Effects of the frequency of ostomy management reinforcement education on self-care knowledge,self-efficacy,and ability of stoma appliance change among Korean hospitalised ostomates

Patients who undergo stoma surgery experience difficulties in adapting physically and psychologically. The priority is to support them in learning self-care for successful rehabilitation and psychosocial adaption to a new life. In order to do this, it is important to provide ostomates with repetitive reinforcement education on self-care in a continuous and individual manner, not just to increase knowledge or perform related skills. This study aims to evaluate the effects of ostomy management reinforcement education (OMRE) in ostomates and to identify the optimal frequency of reinforcement education using an equivalent control group post-test design. Participants were 60 ostomates admitted to a university hospital after ostomy formation surgery, and they were randomly assigned to a control and two experimental groups of this study. The OMRE was given to the control group (n = 20), experimental group 1 (n = 20), and experimental group 2 (n = 20) once, twice, and three times, respectively. Participants' self-care knowledge, self-efficacy, and ability of stoma appliance change were evaluated before and after the OMRE. Major results of this study were as follows: the self-care knowledge score of post-test was higher than the pretest in the control, experimental 1, and experimental two groups (P < 0.001). The self-efficacy score of post-test was higher than the pretest in the control, experimental 1, and experimental 2 groups (P < 0.001). The self-care knowledge score according to the frequency of OMRE did not differ among the control, experimental 1, and experimental 2 groups (F = 1.921, P = 0.156). The self-efficacy score according to the frequency of OMRE was significantly different between the control and experimental groups (F = 8.616, P = 0.001), but there was no difference between the experimental 1 and experimental 2 groups (Scheffe's post-hoc analysis: a < b, c). The ability of stoma appliance change score according to the frequency of OMRE was significantly different between the control and experimental groups (F = 49.546, P < 0.001), but there was no difference between the experimental 1 and experimental 2 groups (Scheffe's post-hoc analysis: a < b, c). Results of this study suggested that the OMRE was effective for promoting hospitalised ostomates' self-care knowledge, self-efficacy, and ability of stoma appliance change, and two sessions of the OMRE was the most effective. Findings of this study may be useful in planning education programmes designed to improve self-care ability for hospitalised ostomates.     

安氏II1 错牙合软组织变化的临床研究

目的：探讨安氏II¹ 错牙合畸形病人在MBT 直丝弓矫治技术配合斜面导板矫治前后的整体容貌的变化
及软组织变化规侓，为临床对安氏II¹ 错牙合畸形的诊断及治疗提供参考依据。方法: 选择40 例符合标准的病例，不
拔牙矫治，采用MBT 直丝弓矫治技术配合斜面导板，按矫治的不同阶段分为: 矫治前，矫治中( 上颌排齐阶段) ，矫治
后( 摘斜导及矫治结束阶段) ，每一病例在每个阶段结束后，均在同一台头颅定位仪X 光机( Kodak 8000 c 全景片
机) 拍摄X 线头颅侧位定位片，利用头影测量分析软件( Winceph 8． 0软件) 标定软组织标志点、绘图，测量出软组织
各测量项目值，对颌面部软组织的变化进行投影测量分析。其中标志点为S( 蝶鞍点，Sella) ，N’( 软组织鼻根点，
Nassion of Soft Tissue) ，Sn( 鼻下点，Subnasale) ，B’( 下唇凹点，颏唇沟Mentolabial sulcus 最凹处) ，Cm( 鼻小柱点，Columella)
，Po( 颏前点，Pogonion) ，Ls( 上唇突点，Labrale Superius) ，Li( 下唇突点，Labrale Inferius) 。7 项软组织测量指
标为: Ls － E( 上唇审美平面距，上唇突点到审美平面的垂直距离) ，Li － E( 下唇审美平面距，下唇突点到审美平面的
垂直距离) ，S － N’－ Sn( 上唇基角，由蝶鞍点、软组织鼻根点和鼻下点构成) ，S － N’－ B’( 下唇基角，由蝶鞍点、软组
织鼻根点和下唇凹点构成) ，Cm － Sn － Ls( 鼻唇角，Cm、Sn、Ls 三点连线所成的角) ，N’－ Sn － Po( 面突角) ，Z 角( 颏
前点Po 与上唇或下唇最突点的连线与FH 平面所成的后下角) 。数据采用SPSS 13． 0软件进行统计学处理，分析矫
治前、中、后测量指标的变化及各指标间的相关性。结果: 1、安氏II¹ 错牙合畸形的病人矫治后整体容貌的变化主要表
现为: 下颌后缩得以改善，侧貌实现协调与美观的效果。2、安氏II¹ 病例矫治前、中、后软组织测量项目的变化: 鼻
唇角增大和面突角减小，上下唇到审美平面距减少。S － N’－ Sn 和Ls － E、和Cm － Sn － Ls 变大( P ＜ 0． 05) ，有统计
学意义。结论: 1、对于恒牙早期安氏II¹ 下颌后缩的病人，采用MBT 直丝弓矫治器联合斜面导板早期治疗，能有效
改变软组织的侧貌，实现颌、牙合、面的协调与美观。2、在治疗过程中，Cm － Sn － Ls、N’－ Sn － Po、Z 角、S － N’－ Sn、S
－ N’－ B’Ls － E 和Li － E 的变化，与上下颌切牙倾斜度和颌骨的位置相关，因此，在正畸治疗中，根据硬组织的
改变来预测软组织的变化具有重要的指导意义。     

