No abstract available.

Purpose: The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. Methods: We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. Results: The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p < .001), forced expiratory volume in one second (t = 6.02, 6.26, p < .001), and peak expiratory flow (t = 5.35, 5.68, p < .001) were significantly higher during breathing exercises using the VR-BRES. User evaluation was also significantly higher for the VR-BRES in terms of efficiency (Z = 3.86, p < .001), entertainingness (Z = 5.00, p < .001), and intention to use (Z = 3.22, p = .001) compared to CDB. However, there was no difference in convenience between the two methods (Z = −0.90, p = .369). Conclusion The VR-BRES has the potential to be an efficient breathing exercise solution. We recommend a clinical study that evaluates the effects of the VR-BRES for a certain period of time for people who need breathing exercises.

Purpose: This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cut-off values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cut-off analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cut-off values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively.Incidence of unplanned readmission was 25.4%. Optimal cut-off values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion The optimal cut-off value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

No abstract available.
Facial Pain* ; Immunosuppression ; Kidney Transplantation* ; Kidney* ; Organ Transplantation

PURPOSE: This study aimed to identify the relationships among physical symptoms, activities of daily living, and health-related quality of life (HRQoL) in community-dwelling older adults. METHODS: A stratified random sampling method was conducted to recruit participants from May 10 to August 17, 2007. Physical symptoms were measured using the Physical Health Questionnaire (PHQ), activities of daily living using the Late-Life Functional and Disability Instrument (LLFDI), and HRQoL using the Medical Outcomes Short-Form Health Survey (SF-36) in 242 community-dwelling elderly Korean people. RESULTS: The HRQoL correlates with the physical symptoms (r=-.31) and the function component (r=.59). Of the two disability parts of the LLFDI, the limitation dimension correlates higher (r=.57) with HRQoL than the frequency dimension (r=.42). The HRQoL is significantly associated with the function component, and disability limitation in capability which explained 44.4% of variance in physical health. CONCLUSION: These results may contribute to a better understanding of physical symptoms, activities of daily living, and HRQoL in community-dwelling older adults. Therefore, health programs for prompting older adult's health should be planned based on results of the study.
*Activities of Daily Living ; Aged ; Aged, 80 and over ; Disability Evaluation ; Female ; Health Status Indicators ; Humans ; Male ; *Quality of Life ; Questionnaires ; Residence Characteristics ; *Sickness Impact Profile

PURPOSE: The purpose of this study was to investigate the relationships among quality of sleep, depression, late-life function and disability in community-dwelling older women with urinary incontinence. METHODS: A stratified random sampling method was conducted to recruit participants from May 10 to August 17, 2007. Data were collected by questionnaires, which were constructed to include lower urinary tract symptoms, quality of sleep, depression, and late-life function and disability in 128 community-dwelling older women. RESULTS: The major findings of this study were as follow: 1) 56.3% of participants belonged to urinary incontinence group. 2) There were significant relationships between depression and sleep latency, sleep duration, daytime dysfunction, quality of sleep, function component, frequency dimension, and limitation dimension. 3) Depression was significantly associated with frequency dimension, limitation dimension in capability which explained 44% of variance in depression. CONCLUSION: These results may contribute to a better understanding of sleep quality, depression, latelife function and disability in the community-dwelling older women with urinary incontinence. Therefore, health programs for prompting older women's health should be planned based on results of the study.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; *Depression ; Female ; Humans ; Quality of Life ; Questionnaires ; Residence Characteristics ; Sleep ; Sleep Disorders/prevention & control/*psychology ; Translating ; Urinary Incontinence/physiopathology/*psychology

Postoperative atlantoaxial rotatory subluxation (AARS) is a rare complication that develops almost exclusively in children following oropharyngeal and otologic surgeries, proposing that oropharyngeal inflammatory responses and excessive head rotation are responsible factors. However, there have been no reports of AARS after excision of a nevus on the head and neck. Here, we present two cases of AARS following limited head rotation during simple nevus excision. Patient 1, a 9-year-old girl, complained of neck pain and limited range of motion after excision of the nevus on the neck. After 2 months, computed tomography and magnetic resonance imaging finally revealed AARS with a ruptured transverse atlantal ligament. A month of halo traction was required for the treatment. Patient 2, an 11-year-old girl, presented with immediate pain and limited neck extension after tissue expander insertion under the upper chest and excision of the nevus on her left cheek. The diagnosis was promptly made using cervical spine radiography. A cervical collar was applied for 1 month. Both patients recovered without any complications after treatment. This report highlights the importance of suspicion for AARS after surgery regardless of surgical duration or amount of head rotation.

