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Overactive bladder (OAB) is prevalent in men and women and negatively impacts physical and psychological health. Fluid and caffeine intake modifications, which are lifestyle modification interventions, are simple methods to manage OAB. However, studies that synthesized both interventions and found scientific evidence are scarce. This review aimed to synthesize scientific evidence on whether fluid and caffeine intake modifications are effective for OAB symptoms. PubMed, CINAHL (Cumulative Index for Nursing and Allied Health Literature), Embase, Scopus, the Cochrane Library, KoreaMed, and RISS (Research Information Sharing Service) were used to search for studies and 8 studies were included. The Cochrane risk of bias tool (RoB 2.0) and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) were used to assess the quality of selected studies. Due to the heterogeneous outcome variables, a meta-analysis was not conducted. Among the 8 included, 7 studies were randomized controlled trials and one was a quasi-experimental study. Four studies assessed urgency. Caffeine reduction was statistically effective for urgency symptoms, but increasing fluid intake was not. Frequency was assessed in 5 studies, which showed decreasing caffeine and fluid intake was effective in treating the symptoms. Urinary incontinence episodes were assessed in 6 studies, and nocturia in 2. Restricting caffeine intake was effective in treating these 2 symptoms, but restricting both caffeine and fluid intake was not. Quality of life (QoL) was examined in 5 studies, and modifying fluid and caffeine intake significantly improved QoL in 2. Although there were limited studies, our review provides scientific evidence that fluid and caffeine intake modification effectively manages OAB symptoms. Further research should examine acceptability and sustainability of interventions in the long-term and enable meta-analysis.
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“Medicine is an art of benevolence [Kr. 인술 Insul, Ch. 仁術 Renshu].” This slogan is widely accepted in East Asia, and at least in South Korea, it is generally regarded as an innate medical ethic. However, the original meaning of ‘In’ (仁, Ch. Ren), which means ‘benevolence,’ ‘humanity,’ or simply ‘love for one another,’ is a Confucian virtue emphasized by Mencius. It is unclear when this Confucian term became the representative medical ethic in South Korea. The term “medical ethic” was not coined until the 19th century in the West (Robert Baker and Laurence B. McCullough, eds. 2009). We often use the terms ‘Insul,’ ‘affection,’ ‘Hippocratic Oath,’ and other related concepts interchangeably, but these words come from different times and have different ideological implications (Shin 2000). This paper examines how ‘Insul’ has been recreated under the tensions between Western and Eastern Medicine in modern Korea.The arrival of Western medicine caused an existential crisis in traditional Korean medicine. The status of TKM doctors was demoted by the ‘Uisaeng Regulation’ in 1913 by the JGGK, which aimed to establish a unicameral medical system based on Western medicine. In response, the scientification of Eastern medicine became an inevitable task, and Eastern medicine had to maintain its identity while also modernizing itself to avoid being absorbed into Western medicine. Until the late Joseon period, ‘Insul’ was rarely used in medicine but rather for political practices. Medical practice was a peripheral way of conducting Ren (仁), the Confucian benevolence. However, TKM rediscovered the concept during the modern era. With the Convention of Korean Uisaeng in October 1915, the TKM community actively used ‘Insul’ as their identity. At this convention, Governor General Terauchi Mastake used the term to mean traditional medicine and implied that without scientification, ‘Insul’ would be disused. This address was immediately and widely quoted in TKM journals. TKM doctors and adherents interpreted his address to mean that if they could achieve scientification of TKM, their medical ideal (Insul) would be used in the future. Soon, a number of articles on ‘Insul’ as a medical ethic were published in newspapers and journals.From the mid-1920s, regardless of whether the doctors practiced East or West medicine, people started to claim that only those who pursued ‘Insul’ were true medical personnel, and they used this as a criterion for evaluating medical doctors. The people’s demand for ‘Insul’ influenced medicine in general, and Western doctors also linked their medical practices to ‘Insul.’ This is an interesting example of the localization of Western medicine in Korea. Through the rivalry relationship or interaction between East and West medicine that took place in modern Korea, ‘Insul’ gradually became a representative term of Korean medical ethics since the mid-1920s. The process took place gradually over a decade, and it has now become firmly established throughout medicine in Korea.