直丝弓矫治器和Begg矫治器治疗安氏Ⅱ类1分类错[牙合]畸形疗效比较

目的:对比不同矫治器对错[牙合]畸形患者面高度及前后牙咬合关系的影响。方法:选取于笔者医院接受矫治的83例错[牙合]畸形患者,根据患者矫治器类型分为直丝弓组和Begg组,分别为42例和41例。比较并分析两组患者治疗前后牙咬合关系、硬组织、磨牙及面高度的变化情况。结果:矫治后,两组患者OJ-PPV、OB-PP、LMA-MPV、LMA-MPV均降低,Begg矫治组OJ-PPV水平显著高于直丝弓矫治组,OB-PP、LMA-MPV、LMA-MPV水平显著低于直丝弓矫治组,差异均具有统计学意义(P<0.05);两组患者LAFH、LAFH/TAFH、PFH/TAFH水平均升高,其中Begg矫治组患者LAFH水平显著低于直丝弓矫治组,差异均具有统计学意义(P<0.05);两组患者LMA-MP、LMC-MP水平均升高,差异具有统计学意义(P<0.05);矫治前后,两组患者SNA、SNA、ANB水平均无统计学差异(P>0.05)。结论:两种矫治器对错[牙合]畸形患者硬组织变化均无明显影响,其中Begg矫治对患者前后牙咬合关系改善作用更强,直丝弓对患者面高度的改善能力更强。     

无托槽隐形矫治器对牙周炎引起前牙扇形移位的女性患者相关生活质量的影响研究

目的探究无托槽隐形矫治器对牙周炎引起前牙扇形移位的女性患者口腔健康相关生活存质量(OHRQOL)的影响。方法 41例进行成年女性错颌畸形矫治患者,按佩戴矫治器类型不同分为试验组(18例)和对照组(23例)。试验组患者佩戴无托槽隐形矫治器,对照组患者佩戴自锁托槽矫治器,记录附件脱落重粘情况,比较两组患者矫治时长以及不同时间段[矫治开始前(T0)、矫治1个月(T1)、矫治3个月(T2)、矫治6个月(T3)、矫治结束(T4)、矫治结束后3个月(T5)]口腔健康影响程度量表(OHIP-14中文版)评分。结果试验组矫治时长最短42步即84周,最长75步即150周,平均矫治时长(97.52±2.35)周,附件脱落重粘48粒,其中2例重启;对照组矫治时长最短34步即68周,最长74步即148周,平均矫治时长(112.38±3.51)周,因颊面管托槽松动掉落重粘115粒。试验组矫治时长短于对照组,差异具有统计学意义(t=15.437, P=0.000<0.05)。T1时,试验组OHIP-14评分(25.42±4.21)分低于对照组的(35.47±4.02)分,差异具有统计学意义(P<0.05);T0、T2、T3、T4、T5时,两组患者的OHIP-14评分比较,差异均无统计学意义(P>0.05)。结论牙周炎引起前牙扇形移位的女性患者佩戴无托槽隐形矫治器较佩戴固定矫治器有利于缩短矫治时间,及较好的生活质量。     

