BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

The aim of this study was to examine the therapeutic potential of sulfasalazine and prednisolone in a mouse collagen antibody-induced arthritis (CAIA) model. Twenty-five male BALB/c mice were randomly divided into five groups: group 1 (G1): control, group 2 (G2): probe control, group 3 (G3): CAIA, group 4 (G4): CAIA+sulfasalazine (10 mg/kg, oral), and group 5 (G5): CAIA+prednisolone (100 mg/kg, oral). Fluorescence bioimaging was performed in vivo 24 and 48 h after treatment with a fluorescence probe (OsteoSense® 680 EX), and all mice were sacrificed. The hind knee joints were fixed in 10% neutral phosphate-buffered formalin, and micro-computed tomography (micro-CT) and histopathological analyses were performed. The paw thickness increased in a time-dependent manner in G3 mice, but trended toward a decrease in both G4 and G5 mice. Fluorescence intensity increased in G3 mice at 24 and 48 h after fluorescence probe treatment, but the fluorescence intensity in G4 and G5 mice was lower than that in G3. Micro-CT analyses showed that the joint surfaces of G3 mice had a rough and irregular articular appearance, but the occurrence of these irregularities was lower in G4 and G5. Hematoxylin and eosin and Safranin O-fast green staining confirmed that destruction of the cartilage and bony structures, synovial hyperplasia, and inflammatory cell infiltration all occurred in G3, and that the occurrence of these phenomena was lower in G4 and G5 than in G3. Taken together, these results suggest that sulfasalazine and prednisolone can reduce acute rheumatoid arthritis in mice.
Animals ; Arthritis* ; Arthritis, Rheumatoid ; Cartilage ; Collagen* ; Eosine Yellowish-(YS) ; Fluorescence ; Formaldehyde ; Hematoxylin ; Humans ; Hyperplasia ; Joints ; Knee Joint ; Male ; Mice* ; Prednisolone ; Sulfasalazine

OBJECTIVE: We investigated the usefulness of shortening of the fetal femur length (FL) and humeral length (HL) to predict Down syndrome at the middle gestation of pregnancy in Korean subjects. METHODS: This retrospective study involved 41 fetuses with Down syndrome and 328 fetuses with normal chromosome between 14+0 and 28+6 weeks of gestation. The expected FL and HL for any biparietal diameter (BPD) was calculated based on the control group data. The odds ratios for measure to expected FL and HL in comparison between normal fetuses and Down syndrome fetuses were calculated. The sensitivities of short FL and HL to predict Down syndrome were analyzed at a fixed false positive rate of 5%. RESULTS: The lengths of femur and humerus long bone for any BPD in Down syndrome group were significantly shorter than the lengths in control group (P<0.001). A low ratio of measured to expected FL and HL increased the risk of fetal Down syndrome (P<0.001). At a fixed false positive rate of 5%, the sensitivities were 21.3% (95% confidence interval [CI] 0.698~0.852, P<0.001) in FL and 29.9% (95% CI 0.773~0.914, P<0.001) in HL. CONCLUSION: Both of short FL and HL are poor marker for Down syndrome at the middle gestation of pregnancy in Korean population though the sensitivity of HL was higher than FL.
Down Syndrome ; Femur ; Fetus ; Humerus ; Odds Ratio ; Pregnancy ; Prenatal Diagnosis ; Retrospective Studies

OBJECTIVE: This study investigated the relationship between orthodontic treatment and temporomandibular disorders (TMD) in South Korean population. METHODS: This study obtained data from the 2012 Korean National Health and Nutrition Examination Survey. The final sample size was 5,567 participants who were ≥ 19 years of age. Logistic regression analysis was performed to evaluate the relationship between orthodontic treatment and TMD. RESULTS: Participants who underwent orthodontic treatment showed higher educational level, lower body mass index, reduced chewing difficulty, and reduced speaking difficulty. The adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) for orthodontic treatment and TMD were 1.614 (1.189–2.190), 1.573 (1.162–2.129) and 1.612 (1.182–2.196) after adjusting for age, sex and psychosocial factors. Adjusted ORs and their 95% CIs for orthodontic treatment and clicking were 1.778 (1.289–2.454), 1.742 (1.265–2.400) and 1.770 (1.280–2.449) after adjusting for confounding factors. However, temporomandibular joint pain and functional impairment was not associated with orthodontic treatment. CONCLUSIONS Temporomandibular joint pain and dysfunction was not associated with orthodontic treatment.

Objectives: To compare presurgical skeletal factors and postsurgical relapse patterns between more relapsed (MR) and less relapsed (LR) groups. Materials and Methods: This study retrospectively examined patients who underwent mandibular setback surgery, classifying them into two groups based on the amount of relapse of the pogonion using K-means analysis. Comparisons were conducted by analyzing cephalometric radiographs presurgically (T0), at 1-month post-surgery (T1), and immediately after orthodontic treatment (T2). Results: The MR group at T0 had a lower articular angle and AB to the mandibular plane angle (MPA), higher gonial angle, shorter anterior and posterior facial heights, and shorter Frankfort horizontal plane to the upper incisor and first molar. The articular angle in the MR group increased postoperatively. The Frankfort MPA (FMA) did not differ significantly between the MR and LR groups. Conclusion Acute articular angle and short facial height with a high gonial angle in the presurgical stage can predict surgical relapse regardless of the FMA.

Objectives: To compare presurgical skeletal factors and postsurgical relapse patterns between more relapsed (MR) and less relapsed (LR) groups. Materials and Methods: This study retrospectively examined patients who underwent mandibular setback surgery, classifying them into two groups based on the amount of relapse of the pogonion using K-means analysis. Comparisons were conducted by analyzing cephalometric radiographs presurgically (T0), at 1-month post-surgery (T1), and immediately after orthodontic treatment (T2). Results: The MR group at T0 had a lower articular angle and AB to the mandibular plane angle (MPA), higher gonial angle, shorter anterior and posterior facial heights, and shorter Frankfort horizontal plane to the upper incisor and first molar. The articular angle in the MR group increased postoperatively. The Frankfort MPA (FMA) did not differ significantly between the MR and LR groups. Conclusion Acute articular angle and short facial height with a high gonial angle in the presurgical stage can predict surgical relapse regardless of the FMA.

Objectives: To compare presurgical skeletal factors and postsurgical relapse patterns between more relapsed (MR) and less relapsed (LR) groups. Materials and Methods: This study retrospectively examined patients who underwent mandibular setback surgery, classifying them into two groups based on the amount of relapse of the pogonion using K-means analysis. Comparisons were conducted by analyzing cephalometric radiographs presurgically (T0), at 1-month post-surgery (T1), and immediately after orthodontic treatment (T2). Results: The MR group at T0 had a lower articular angle and AB to the mandibular plane angle (MPA), higher gonial angle, shorter anterior and posterior facial heights, and shorter Frankfort horizontal plane to the upper incisor and first molar. The articular angle in the MR group increased postoperatively. The Frankfort MPA (FMA) did not differ significantly between the MR and LR groups. Conclusion Acute articular angle and short facial height with a high gonial angle in the presurgical stage can predict surgical relapse regardless of the FMA.