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The identification for skeletal remains is one of roles of forensic medicine. For this purpose, dating, i.e., estimating the birth year and death year is expected as useful, however has not yet been practically applied. A dating method using radiocarbon analysis was recently introduced and related studies have been reported. In this study, we tried to confirm the applicability of radiocarbon dating for the identification of skeletal remains and to develop formulas to estimate the death year. Thirty-four autopsy cases from the National Forensic Service, from December 2014 to July 2022, with known death year were selected for inclusion. For each case, two samples were taken: the spongy bone of the femur head, and the compact bone of the femur midshaft. For each sample, radiocarbon analysis was carried out and the corresponding femur year were calculated using the bomb peak curve. The differences between the femur year and the death year were determined and analyzed on the influence of variables. A formula for estimating the death year was developed and the applicability of the formula was determined. The results showed that the difference between death year and femur head year was 14.2 years on average. In male, the difference between death year and femur head year increased with age, however, it did not show any difference according to age in female. The estimation formula of death year was as follows: (In male) Death year=0.993×(Femur head year)+0.288×(Age)+15.061, (In female) Death year=0.769×(Femur head year)-0.218×(Age)+489.676. The formula for male had relatively high explanatory power (adjusted R2=0.710), however, the formula for female had low explanatory power (adjusted R2=0.588). This study is meaningful because it is the largest single study of its kind, to date, and uses specific and identical skeleton (femur head/femur midshaft) to increase the accuracy of the death year estimation. We expect that the results of this study will be supplemented through additional research in the future.
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In Asia, the roots of Paeonia lactiflora and Astragalus membranaceus have been used as therapeutic agents for thousands of years. Once the medicinal plants are harvested, they are dried and their ingredients are extracted by heat-mediated reflux extraction. However, the condensed structure of organic products (especially roots) limits the extraction of bioactive components. In this study, we assessed the effect of the puffing method (using high temperature and pressure) before the extraction process in relation to the profile and antioxidant capacity of active ingredients. We demonstrated that the additional puffing process before extraction methods improves the yield of polyphenol concentrations and antioxidant activities from the roots of P. lactiflora and A.membranaceus.
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Purpose@#This study aimed to investigate gender differences as ecological factors associated with depression of single-parents who lived with minors. @*Methods@#This study was secondary data analysis using national data from the 2018 Single Parent Family Survey, including 2,427 participants (1,575 mothers and 852 fathers). Data were analyzed using SPSS/MAC 26.0 program for the descriptive analysis, independent t-tests, chi-squared tests, and binary logistic regression. @*Results@#The depression groups were identified as 17.4% for women and 11.0% for men based on Patient Health Questionnaire-9. In logistic regression, single mothers’ depression was significantly associated with low income, unemployment, low education level, parenting difficulties, a sense of distance from family, and family discrimination experiences. However, single fathers’ depression was significantly associated with low income, unemployment, and parenting difficulties. @*Conclusion@#Our study findings suggest that depression interventions should be tailored to different gender groups of the single-parents, specifically socio-emotional factors should be considered for the single mother group.
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Purpose@#The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol. @*Methods@#Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution’s ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). @*Results@#After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups. @*Conclusion@#SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.
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Purpose@#The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol. @*Methods@#Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution’s ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). @*Results@#After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups. @*Conclusion@#SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.
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Purpose@#This study aimed to determine the effect of an exercise intervention on subjective cancer-related fatigue (CRF) and pro-inflammatory cytokine levels in breast cancer survivors (BCS). @*Methods@#BCS with greater than moderate CRF (≥ 4) were recruited and randomly assigned to experimental or control groups. The experimental group participated in a 12-week exercise adherence program (Better Life after Cancer - Energy, Strength, and Support; BLESS). Interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) levels were determined at 3 time points (M1: baseline, M2: post-intervention, and M4: 6 months after intervention). Subjective fatigue was measured using the Korean version of the revised Piper Fatigue Scale. @*Results@#In this analysis of participants with physiological fatigue measures available (19 experimental, 21 control), there were no statistically significant differences in IL-6 (F = 1.157, p = 0.341), TNF-α levels (F = 0.878, p = 0.436), and level of fatigue (F = 2.067, p = 0.118) between the 2 groups at baseline. Fatigue in the experimental group showed statistically significant improvement compared to the control only at M2 (p = 0.022). There was no significant relationship between subjective and physiological fatigue at the 3 measurement points. @*Conclusion@#The BLESS intervention improved CRF in BCS immediately at post-intervention, and this study presents clinical feasibility for the management of CRF in BCS in the early survivorship phase who are already experiencing fatigue.