某家电制造企业职工五官科查体情况分析

目的 了解某家电制造企业职业健康检查五官科查体情况，为预防职业相关疾病提供依据。
方法 以该企业在岗及离岗人员为接触组，对其职业健康体检中五官科结果进行统计分析；并以岗前人员为对照组，就危害因素对2组人群进行分析比较。
结果 该企业职业病危害因素包括噪声、粉尘、高温、紫外线、苯乙烯、锰及其化合物、苯及苯系物等60多种。该企业接触组五官科总异常检出率为25.78%，接触组的五官科异常率高于对照组（P < 0.05），接触组男性的异常检出率高于女性（P < 0.05），不同年龄工人异常检出率差异有统计学意义（P < 0.05），接害工龄越长，异常检出率越高（P < 0.05）。五官各部位异常检出率亦有差异，其中以耳部的异常检出率最高；眼部、耳部、鼻部、咽部的主要检出病症分别为翼状胬肉、耵聍栓塞、鼻炎、咽炎。不同危害因素接触组的五官科异常检出率差异并无统计学意义（P>0.05），但噪声、紫外线+电焊烟尘、噪声+粉尘、苯及苯系物接触者的异常检出率处于较高水平。
结论 性别、年龄、工龄、接触职业病危害因素均可能影响五官科异常检出率，应采取积极的针对性预防措施。
     

The effect of oral appliances that advanced the mandible forward and limited mouth opening in patients with obstructive sleep apnea: A systematic review and meta‐analysis of randomised controlled trials

Oral appliances (OAs) have demonstrated efficacy in treating obstructive sleep apnea (OSA), but many different OA devices are available. The Japanese Academy of Dental Sleep Medicine supported the use of OAs that advanced the mandible forward and limited mouth opening and suggested an evaluation of their effects in comparison with untreated or CPAP. A systematic search was undertaken in 16 April 2012. The outcome measures of interest were as follows: Apnea Hypopnea Index (AHI), lowest SpO₂, arousal index, Epworth Sleepiness Scale (ESS), the SF‐36 Health Survey. We performed this meta‐analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Five studies remained eligible after applying the exclusion criteria. Comparing OA and control appliance, OA significantly reduced the weighted mean difference (WMD) in both AHI and the arousal index (favouring OA, AHI: ?7·05 events h^?1; 95% CI, ?12·07 to ?2·03; P = 0·006, arousal index: ?6·95 events h^?1; 95% CI, ?11·75 to ?2·15; P = 0·005). OAs were significantly less effective at reducing the WMD in AHI and improving lowest SpO₂ and SF‐36 than CPAP, (favouring OA, AHI: 6·11 events h^?1; 95% CI, 3·24 to 8·98; P = 0·0001, lowest SpO₂: ?2·52%; 95% CI, ?4·81 to ?0·23; P = 0·03, SF‐36: ?1·80; 95% CI, ?3·17 to ?042; P = 0·01). Apnea Hypopnea Index and arousal index were significantly improved by OA relative to the untreated disease. Apnea Hypopnea Index, lowest SpO₂ and SF‐36 were significantly better with CPAP than with OA. The results of this study suggested that OAs improve OSA compared with untreated. CPAP appears to be more effective in improving OSA than OAs.     

INAUGURAL ARTICLE by a Recently Elected Academy Member:Intrinsic unfoldase/foldase activity of the chaperonin GroEL directly demonstrated using multinuclear relaxation-based NMR

