat grafts have some problems including uncertain viability of the grafted fat and a low rate of graft survival. To overcome the problems associated with autologous fat grafts, we used uncultured adipose tissue-derived stromal cell (stromal vascular fraction, SVF) assisted autologous fat grafting. Thus, the purpose of this study was to evaluate the effect of SVF in a clinical trial. Methods SVF cells were freshly isolated from half of the aspirated fat and were used in combination with the other half of the aspirated fat during the procedure. Between March 2007 and February 2008, a total of 9 SVF-assisted fat grafts were performed in 9 patients. The patients were followed for 12 weeks after treatment. Data collected at each follow-up visit included clinical examination of the graft site(s), photographs for historical comparison, and information from a patient questionnaire that measured the outcomes from the patient perspective. The photographs were evaluated by medical professionals. Results Scores of the left facial area grafted with adipose tissue mixed with SVF cells were significantly higher compared with those of the right facial area grafted with adipose tissue without SVF cells. There was no significant adverse effect. Conclusions The subjective patient satisfaction survey and surgeon survey showed that SVF-assisted fat grafting was a surgical procedure with superior results.