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BACKGROUND: Lung cancer in never smokers (LCINS) differs etiologically and clinically from lung cancer attributed to smoking. After smoking, radon exposure is the second leading cause and the primary risk factor of lung cancer among never smokers. Exposure to radon can lead to genetic and epigenetic alterations in tumor genomes affecting genes and pathways involved in lung cancer development. The present study sought to explore genetic alterations associated with LCINS exposed to radon gas indoors. METHODS: Genetic associations were assessed via a case-control study of LCINS (39 cases and 30 controls) using next generation sequencing. Associations between genetic mutations and high exposure to radon were investigated by OncoPrint and heatmap graphs. Bioinformatic analysis was conducted using various tools. According radon exposure levels, we divided subjects in two groups of cases and controls. RESULTS: We found that ABL2 rs117218074, SMARCA4 rs2288845, PIK3R2 rs142933317, MAPK1 rs1803545, and androgen receptor (AR) rs66766400 were associated with LCINS exposed to high radon levels. Among these, Chromodomain helicase DNA-binding protein 4 (CHD4) rs74790047, TSC2 rs2121870, and AR rs66766408 were identified as common exonic mutations in both lung cancer patients and normal individuals exposed to high levels of radon indoor. CONCLUSION: We identified that CHD4 rs74790047, TSC2 rs2121870, and AR rs66766408 are found to be common exonic mutations in both lung cancer patients and normal individuals exposed to radon indoors. Further analysis is needed to determine whether these genes are completely responsible for LCINS exposed to residential radon.
Subject(s)
Humans , Case-Control Studies , Computational Biology , Epigenomics , Exons , Genetic Variation , Genome , Lung Neoplasms , Lung , Radon , Receptors, Androgen , Risk Factors , Smoke , SmokingABSTRACT
The original version of the article contained error in the funding statement in Acknowledgements section.
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The original version of this article contained error in the name of the fourth author which was given incorrectly as Hye Run Kim. The author’s name should have been written as Hye Ryun Kim.
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Herpes zoster (HZ), or shingles, is caused by the reactivation of latent varicella-zoster virus (VZV) from the sensory ganglia when VZV-specific T-cell immunity is decreased because of aging or immunosuppression. In the present study, we developed HZ DNA vaccine candidates encoding VZV proteins and cytokine adjuvants, such as IL-7 and IL-33. We immunized C57BL/6 mice with DNA plasmids encoding VZV glycoprotein E (gE), immediate early (IE) 63, or IE62 proteins and found that robust VZV protein-specific T-cell responses were elicited by HZ DNA vaccination. Co-administration of DNA plasmids encoding IL-7 or IL-33 in HZ DNA vaccination significantly enhanced the magnitude of VZV protein-specific T-cell responses. Protective immunity elicited by HZ DNA vaccination was proven by challenge experiments with a surrogate virus, vaccinia virus expressing gE (VV-gE). A single dose of HZ DNA vaccine strongly boosted gE-specific T-cell responses in mice with a history of previous infection by VV-gE. Thus, HZ DNA vaccines with IL-7 and IL-33 adjuvants strongly elicit protective immunity.
