Effectiveness of Acceptance and Commitment Therapy for Chronic Pain Patients: A Systematic Review and Meta-Analysis / 정신간호학회지

PURPOSE: The aims of this study was to evaluate the effects of acceptance and commitment therapy (ACT) for chronic pain patients. METHODS: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses, we searched the Cochrane Library, CINAHL, EMBASE, OVID, PubMed and Korean databases to identify randomized controlled trials published through May 2019. To estimate the effect size, a meta-analysis of the studies was performed using the R program, and the risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies. RESULTS: A total of 11 studies were included in this study. Studies were heterogeneous, and random effects models were used in the analyses. ACT was effective for improving pain (g=−0.40, 95%CI:−0.69~−1.12, p<.001, I2=80%), pain acceptance (g=1.24, 95% CI:0.41~2.05, p<.001, I²=95%), anxiety (g=−0.47, 95% CI:−0.81~−0.13, p<.001, I²=84%), depression (g=−0.52, 95% CI:−0.85~−0.19, p<.001, I²=85%), and quality of life (g=1.14, 95% CI:0.11~2.17, p<.001, I²=95%). CONCLUSION: Our study findings of the ACT seems to be effective for improving pain, pain acceptance, anxiety, depression, and quality of life in patients with chronic pain. Additionally, ACT may be useful for reducing barriers to therapy, and various studies should be attempted.

Frequency of Self-Monitoring of Blood Glucose during the School Day Is Associated with the Optimal Glycemic Control among Korean Adolescents with Type 1 Diabetes

BACKGROUND: This study aimed to evaluate the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycosylated hemoglobin (HbA1c) levels among Korean adolescents with type 1 diabetes mellitus (T1DM). Factors affecting the SMBG frequency were analyzed in order to improve their glycemic control. METHODS: Sixty-one adolescents aged 13 to 18 years with T1DM were included from one tertiary center. Clinical and biochemical variables were recorded. Factors associated with SMBG frequency were assessed using structured self-reported questionnaires. RESULTS: Average total daily SMBG frequency was 3.8±2.1 and frequency during the school day was 1.3±1.2. The mean HbA1c level was 8.6%±1.4%. As the daily SMBG frequency increased, HbA1c levels declined (P=0.001). The adjusted odds of achieving the target HbA1c in participants who performed daily SMBG ≥5 significantly increased 9.87 folds (95% confidence interval [CI], 1.58 to 61.70) compared with those performed SMBG four times a day. In the subjects whose SMBG frequency < 1/day during the school day, an 80% reduction in the adjusted odds ratio 0.2 (95% CI, 0.05 to 0.86) showed compared to the group with performing two SMBG measurements in the school setting. The number of SMBG testing performed at school was significantly high for individuals assisted by their friends (P=0.031) and for those who did SMBG in the classrooms (P=0.039). CONCLUSION: Higher SMBG frequency was significantly associated with lower HbA1c in Korean adolescents with T1DM. It would be necessary to establish the school environments that can facilitate adequate glycemic control, including frequent SMBG.

Insulin Self-injection in School by Children with Type 1 Diabetes Mellitus

PURPOSE: Patients with type 1 diabetes have difficulty controlling diabetes during adolescence. Active self-management of diabetes in school during adolescence is essential for type 1 diabetic adolescents to successfully adapt to school and shift toward a healthy adulthood. This research examined insulin self-injection in school by diabetic adolescents and the correlation between the control of blood sugar and school adaptation. METHOD: Forty adolescents (aged 10-18 years) who were receiving care for type 1 diabetes in pediatric divisions of two university hospitals in the Incheon and Bucheon area from July 2011 to May 2012 were surveyed. RESULTS: Of the intense insulin treatment group (33/40), self-administration of insulin took place outside (22/33, 67%) and inside (11/33, 33%) restrooms. There was no significant difference in hemoglobin A1c between the two groups (P=0.7). 60% of those that had self-injected themselves within the restroom had not exposed their diabetes with more than 5 friends, while only 23% of those that had self-injected themselves outside the restroom had not exposed their diabetes with more than 5 friends, showing statistic significance between the two groups (P=0.02). There was also a significant difference in the frequency of experiencing depression: 91% for the group with self-injection in the restroom and 45% for the group with self-injection outside the restroom (P=0.02). CONCLUSION: Thirty-three percent of diabetic adolescents administered insulin in the restroom. These diabetic adolescents were reluctant to discuss the disease with others and had a higher frequency of experiencing depression. Thus, schools need to provide active support and care for students with type 1 diabetes.