The prototypical chaperonin GroEL assists protein folding through an ATP-dependent encapsulation mechanism. The details of how GroEL folds proteins remain elusive, particularly because encapsulation is not an absolute requirement for successful re/folding. Here we make use of a metastable model protein substrate, comprising a triple mutant of Fyn SH3, to directly demonstrate, by simultaneous analysis of three complementary NMR-based relaxation experiments (lifetime line broadening, dark state exchange saturation transfer, and Carr–Purcell–Meinboom–Gill relaxation dispersion), that apo GroEL accelerates the overall interconversion rate between the native state and a well-defined folding intermediate by about 20-fold, under conditions where the “invisible” GroEL-bound states have occupancies below 1%. This is largely achieved through a 500-fold acceleration in the folded-to-intermediate transition of the protein substrate. Catalysis is modulated by a kinetic deuterium isotope effect that reduces the overall interconversion rate between the GroEL-bound species by about 3-fold, indicative of a significant hydrophobic contribution. The location of the GroEL binding site on the folding intermediate, mapped from ¹⁵N, ¹H_N, and ¹³C_methyl relaxation dispersion experiments, is composed of a prominent, surface-exposed hydrophobic patch.Chaperone networks have evolved to correctly fold native proteins and protect against the damaging effects of misfolding and aggregation on protein homeostasis (1, 2). The chaperonins, a ubiquitous subclass of chaperones, are barrel-shaped, multisubunit assemblies composed of two ring cavities, transiently capped by either an extrinsic cochaperone or a built-in lid domain, which assist protein folding in an ATP-dependent manner (3–6). Although the encapsulation mechanism and accompanying allosteric transitions driven by ATP have been extensively studied, the details of how chaperonins fold proteins remain elusive (3, 6, 7). Further, encapsulation does not appear to be an absolute requirement for successful re/folding (8). Moreover, hydrogen/deuterium exchange experiments on several protein substrates (9–12) and fluorescence-based refolding experiments (13) suggest that the prototypical chaperonin GroEL may possess intrinsic unfoldase activity. Here we take advantage of a monomeric, nonaggregating, well-defined system—a triple mutant of the Fyn SH3 domain that exists in dynamic equilibrium between the major native state and a sparsely populated folding intermediate (14, 15)—to directly demonstrate, using NMR relaxation-based methods (16), the ability of apo GroEL to accelerate the interconversion between these two states by almost three orders of magnitude. Simultaneous analysis of lifetime line-broadening (17), dark state exchange saturation transfer (DEST) (18), and Carr–Purcell–Meinboom–Gill (CPMG) relaxation dispersion (19) data permitted us to determine the catalytic rate constants and ascertain the location of the GroEL binding site on the folding intermediate under conditions where the population of GroEL-bound native and intermediate states is less than 1%. Further, GroEL unfoldase/foldase activity is modulated by SH3 deuteration, indicating that catalysis of the exchange reaction between folded and intermediate states involves direct interaction of the substrate with the walls of the GroEL chambers. These results provide a basis for how chaperonins, in the absence of cofactors and encapsulation, may be able to passively protect the cell from the deleterious effects of misfolded protein accumulation.     

Molar Distalization with Different Pendulum Appliances: In Vitro Registration of Orthodontic Forces and Moments in the Initial Phase

Abstract. Aim: Registration of the orthodontic forces and moments acting with different types of pendulum appliance for non-compliance upper molar distalization in an in vitro study. Material and Methods: The purpose-designed test set-up comprised the following components: artificial maxilla with anchorage unit and two electrothermodynamic (ETD) molars, electronic measuring unit for temperature control and regulation, and a sensor unit with force-moment sensor, analog/digital converter and data readout unit. This set-up permitted virtually authentic simulation of in vivo conditions on the one hand and precise determination of the force systems on the other.The appliances investigated were the standard pendulum appliance with U-loop activation according to Hilgers and with uprighting activation according to Byloff, the M-pendulum with U-loop activation according to Scuzzo, and the Pendulum K with initial uprighting activation, toe-in bend and incorporated distal screw according to Kinzinger. Results and Conclusions: The effects shown by the standard pendulum appliance and the M-pendulum over a 3 mm simulated distalization increment were a marked decrease in the distally directed forces, and an increase in the intrusive and palatally directed forces as well as in the distoinclinatory, mesially inward, and palatally rotating moments.Activations in the U-loop region of the pendulum springs induced an increase in distally and buccally directed forces and in uprighting and buccally rotating moments as well as a marked rise in extrusive forces. Whereas the activation described by Hilgers led to mesially outward rotating moments, activation according to Scuzzo resulted in a further increase in the mesially inward rotating moments.In the measured standard pendulum appliances, uprighting activation at the end of the pendulum according to Byloff led to an increase in distally and buccally directed as well as in mildly intrusive forces, and to an increase in uprighting as well as in buccally and mesially outward rotating moments.With the Pendulum K according to Kinzinger, the initial toe-in bend and uprighting activation in the region of the end of the pendulum spring together with regular adjustment of the incorporated distal screw permitted virtually translatory molar distalization: constantly distalizing forces with slight intrusive, buccally directed, and rotating side effects.