Background: Despite the distinctly high risk of suicide among patients with psychiatric disorders, little is known regarding the nationwide rates and risk factors for suicide among individual subgroups of patients with psychiatric disorders. This study aimed to assess differences in suicide rates and identify risk factors for suicide across multiple psychiatric diseases using data from a nationally representative cohort in Korea. Methods: Six groups of incident patients with psychiatric disorders, namely those with drug use disorder (DUD), alcohol use disorder (AUD), schizophrenia (SCZ), bipolar disorder (BD), depressive disorder (DD), or other affective disorders (OADs), were extracted from the National Health Information Database and followed up. Suicide rates and risk factors were then determined for each disease group. Results: Patients with psychiatric disorders had higher suicide rates than did the general population, with standardized mortality ratios (SMRs) ranging from 2.5 to 16.6. In particular, patients with DUD showed markedly higher suicide rate (584.0 per 100,000 person-years [PYs]; SMR, 16.6) than did patients with affective disorders, including DD (119.8 per 100,000 PYs; SMR, 3.1). AUD, DUD, SCZ, and BD showed lower male/female suicide rate ratios (1.1–1.4) than did depressive and OADs (2.2–2.4). Old age increased the risk for suicide among those with DUD and OADs, while medical aid recipients exhibited the lowest suicide risk among those with the AUD and SCZ. Male sex and the presence of multiple psychiatric comorbidities were consistently identified as suicide risk factors across mental illness subgroups. Conclusion The current study observed substantial variations in suicide rates and risk factors across psychiatric disorders and patient characteristics, which have significant implications for suicide prevention strategies.

Background: The need for regulatory science development to evaluate advanced regulatory products is gradually increasing without hindering the technological development. Creating a research environment and fostering experts through the establishment of regulatory agency-led policies are essential for the development of regulatory science. Method: This is a comparative study of the United States, Japan, Singapore, and Korea. The literature and websites of each regulatory agency were reviewed, and the focus was on advantages and comparing advantages based on definition, development trends, and expert training projects. Results: The United States is striving to develop regulatory science in response to changes in the new pharmaceutical industry through the regulatory science report, and to foster expert both inside and outside the Food and Drug Administration (FDA). Japan is promoting regulatory science centered on regulatory science centers, and is focusing on researching work-related regulatory science within the Pharmaceuticals and Medical Devices Agency (PMDA) and improving employees’ ability to make regulatory decisions. Singapore was aiming to improve Southeast Asia’s regulatory capabilities under the leadership of Centre of Regulatory Excellence (CoRE) within Duke-NUS University. In 2021, Korea is in its early stages, starting to run a university's degree program related to regulatory science this year. Conclusion Regulatory science should be developed with the aim of improving the regulatory ability of the Ministry of Food and Drug Safety with Korea’s independent concept of regulatory science.

The prevalence of unruptured intracranial aneurysm varies between 3.6% and 6%.Aneurysms in the posterior circulation, inaccessible by normothermic surgical clipping and giant aneurysms require direct surgical clipping under hypothermic circulatory arrest for cerebral protection.The authors describe a case of giant basilar aneurysm clipping requiring deep hypothermic total circulatory arrest under total intravenous anesthesia.The patient was a 43-year-old female with a giant aneurysm at the tip of the basilar artery.Total intravenous anesthesia with propofol (average effect site concentration 4 mcg/ml) and remifentanil (average effect site concentration 3 ng/ml) and deep hypothermic total circulatory arrest were performed.Neurophysiologic function was monitored by electroencephalography, and somatosensory and motor evoked potentials. Cardiac and coagulation profiles showed no significant changes. The aneurysm was successfully clipped but the patient expired. Further collations of clinical experiences should enable the identification of an optimal means of anesthetic management during complex cerebrovascular surgery.
Adult ; Anesthesia, Intravenous ; Aneurysm ; Circulatory Arrest, Deep Hypothermia Induced ; Electroencephalography ; Evoked Potentials, Motor ; Female ; Humans ; Intracranial Aneurysm ; Piperidines ; Prevalence ; Propofol ; Surgical Instruments