OBJECTIVES: This study examined the effectiveness of community-based interventions designed for older adults living alone through a systematic review and meta-analysis. METHODS: The study incorporated 4 randomized controlled trials (RCTs) and 5 non-RCTs to evaluate various interventions. The methodological quality of these studies was assessed using the Downs and Black checklist, while Q-statistic and I-square tests were performed to examine statistical heterogeneity. Additionally, visual inspection of funnel plots and the trim-and-fill method were employed to investigate potential publication bias. Of the 2,729 identified studies, 9 met the criteria for inclusion in this review. Independent variables were categorized into 5 groups (physical activity, nutrition, social relationships, social participation, and combined intervention) to examine their effects. Dependent variables were similarly classified into 5 subgroups to identify the specific effects of the interventions. RESULTS: Interventions focusing on nutrition and combined approaches were the most effective, yielding effect sizes of 0.96 (95% confidence interval [CI], 0.66 to 1.25) and 0.43 (95% CI, 0.26 to 0.60), respectively. The interventions had the greatest impacts on the health behavior and mental health of the participants, with effect sizes of 0.98 (95% CI, 0.73 to 1.22) for health behavior and 0.67 (95% CI, 0.19 to 1.16) for mental health. CONCLUSIONS This study suggests a direction for the development of community-based interventions tailored to the needs of older adults living alone. Additionally, it provides evidence to inform policy decisions concerning this demographic.

Objectives: This study aimed to demonstrate the bone mineral density (BMD) and body composition in postmenopausal women with knee osteoarthritis (OA) who underwent surgical treatment, such as total knee arthroplasty, osteotomy, or meniscectomy. Methods: A total of 254 women with OA aged 50 years who underwent surgical treatment were enrolled in this study. We evaluated obesity-related factors, muscle components, and BMD using dual-energy X-ray absorptiometry. Results: No significant differences were noted in the BMD of the hip joint between the symptomatic side of the leg with knee OA and the contralateral side. However, when comparing the BMD of each component, the results indicated a significantly higher BMD in the obesity group based on body mass index (BMI). When defining sarcopenic obesity (SO) using various indicators of obesity (BMI, the estimated visceral adipose tissue area, android/gynoid ratio, and total body fat percentage), the prevalence of SO in the OA group who underwent surgical treatment ranged from 22.0% to 49.6%. Conclusions This study investigated obesity-related factors in patients with advanced knee OA who underwent surgery, revealing a high prevalence of overweight/obese individuals, the presence of SO, and a complex relationship between obesity, body composition, and bone density, highlighting the potential protective effects of weight-bearing on bone health while exploring the impact of sarcopenia on bone density differences in the context of OA. Depending on various definitions of obesity, diverse proportions of SO in patients with OA have been observed, and further detailed research is required to understand its impact on the condition.

Objectives: Bone mineral density (BMD) is measured in the hip and posteroanterior spine; moreover, according to the 2019 International Society for Clinical Densitometry guidelines, unilateral hip can be used. This study aimed to determine whether there is a difference between the BMD of both the femurs in postmenopausal women. Methods: A total of 343 postmenopausal women were enrolled in this study from January 1, 2010, to December 31, 2019 at a single tertiary hospital. By using the Hologic® Horizon W DXA System, the femur and spine BMD was measured; BMD was recorded in g/cm 2 .Following regions were analyzed in both the femurs: the femur neck, the trochanter area, and total femur. Results: Mean age at imaging was 62 ± 9.7 years, and significant difference in the total BMD of both the femurs (P = 0.003) was observed. In secondary analysis, patients with osteoporosis showed significant contralateral BMD discrepancies in trochanter and total proximal femur BMD (P = 0.041 and P = 0.011, respectively). However, in women with normal BMD, no significant difference between the right and left femur BMD was observed. Furthermore, measurement of solely the unilateral hip can lead to a 16.9% of underdiagnosis in postmenopausal women. Conclusions In conclusion, it is necessary to check BMD in both hips, particularly in patients suspected of osteoporosis.

Purpose: The objective of this study was to investigate food and nutrition information utilization practices of adults aged between 20 and 30 years to provide the basic data for developing customized content. Methods: Statistical analyses were performed using the SPSS program (ver. 24.0) for the χ 2 -test, t-test, one-way analysis of variance, and Duncan's multiple range test. Results: Of the 570 subjects surveyed, 45.4% were men, 54.6% were women, 66.3% were in their 20s, 33.7% were in their 30s, 41.4% were single-person households, and 58.6% lived with their families. On average, 14.2% of televisions (TVs), 26.0% of personal computers (PCs), and 63.7% of smartphones were used for more than three hours per day. 30.9% of respondents searched for food and nutrition information more than once a week. 70.0% of the respondents had then applied the information in real life and 54.7% of the respondents said they would share information with others. Information retrieval rate was in the order of ‘restaurant (64.8%)’, ‘diet (57.5%)’, and ‘food recipes (55.7%)’. Overall satisfaction with food and nutrition information averaged 3.33 on a five-point scale. Satisfaction score was in the order of ‘enough description and easy to understand (3.43)’, ‘matching title and content (3.35)’, and ‘providing new and novel information (3.22)’. Satisfaction scores were significantly higher in the group that searched for information (p < 0.001), the group that used the retrieved information in real life (p < 0.001), and the group that conveyed this information to others (p < 0.001). Conclusion To improve information user satisfaction, it is necessary to provide customized information that fits the characteristics of information users. For this purpose, it is necessary to continuously conduct surveys and satisfaction evaluations for each target group.

