Objectives : Ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy. The aim of this study was to identify factors associated with the surgical outcome on the basis of preoperative clinical and radiological findings. Methods : Data obtained in 26 patients whot underwent posterior decompression for thoracic myelopathy, caused by thoracic OLF, were analyzed retrospectively. Patient age, duration of symptoms, OLF type, preoperative and postoperative neurological status using the Japanese Orthopedic Association (JOA) scoring system, surgical outcome, and other factors were reviewed. We compared the various factors and postoperative prognosis. All patients had undergone decompressive laminectomy and excision of the OLF. Results : Using the JOA score, the functional improvement was excellent in 8 patients, good in 14, fair in 2, and unchanged in 2. A mean preoperative JOA score of 6.65 improved to 8.17 after an average of 27.3 months. According to our analysis, age, gender, duration of symptoms, the involved spinal level, coexisting spinal disorders, associated trauma, intramedullary signal change, and dural adhesions were not related to the surgical outcome. However, the preoperative JOA score and type of OLF were the most important predictors of the surgical outcome. Conclusion : Early diagnosis and sufficient surgical decompression could improve the functional prognosis for thoracic OLF. The postoperative results were found to be significantly associated with the preoperative severity of myelopathy and type of OLF.
Objectives: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. Methods: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). Results: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI = 0.43 - 0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb${\geq}$11 g/dL, blood pressure within the range of 100-140 /60-90 mmHg, calcium x phosphate${\leq}$55 $g^2/dL^2$ and albumin${\geq}$4 g/dL were not significantly different between the groups. Conclusions: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.
BACKGROUND/OBJECTIVES: Calcium is important but deficient in diets of young adult women. This study aimed to examine if cognitive factors and eating behaviors differ according to calcium intake based on the Social Cognitive Theory. SUBJECTS/METHODS: Subjects were female college students in Seoul, Korea. Three hundred students completed the questionnaire regarding calcium intake, nutrition knowledge, outcome expectations, self-efficacy and eating behaviors. Data on 240 students were analyzed using t-test or ${\chi}^2$-test. Subjects were categorized into two groups, high calcium intake (HC, ${\geq}650mg/day$) and low calcium intake (LC, < 650 mg/day), according to recommended intakes of calcium for women aged 19-29 years. RESULTS: The LC group constituted 77.9% of total subjects. Nutrition knowledge was not different according to calcium intake. Three out of 12 outcome expectations items were significantly different between the HC and LC groups. Subjects in the HC group agreed more strongly with the practical benefits of consuming calcium-rich foods, including 'taste' (P < 0.01) and 'going well with other snacks' (P < 0.05), compared to those in the LC group. Negative expectations of 'indigestion' were stronger in the LC group than HC group (P < 0.001). Among self-efficacy items, perceived ability of 'eating dairy foods for snacks' (P < 0.001), 'eating dairy foods every day' (P < 0.01), and 'eating calcium-rich side dishes at meals' (P < 0.05) differed significantly between the HC and LC groups. Eating behaviors including more frequent consumption of dairy foods, fruits or fruit juice (P < 0.001), anchovy, seaweeds, green vegetables, protein-rich foods (P < 0.05), and less frequent consumption of sweets or soft drinks (P < 0.01) were significantly related to calcium intake. CONCLUSIONS: This study found that outcome expectations, self-efficacy in consuming calcium-rich foods, and eating behaviors are important in explaining calcium intake. Nutrition education needs to address practical benefits, reduce negative expectations of calcium-rich foods, increase self-efficacy, and modify eating behaviors contributing to calcium intake.
Ryynanen, Olli-Pekka;Leppanen, Timo;Kekolahti, Pekka;Mervaala, Esa;Toyras, Juha
Healthcare Informatics Research
/
v.24
no.4
/
pp.346-358
/
2018
Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).
Objectives The present study retrospectively investigated clinical outcome of patients with structual scoliosis during Chuna treatment. Methods : The study population consisted of 34 patients(14 patients of adolescent and 20 patients of adult) who were diagnosised as scoliosis with radiological finding. All patients were treated with Chuna treatment, and after treatment, evaluated with radiological measurement by calculating the scoliosis correction angle from the Initial and follow-up spine AP and lateral views. Also the evaluation of clinical outcome was done twice pre and post treatment during this study. Results : The results were summarized as follows ; 1) The 85.3 percent of patients complained physical pain. and adult group had various painful lesion compared with adolescent group. 2) Adult group had treated $18.0{\pm}7.2$ times and adolescent group treated $13.5{\pm}5.7$ times with Chuna treatment. 3) Scoliotic angle is reduced in 92.9 percent of adolescent group and had all of adult group after Chuna treatment, especially, statistically significance appeared in adult group. 4) Adult group was superior to adolescent group in correctability and scoliotic angle change. 5) Correction effect was better in the group which initial scoliotic angle was lessor, or had more time of treatment. 6) According to grade of vertebral body rotation, scoliotic angle is larger and correctability was lower. Conclusions : Chuna treatment was efficacious against scoliosis. And it is necessary for adolescent scoliosis patient to be more carefully treated and observed.
