PURPOSE: The purpose of this study was to compare the validity of three fall risk assessment scales including the Morse Fall Scale (MFS), the Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and the Johns Hopkins Hospital Fall Risk Assessment Tool (JHFRAT). METHODS: This study was a prospective validation cohort study in five acute care hospitals in Seoul and Gyeonggi-Do, Korea. In total, 356 patients over the age of 18 years admitted from December 2009 to February 2010 participated. The three fall risk assessment scales listed above were tested for sensitivity, specificity, positive predictive and negative predictive values. A receiver-operating characteristic (ROC) curve was generated to show sensitivities and specificities for predicting falls based on different threshold scores for considering patients at high risk. RESULTS: Based on the mean scores of each scale for falls, the MFS at a cut-off score of 50 had a sensitivity of 78.9%, specificity of 55.8%, positive predictive value of 30.8%, and negative predictive value of 91.4%, which were the highest values among the three fall assessment scales. Areas under the curve of the ROC curves were .761 for the MFS, .715 for the BMFRAS, and .708 for the JHFRAT. CONCLUSIONS: Accordingly, of the three fall risk assessment scales, the highest predictive validity for identifying patients at high risk for falls was achieved by the MFS.
Accidental Falls ; Cohort Studies ; Humans ; Korea ; Prospective Studies ; Risk Assessment ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures

Amygdalin is known as vitamain B17, and it was called laetrile. Amygdalin is composed of two molecules of glucose, one molecule of benzaldehyde which induces an analgesic action, and one molecule of hydrocyanic acid which is an anti-neoplastic compound. Amygdalin had been used to treat cancers and relieve pain. In order to evaluate whether the analgesic action of amygdalin is related with descending pain control system, we performed patch clamp study. In the present study, the modulatory effects of amygdalin on glycine- and glutamate-induced ion currents in periaqueductal gray (PAG) neurons were investigated using the nystatin-perforated patch clamp method. Continuous application of lipopolysaccharides (LPS) on PAG neurons resulted in increased glycine-induced ion current, and in decreased glutamate-induced ion current. In contrast, continuous application of amygdalin with LPS resulted in decreased glycine-induced ion current increased by LPS, and increased glutamate- induced ion current decreased by LPS in concentration- and time-dependent fashion. These results demonstrate that amygdalin modulates neuronal activity of PAG by modulation of glycine and glutamate. Based on the present results, it can be suggested that amygdalin participates in the regulation of the descending pain control system in the level of PAG neurons. The present study demonstrated that activation of the descending pain control system is one of the possible analgesic mechanisms of amygdalin.
Amygdalin ; Animals ; Benzaldehydes ; Cyclooxygenase 2 ; Glucose ; Glutamic Acid ; Glycine ; Hydrogen Cyanide ; Lipopolysaccharides ; Neurons ; Periaqueductal Gray ; Rats

Peripheral nerve injuries are a commonly encountered clinical problem and often result in a chronic pain and severe functional deficits. c-Fos expression is sometimes used as a marker of increased neuronal activity. We have developed herbal bath "HAC" for pain control using the following herbs: Harpagophytum procumbens, Atractylodes japonica, and Corydalis tuber. In the present study, we investigated the effects of herbal bath "HAC" on the recovery rate of the locomotor function and the expression of c-Fos in the ventrolateral periaqueductal gray (vlPAG) region of brain following sciatic crushed nerve injury in rats. Walking track analysis for the evaluation of functional recovery and immunohistochemistry for the c-Fos expression were used for this study. In the present results, characteristic gait change with dropping of the sciatic function index (SFI) was observed and c-Fos expression in the vlPAG was suppressed following sciatic crushed nerve injury in rats. Immersion into herbal bath "HAC" enhanced SFI value and restored c-Fos expression in the vlPAG to the control value. These results suggest that herbal bath "HAC" might activate neurons in the vlPAG, and it facilitates functional recovery from peripheral nerve injury. Here we showed that herbal bath "HAC" could be used as a new therapeutic intervention for pain control and functional recovery from peripheral nerve injury.
Animals ; Atractylodes ; Baths ; Brain ; Chronic Pain ; Corydalis ; Gait ; Harpagophytum ; Immersion ; Immunohistochemistry ; Neurons ; Periaqueductal Gray ; Peripheral Nerve Injuries ; Rats ; Track and Field ; Walking

PURPOSE: The purpose of this study was to identify the effects of an education program on safety perception, safety control, autonomy and accountability in clinical nurses. Precedent cases related to patient safety were used in the education program. METHODS: A quasi-experimental design with pretest and posttest measures was used. Participants in the study, 72 nurses in the experimental group, 71 nurses in the control group, were enrolled for 3 months. The education program was composed of the 20 precedent cases related to patient safety from home and foreign countries. RESULTS: The major findings of this study were as follows: Safety perception (p=.000), Safety control (p=.000), attitude toward autonomy (p=.000), and attitude toward accountability (p=.000) improved after the education program. CONCLUSION: The findings from this study indicate that an education program using precedent cases is an efficient method to improve behavior and change attitudes towards protecting patients' safety and preventing malpractice claims against nurses.
Humans ; Malpractice ; Patient Safety ; Social Responsibility

BACKGROUND/OBJECTIVES: Weight loss via a mobile application (App) or a paper-based diary (Paper) may confer favorable metabolic and anthropometric changes. SUBJECTS/METHODS: A randomized parallel trial was conducted among 57 adults whose body mass indices (BMIs) were 25 kg/m 2 or greater. Participants randomly assigned to either the App group (n = 30) or the Paper group (n = 27) were advised to record their foods and supplements through App or Paper during the 12-week intervention period. Relative changes of anthropometries and biomarker levels were compared between the 2 intervention groups.Untargeted metabolic profiling was identified to discriminate metabolic profiles. RESULTS: Out of the 57 participants, 54 participants completed the trial. Changes in body weight and BMI were not significantly different between the 2 groups (P = 0.11). However, body fat and low-density lipoprotein (LDL)-cholesterol levels increased in the App group but decreased in the Paper group, and the difference was statistically significant (P = 0.03 for body fat and 0.02 for LDL-cholesterol). In the metabolomics analysis, decreases in methylglyoxal and (S)-malate in pyruvate metabolism and phosphatidylcholine (lecithin) in linoleic acid metabolism from pre- to post-intervention were observed in the Paper group. CONCLUSIONS In the 12-week randomized parallel trial of weight loss through a App or a Paper, we found no significant difference in change in BMI or weight between the App and Paper groups, but improvement in body fatness and LDL-cholesterol levels only in the Paper group under the circumstances with minimal contact by dietitians or health care providers.Trial Registration: Clinical Research Information Service Identifier: KCT0004226