Purpose: The objective of this study was to investigate food and nutrition information utilization practices of adults aged between 20 and 30 years to provide the basic data for developing customized content. Methods: Statistical analyses were performed using the SPSS program (ver. 24.0) for the χ 2 -test, t-test, one-way analysis of variance, and Duncan's multiple range test. Results: Of the 570 subjects surveyed, 45.4% were men, 54.6% were women, 66.3% were in their 20s, 33.7% were in their 30s, 41.4% were single-person households, and 58.6% lived with their families. On average, 14.2% of televisions (TVs), 26.0% of personal computers (PCs), and 63.7% of smartphones were used for more than three hours per day. 30.9% of respondents searched for food and nutrition information more than once a week. 70.0% of the respondents had then applied the information in real life and 54.7% of the respondents said they would share information with others. Information retrieval rate was in the order of ‘restaurant (64.8%)’, ‘diet (57.5%)’, and ‘food recipes (55.7%)’. Overall satisfaction with food and nutrition information averaged 3.33 on a five-point scale. Satisfaction score was in the order of ‘enough description and easy to understand (3.43)’, ‘matching title and content (3.35)’, and ‘providing new and novel information (3.22)’. Satisfaction scores were significantly higher in the group that searched for information (p < 0.001), the group that used the retrieved information in real life (p < 0.001), and the group that conveyed this information to others (p < 0.001). Conclusion To improve information user satisfaction, it is necessary to provide customized information that fits the characteristics of information users. For this purpose, it is necessary to continuously conduct surveys and satisfaction evaluations for each target group.

PURPOSE: The Korean Triage and Acuity Scale (KTAS), which was developed in 2012 due to the need for a single triage tool for emergency patients in Korea, has since become nationalized. Although five years has passed, there has been limited evidence of its validation. Therefore, this study was conducted to analyze the validity of the new triage system. METHODS: We conducted a multicenter prospective study. Data were collected from seven hospitals and 42,187 patients were classified using the KTAS from April 1, 2013 to July 6, 2014. We analyzed whether the indirect severity variables showed meaningful differences according to KTAS levels. The variables consisted of disposition from emergency room, length of stay, numbers of consultations, examination of computed tomography, emergency room costs, and performance of emergent interventions. RESULTS: From KTAS level 1 to 5, a decreasing trend in the length of stay in emergency room, frequency of consultation with other departments, admission, computed tomography rate, emergency intervention rate, and emergency room costs was observed. Upon binominal logistic regression, disposition from emergency room and emergent intervention rate showed the highest odds ratio with statistical significance. CONCLUSION: The results of this study demonstrated that KTAS is a valid emergency triage tool that reflects the severity of the patient with indirect indicators. The results of this study will be useful as a reference for quality control of KTAS.
Emergencies ; Emergency Service, Hospital ; Health Resources ; Humans ; Korea ; Length of Stay ; Logistic Models ; Odds Ratio ; Prospective Studies ; Quality Control ; Referral and Consultation ; Triage

Thyroid hemiagenesis is a rare congenital anomaly that is caused by a developmental defect of a thyroid. Previous reports indicate that thyroid cancer associated with hemiagenesis is extremely rare. A 47-year-old woman presented with single nodule in the right thyroid gland that was incidentally detected during a routine medical checkup. Ultrasonography showed a 1.5×1.2 cm sized ill-defined irregular hypoehoic nodule in the right thyroid and the isthmus was present. However, the left thyroid was not seen and thyroid was disconnected at left paraisthmic area. Fine-needle aspiration cytology confirmed that the right thyroid nodule was papillary thyroid carcinoma. Total thyroidectomy with bilateral central compartment node dissection was performed. Permanent pathologic finding was 1.3×1 cm sized classical type papillary thyroid carcinoma with nodular hyperplasia. There was extensive lymphatic invasion and 3 metastatic lymph nodes out of 4 in central compartment. In conclusion, although thyroid hemiagenesis associated with thyroid carcinoma is extremely rare, treatment strategy is not different with patients with normal anatomy. And the possibility of developing a thyroid carcinoma should be considered in patients with hemiagenesis. Furthermore, it requires awareness of anatomical difference around the thyroid gland during operation.
Biopsy, Fine-Needle ; Female ; Humans ; Hyperplasia ; Lymph Nodes ; Middle Aged ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