The prevalence of anemia and iron depletion in the population aged 10 years or older / 대한혈액학회지

BACKGROUND: Anemia and iron depletion continue to be common disorders in the world. This study was aimed at assessing the prevalence of anemia and iron depletion in apparently healthy Koreans aged 10 years or more. METHODS: We used the data of the 4th Korean National Health & Nutrition Examination Survey (KNHANES), which assessed 7,607 individuals (3,337 males and 4,270 females). Iron depletion was defined as serum ferritin less than 15 ng/mL. RESULTS: In males, mean hemoglobin (Hb) concentration decreased after the age of 50. The prevalence of anemia was 7.1% in 60 to 69 year olds and 12.3% in men aged 70 or older. As for females, the prevalence of anemia was 8.8% in 15 to 17 year olds, 16.7% in 18 to 49 year olds, 10.9% in 60 to 69 year olds, and 18.2% women aged 70 or older. In males, the prevalence of iron depletion was 8.6% at ages 10 to 14 years, 3.9% at 15 to 17, and 2.6% at 70 years or older. In females, the prevalence of iron depletion was 17.2% at ages 10 to 14 years, 24.1% at 15 to 17, 33.0% at 18 to 49, and 5.7% at 70 years or older. Although normocytic anemia was most common in both males and females, the proportion of microcytosis and macrocytosis increased at age 70 or older. CONCLUSION: The prevalence of anemia and iron depletion was high in women of reproductive age and in the elderly. Considering the rapid increase in the older population, an intervention to prevent anemia and iron depletion is imperative.

The Prevalence Change of Anemia in the Population Aged 10 Years or Older: 2005 and 2009 / 임상소아혈액종양

BACKGROUND: Anemia still remains the most common hematologic disorder in the world despite improvements in general health and nutrition. This study was aimed at assessing the prevalence of anemia and iron deficiency in 'apparently' healthy Koreans aged over 10 years.METHODS: We used the data of the 3rd and 4th Korea National Health & Nutrition Examination Survey (KNHANES) which assessed 6,388 individuals in 2005 and 8,249 individuals in 2009. Anemia was defined in accordance with WHO criteria.RESULTS: As for males, mean hemoglobin (Hb) concentration decreased with age after 50 years old. In the 2005 data, the prevalence of anemia in males was 0.6% in 10-14 years, 1.5% in 15-17 years, 9.2% in 15-17 years, 60-69 years and 17.1% in 70 years or older. The prevalence was not much different with the 2009 data. As for females, mean Hb concentration decreased after 70 years old. The prevalence of anemia in females was 6.7% in 10-14 years, 17.5% in 18-49 years, 11.8% in 60-69 y years, and 20.5% in 70 years or older, which were similar with the 2009 data. Although normocytic anemia was most common in both males and females, the proportion of macrocytosis increased with the age 70 years or older.CONCLUSION: The prevalence of anemia was high in women of reproductive age and in elderly persons, especially over 70. Considering the rapid increase in the older population, an intervention to prevent and to treat anemia looks imperative.

The Prevalence Change of Anemia in the Population Aged 10 Years or Older: 2005 and 2009 / 임상소아혈액종양

BACKGROUND: Anemia still remains the most common hematologic disorder in the world despite improvements in general health and nutrition. This study was aimed at assessing the prevalence of anemia and iron deficiency in 'apparently' healthy Koreans aged over 10 years. METHODS: We used the data of the 3rd and 4th Korea National Health & Nutrition Examination Survey (KNHANES) which assessed 6,388 individuals in 2005 and 8,249 individuals in 2009. Anemia was defined in accordance with WHO criteria. RESULTS: As for males, mean hemoglobin (Hb) concentration decreased with age after 50 years old. In the 2005 data, the prevalence of anemia in males was 0.6% in 10-14 years, 1.5% in 15-17 years, 9.2% in 15-17 years, 60-69 years and 17.1% in 70 years or older. The prevalence was not much different with the 2009 data. As for females, mean Hb concentration decreased after 70 years old. The prevalence of anemia in females was 6.7% in 10-14 years, 17.5% in 18-49 years, 11.8% in 60-69 y years, and 20.5% in 70 years or older, which were similar with the 2009 data. Although normocytic anemia was most common in both males and females, the proportion of macrocytosis increased with the age 70 years or older. CONCLUSION: The prevalence of anemia was high in women of reproductive age and in elderly persons, especially over 70. Considering the rapid increase in the older population, an intervention to prevent and to treat anemia looks imperative.

Protective effects of garlic juice against embryotoxicity of methylmercuric chloride administered to pregnant Fischer 344 rats

In order to investigate the beneficial effects of 0.5 or 1.0 g/kg Korean garlic juice against the embryotoxicity of 20 mg/kg methylmercury chloride (MMC, CH3HgCl), pregnant Fisher 344 rats were simultaneously orally administered on day 7 of gestation. On day 20 of gestation the dams were laparotomized under ether anesthesia, and the fetuses were removed and examined for toxicity of methylmercury. Garlic juice depressed the toxicity in terms of some parameters. In the case of simultaneous treatment with 0.1 g/kg garlic juice and MMC, rates of increase were 17.5% in maternal body weight, 13.2% and 41.9% in fetal and litters' weight respectively, and 37.0% in fetal survival rate. Decreasing rates were 10.0% in maternal death rate, and 6.9% and 31.3% in pre- and post-implantation loss respectively. Decreasing rates of mercury levels in dams were 67.2% in liver, 57.6% in brain, 47.2% in kidney, 42.1% in spleen and 40.9% in blood. As well, decreasing rates of mercury level in fetuses were 54.9% in all body burden, 55.9% in liver, 46.7% in kidney and 37% in brain, respectively. The number of fetal ossification centers were reduced by 23.8% to 58.0% following simultaneous treatment with 1.0 g/kg garlic juice. These findings indicated that garlic juice effectively inhibited the embryotoxicity of methylmercury in pregnant Fischer 344 rats.