Subject(s)
Animals , Mice , Aging , DNA , Ganglia, Sensory , Glycoproteins , Herpes Zoster , Herpesvirus 3, Human , Immunosuppression Therapy , Interleukin-33 , Interleukin-7 , Plasmids , T-Lymphocytes , Vaccination , Vaccines, DNA , Vaccinia virusABSTRACT
PURPOSE: Although innovative interventions using technologies have been introduced in long-term care settings, available evidence is still anecdotal. The purpose of this study is to investigate and synthesize the outcomes of interventions using technologies delivered to nursing home residents. METHODS: Published clinical trials were identified through PubMed, CINHAL, Cochrane and PsycINFO databases and manually hand-searching. Eligible studies were articles published between 1997–2016 in English or Korean with a randomized controlled trial or quasi-experimental design in which interventions using technologies were delivered to nursing home residents. RESULTS: A total of 20 studies were selected for this review. Types of interventions using technologies were classified into the electronic documentation technology (n=1), the clinical decision support system (n=1), the safety technology (n=1), the health and wellness technology (n=10), and the social connectedness technology (n=7). Overall resident outcomes indicated that interventions using technologies improved behavioral symptoms and psycho-social outcomes, but mixed results were shown in the aspects of physical function, cognitive function, social relationship and quality of service. CONCLUSION: This review demonstrates that incorporating technologies into nursing home care have positive effects on residents' psycho-social outcomes and behavioral symptoms. To disseminate the effectiveness of interventions using technologies, further research is needed to determine what mechanisms underlying such relationships exist.
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Adult , Humans , Behavioral Symptoms , Cognition , Decision Support Systems, Clinical , Long-Term Care , Nursing HomesABSTRACT
Severe fever with thrombocytopenia syndrome (SFTS) is caused by the SFTS virus (SFTSV). The SFTSV appears to have a wide host range, as SFTSV-positive ticks have been isolated from both farm animals and wild rodents. Therefore, it is important to monitor SFTSV-positive animals to prevent the transmission of SFTSV from animals to humans. Previously, we developed a competitive enzyme-linked immunosorbent assay (cELISA) to detect SFTSV-specific antibodies from field animals and compared the cELISA results to those from an indirect immunofluorescence assay (IFA). In this study, cELISA results were compared to and evaluated against the results from both an IFA and a virus neutralization (VN) test of 193 bovine serum samples (including two bovine positive control sera) and 70 horse serum samples. The consistency (98.9%) between cELISA and VN results was higher than that (97.4%) between cELISA and IFA for the bovine serum samples. Similarly, for the horse serum samples, the consistency (88.6%) between cELISA and VN results was higher than that (84.3%) between the cELISA and IFA. These findings indicate that our newly developed cELISA can be used for surveillance or epidemiological studies of SFTSV in animals.
Subject(s)
Animals , Humans , Animals, Domestic , Antibodies , Enzyme-Linked Immunosorbent Assay , Epidemiologic Studies , Fever , Fluorescent Antibody Technique, Indirect , Horses , Host Specificity , Neutralization Tests , Rodentia , Thrombocytopenia , TicksABSTRACT
BACKGROUND: In March 2013, human infection with avian influenza A (H7N9) virus emerged in China, causing serious public health concerns and raising the possibility of avian-source pandemic influenza. Thus, the development of an effective vaccine for preventing and rapidly controlling avian influenza A (H7N9) virus is needed. In this study, we evaluated the immunogenicity of a synthetic DNA vaccine against H7 HA antigens in mice. MATERIALS AND METHODS: The synthetic consensus H7 HA DNA vaccine (25 or 50 µg) was administered to BALB/c mice at 0, 14, and 28 days by intramuscular injection followed by electroporation. Humoral and cellular immune responses were analyzed in a hemagglutination inhibition test and interferon-gamma enzyme-linked immunospot (ELISpot) assay, respectively. RESULTS: H7 HA-vaccinated mice showed 100% seroprotection and seroconversion rate against H7N9 reassortant influenza virus after both second and third immunizations. The geometric mean titer by the hemagglutination inhibition test increased with an increasing number of immunizations. However, there was no significant difference in geometric titer between the two groups injected with 25 and 50 µg of H7 HA DNA vaccine after two (79.98 vs. 107.65, P = 0.39) and three (159.96 vs. 215.28, P = 0.18) doses. In addition, the ELISpot assay revealed that administration of H7 HA DNA vaccine induced potent interferon-gamma production from mouse splenocytes. CONCLUSIONS: This study demonstrated the humoral and cellular immunogenicity of synthetic consensus H7 HA DNA vaccine in mice. This work demonstrates the potential of the H7 HA DNA vaccine as an efficient tool for the rapid control of emerging influenza A (H7N9) virus.