This study is to consider the result of the Field Trip Contest(FTC) and get a suggestion as a way of environmental education at school level in field. FTC was executed with selected students(3/1team) of 5th grade nationwide at Nam-Han mountain fortress in the suburbs of Seoul in Oct., 1994. The outcome of FTC was very high with the score of 1.38/2.0, and the quality of the program was generally high with the score of 1.09/2.0. Among areas of the outcome domain, accomplishment of the objectives of FTC was very high(1.55), execution of the policy of FTC was generally high(1.27), and operation and promotion of FTC was generally high(1.16). And in the Program of FTC domain, meaning of execution was very high(1.57), possibility of accomplishment was not high(0.03), validity of the content was generally high(1.18), appropriateness of activity scope was generally high(1.15), possibility of application into school system was generally high(1.22), and extending effect to education was generally high(0.9). Participants responded they got a great experience of inquiry for protecting nature during the activity of FTC and teachers accompanying found a good possibility to do in own school province.
Objectives: Adjusting for potential confounders is crucial for producing valuable evidence in outcome studies. Although numerous studies have been published using the Korea National Health Insurance Claim Database, no study has critically reviewed the methods used to adjust for confounders. This study aimed to review these studies and suggest methods and applications to adjust for confounders. Methods: We conducted a literature search of electronic databases, including PubMed and Embase, from January 1, 2021 to December 31, 2022. In total, 278 studies were retrieved. Eligibility criteria were published in English and outcome studies. A literature search and article screening were independently performed by 2 authors and finally, 173 of 278 studies were included. Results: Thirty-nine studies used matching at the study design stage, and 171 adjusted for confounders using regression analysis or propensity scores at the analysis stage. Of these, 125 conducted regression analyses based on the study questions. Propensity score matching was the most common method involving propensity scores. A total of 171 studies included age and/or sex as confounders. Comorbidities and healthcare utilization, including medications and procedures, were used as confounders in 146 and 82 studies, respectively. Conclusions: This is the first review to address the methods and applications used to adjust for confounders in recently published studies. Our results indicate that all studies adjusted for confounders with appropriate study designs and statistical methodologies; however, a thorough understanding and careful application of confounding variables are required to avoid erroneous results.
Journal of the Korean Society of Manufacturing Process Engineers
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v.7
no.4
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pp.82-95
/
2008
As society has changed to being more knowledge-based, it is necessary that change of paradigm is incorporated into engineering education and the education goals and the assessment method of educational outcomes is developed to promptly meet the needs of the times. A purpose of this study is to measure learning outcomes in coursework of engineering college every semester, which ultimately provides to validate program outcomes. We looked into teaching-learning style of course in the engineering college and analyzed its grade method and tool. By use of a survey, we derived a reasonable method to measure for the learning outcomes in course and presented tools for course-embedded assessment to measure that learning outcomes had been tied to their objectives. These tools are effective to determine that program outcomes and education goals have been achieved, ultimately. In addition, it will help that instruction builds a loop system for better.
This paper explores and proposes the evaluation criteria of design projects in the entry-level design course. In the entry-level engineering design course the students proceeds various design projects to understand the concept of engineering design process and to develop the creativity. The evaluation criteria of design projects is very important component because the outcome of students in the engineering design course are effected from the evaluation criteria that enforces the students to focus on doing their task. According to this case study the evaluation criteria can be good solution to evaluate the design projects. By the outcome standard of ABEEK on the entry-level engineering design course the evaluation criteria was selected with the results of design projects such as design plan, report, handicrafts, objectives.
Objectives: This study investigated the association between menopausal-specific quality of life (MENQOL) and breast cancer screening beliefs among Hong Kong Chinese menopausal and postmenopausal women. Methods: A cross-sectional study was employed to collect data. The questionnaire was distributed to a convenience sample of 218 women aged above 45. The outcome variables were breast cancer screening beliefs and breast examination. Multiple regression analyses were conducted to test the effect of 4 domains in MENQOL (vasomotor, psycho-social, physical, and sexual symptom) and the health behaviors on the 2 outcome variables. Results: This study found that the overall MENQOL scores (in particular psycho-social, and physical aspects) were significantly associated with positive attitudes toward health check-ups and better knowledge and perceptions in breast cancer. Regular exercise was also significantly related to breast examination. Conclusions: MENQOL (especially psycho-social and physical domain) and regular exercise are important factors associated with breast cancer screening beliefs. The results of this study illuminate health care professionals to develop primary health care strategies to improve the quality of life of mid-life women.
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