We aimed to quantify periarticular osteoporosis and investigate its significance in 45 patients with rheumatoid arthritis (RA) and 106 controls. Dual-energy X-ray absorptiometry (DXA) was used to determine the ratio of shaft to periarticular bone mineral density (BMD) as an index of periarticular demineralization. Periarticular osteoporosis was measured by conventional radiography. The BMDs of shaft and periarticular regions in eight designated areas on proximal phalanges were quantified. Clinical variables were examined to identify risk factors for periarticular osteoporosis. The assessment of periarticular osteoporosis on X-ray images reached a moderate degree of interobserver agreement among four physicians (k = 0.47). For BMD quantification, we designed three types of mathematical formulae: the ratio of shaft to periarticular BMD, the mean of the ratios, and the ratio of the sums. These ratios were significantly higher in the patients with early RA (disease duration < or = 3 yr) than in controls (P < 0.01). The findings were not as distinctive in patients with established RA. Body mass index, cumulative dose of corticosteroid, and C-terminal telopeptide were correlated with BMD ratios. Conclusively, DXA-assisted localized quantification and BMD ratio calculations are feasible for assessing periarticular demineralization. Periarticular osteoporosis is a relatively distinctive feature of early RA.
Absorptiometry, Photon ; Adrenal Cortex Hormones/therapeutic use ; Adult ; Aged ; Arthritis, Rheumatoid/*diagnosis/etiology ; Body Mass Index ; *Bone Density ; Collagen Type I/analysis ; Female ; Humans ; Joints ; Male ; Middle Aged ; Osteoporosis/complications/*diagnosis/radiography ; Peptides/analysis ; ROC Curve ; Risk Factors

PURPOSE: Medullary breast carcinomas (MBC) have been known to represent a rare breast cancer subtype associated with a more favorable prognosis than invasive ductal carcinomas (IDC). The purpose of this study was to compare the clinicopathologic characteristics and outcomes of MBC with those of IDC. METHODS: We retrospectively reviewed medical records of patients with invasive breast cancer who were managed surgically from August 1995 to June 2010. RESULTS: Fifty-two patients were identified with MBC and 5,716 patients were identified with IDC. The clinicopathologic features, disease-free survival (DFS), and overall survival (OS) of patients with MBC were compared with those of patients with IDC. The MBC group presented at a younger age (p=0.005) and had a significant association with a higher histological grade (p=0.003) and nuclear grade (p<0.001) as well as negative estrogen receptor (p<0.001) and progesterone receptor (p<0.001) status. Lymphatic invasion was absent (p<0.001) and lymph node metastasis was rare (p<0.001). The DFS and OS did not differ significantly between the two groups (5-year DFS: 88.0% vs. 89.2%, p=0.920; 5-year OS: 93.4% vs. 94.4%, p=0.503). In multivariate analysis, the factors associated with DFS and OS were nuclear grade, histological grade, tumor size, lymph node metastasis, estrogen receptor status, progesterone receptor status, and human epidermal growth factor receptor 2 status, chemotherapy, and hormone therapy. However, DFS and OS were not significantly different between IDC and MBC according to histological type itself (DFS: hazard ratio 0.85, 95% confidence interval 0.12-6.05, p=0.866; OS: hazard ratio 1.49, 95% confidence interval 0.21-10.77, p=0.692). CONCLUSION: Although MBC has specific clinicopathologic features, its prognosis does not differ from IDC and is determined by prognostic factors such as tumor size and lymph node metastasis. Therefore, patients with MBC also require the same intensive treatment provided for IDC.
Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Medullary ; Disease-Free Survival ; Drug Therapy ; Estrogens ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Medical Records ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Receptor, Epidermal Growth Factor ; Receptors, Progesterone ; Retrospective Studies

PURPOSE: This study was done to identify the differences nursing needs and satisfaction with medications in patients admitted to hospital. METHOD: The participants were 258 patients admitted for 3days or more to D hospital. The data were analyzed using frequencies, percentages, means, standard deviations, t-test and ANOVA. SPSS-WIN 11.0 was used to assist analysis. RESULTS: The results are as follow: 1. Variables effecting nursing needs were education and economic level. All scores of nursing needs were higher in the group with less than middle school education compared to those with high school education or higher. 2. The scores for nursing needs were higher than the score for satisfaction in common item and injection domains. The scores for nursing satisfaction were higher than nursing needs in the oral medication domain. 3. The item with the highest difference between the scores for nursing needs and satisfaction was 'I want to know the side effect of the drugs'. CONCLUSION: Patients admitted to hospital want to know the therapeutic effect, side effect and reason for their drugs. However satisfaction with medication was not equal to needs. It is necessary to emphasize clinical pharmacology in nursing education programs.
Education ; Education, Nursing ; Humans ; Nursing* ; Pharmacology, Clinical