Subject(s)
Animals , Humans , Mice , China , Consensus , DNA , Electroporation , Enzyme-Linked Immunospot Assay , Hemagglutination Inhibition Tests , Immunity, Cellular , Immunization , Influenza in Birds , Influenza, Human , Injections, Intramuscular , Interferon-gamma , Orthomyxoviridae , Pandemics , Public Health , SeroconversionABSTRACT
BACKGROUND: Lung cancer is the leading cause of cancer-related death worldwide, for which smoking is considered as the primary risk factor. The present study was conducted to determine whether genetic alterations induced by radon exposure are associated with the susceptible risk of lung cancer in never smokers. METHODS: To accurately identify mutations within individual tumors, next generation sequencing was conduct for 19 pairs of lung cancer tissue. The associations of germline and somatic variations with radon exposure were visualized using OncoPrint and heatmap graphs. Bioinformatic analysis was performed using various tools. RESULTS: Alterations in several genes were implicated in lung cancer resulting from exposure to radon indoors, namely those in epidermal growth factor receptor (EGFR), tumor protein p53 (TP53), NK2 homeobox 1 (NKX2.1), phosphatase and tensin homolog (PTEN), chromodomain helicase DNA binding protein 7 (CHD7), discoidin domain receptor tyrosine kinase 2 (DDR2), lysine methyltransferase 2C (MLL3), chromodomain helicase DNA binding protein 5 (CHD5), FAT atypical cadherin 1 (FAT1), and dual specificity phosphatase 27 (putative) (DUSP27). CONCLUSIONS: While these genes might regulate the carcinogenic pathways of radioactivity, further analysis is needed to determine whether the genes are indeed completely responsible for causing lung cancer in never smokers exposed to residential radon.
Subject(s)
Cadherins , Computational Biology , DNA-Binding Proteins , Dual-Specificity Phosphatases , Genes, Homeobox , Lung Neoplasms , Lung , Lysine , Radioactivity , Radon , ErbB Receptors , Risk Factors , Smoke , Smoking , TYK2 KinaseABSTRACT
OBJECTIVE: To determine whether local bupivacaine injection into the incision site after gynecologic laparoendoscopic single site surgery (LESS) improves postoperative pain. METHODS: This prospective cohort study included consecutive 158 patients who had LESS for benign adnexal disease from March 2013 to December 2015. Chronologically, 82 patients (March 2013 to August 2014) received no bupivacaine (group 1) and 76 (August 2014 to December 2015) received a bupivacaine block (group 2). For group 2, 10 mL 0.25% bupivacaine was injected into the 20 mm-incision site through all preperitoneal layers after LESS completion. Primary outcome is postoperative pain score using the visual analog scale (VAS). RESULTS: There was no difference in clinicopathological characteristics between the groups. Operating time (expressed as median [range], 92 [55–222] vs. 100 [50–185] minutes, P=0.137) and estimated blood loss (50 [30–1,500] vs. 125 [30–1,000] mL, P=0.482) were similar between the groups. Post-surgical VAS pain scores after 3 hours (3.5 [2–6] vs. 3.5 [2–5], P=0.478), 6 to 8 hours (3.5 [2–6] vs. 3 [1–8], P=0.478), and 16 to 24 hours (3 [2–4] vs. 3 [1–7], P=0.664) did not differ between groups. CONCLUSION: Bupivacaine injection into the trocar site did not improve postoperative pain after LESS. Randomized trials are needed to evaluate the benefits of local bupivacaine anesthetic for postoperative pain reduction.
Subject(s)
Female , Humans , Adnexal Diseases , Anesthesia, Local , Bupivacaine , Cohort Studies , Laparoscopy , Minimally Invasive Surgical Procedures , Pain, Postoperative , Prospective Studies , Surgical Instruments , Visual Analog ScaleABSTRACT
Drug-induced liver injury (DILI) is a significant threat to patient health and a major concern during drug development. Recently, multiple circulating microRNAs (miRNAs) have been reported to be potential biomarkers for DILI. To adapt and validate miRNAs for clinical use, we investigated the time-course changes in miR-122 expression levels in an acetaminophen-induced liver injury model in rats. In addition, miR-155 and miR-21 were evaluated as makers of inflammation and regeneration, respectively, to characterize liver status. Our results revealed that miR-122 is an early and sensitive biomarker of hepatocellular injury at a stage when alanine transaminase, aspartate transaminase, and total bilirubin were not detectable. However, no significant differences in the expression levels of other miRNAs (miR-155 and -21) were observed between treatment and vehicle groups. Collectively, these time-course changes in the expression levels of miRNAs may be useful as markers for clinical decision-making, in the diagnosis and treatment of DILI.
Subject(s)
Animals , Rats , Acetaminophen/toxicity , Biomarkers/blood , Chemical and Drug Induced Liver Injury/blood , Gene Expression Profiling , Gene Expression Regulation/drug effects , Hepatocytes/drug effects , Inflammation/blood , Liver Regeneration , MicroRNAs/blood , Predictive Value of Tests , TimeABSTRACT
OBJECTIVES: This study aimed to compare two nickel-titanium systems (rotary vs. reciprocating) for their acceptance by undergraduate students who experienced nickel-titanium (NiTi) instruments for the first time. MATERIALS AND METHODS: Eighty-one sophomore dental students were first taught on manual root canal preparation with stainless-steel files. After that, they were instructed on the use of ProTaper Universal system (PTU, Dentsply Maillefer), then the WaveOne (WO, Dentsply Maillefer). They practiced with each system on 2 extracted molars, before using those files to shape the buccal or mesial canals of additional first molars. A questionnaire was completed after using each file system, seeking students' perception about 'Ease of use', 'Flexibility', 'Cutting-efficiency', 'Screwing-effect', 'Feeling-safety', and 'Instrumentation-time' of the NiTi files, relative to stainless-steel instrumentation, on a 5-point Likert-type scale. They were also requested to indicate their preference between the two systems. Data was compared between groups using t-test, and with Chi-square test for correlation of each perception value with the preferred choice (p = 0.05). RESULTS: Among the 81 students, 55 indicated their preferred file system as WO and 22 as PTU. All scores were greater than 4 (better) for both systems, compared with stainless-steel files, except for 'Screwing-effect' for PTU. The scores for WO in the categories of 'Flexibility', 'Screwing-effect', and 'Feeling-safety' were significantly higher scores than those of PTU. A significant association between the 'Screwing-effect' and students' preference for WO was observed. CONCLUSIONS: Novice operators preferred nickel-titanium instruments to stainless-steel, and majority of them opted for reciprocating file instead of continuous rotating system.
Subject(s)
Humans , Molar , Root Canal Preparation , Students, DentalABSTRACT
PURPOSE: It is crucial to provide adequate enteral nutrition for postoperative recovery, wound healing and normal growth in infants in pediatric cardiac ICUs. This study was done to develop a feeding protocol using the vaso-active inotropic (VAI) score and to evaluate the impact of nutritional outcomes following the new feeding protocol for infants who underwent cardiac surgery. METHODS: This study consisted of three phases. First, a feeding protocol was developed based on a literature review. Second, ten experts rated the content validity. Third, a comparison study was conducted to evaluate the impact of the new feeding protocol. Data were analyzed using SPSS Version 20. RESULTS: Twenty-nine infants were enrolled in the pre-protocol group, and 22 infants in the post-protocol group. Patients in the 2 groups were similar. Time to reach feeding goal was significantly decreased from 56.0 (27-210) hours to 28.5 (10-496) hours in the post-protocol group (Z=-4.22, p<.001). Level of enteral feeding knowledge among nurses increased significantly after implementation of the protocol. CONCLUSION: The feeding protocol using VAI score facilitates the achievement feeding goal to decrease feeding interruptions and help nurses in their practice. Larger studies are necessary to examine clinical outcomes following the implementation of this feeding protocol.