Mesenchymal stem cells (MSCs) are known to have a potential for articular cartilage regeneration. However, most studies focused on focal cartilage defect through surgical implantation. For the treatment of generalized cartilage loss in osteoarthritis, an alternative delivery strategy would be more appropriate. The purpose of this study was to assess the safety and efficacy of intra‐articular injection of autologous adipose tissue derived MSCs (AD‐MSCs) for knee osteoarthritis. We enrolled 18 patients with osteoarthritis of the knee and injected AD MSCs into the knee. The phase I study consists of three dose‐escalation cohorts; the low‐dose (1.0 × 107 cells), mid‐dose (5.0 × 107), and high‐dose (1.0 × 108) group with three patients each. The phase II included nine patients receiving the high‐dose. The primary outcomes were the safety and the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at 6 months. Secondary outcomes included clinical, radiological, arthroscopic, and histological evaluations. There was no treatment‐related adverse event. The WOMAC score improved at 6 months after injection in the high‐dose group. The size of cartilage defect decreased while the volume of cartilage increased in the medial femoral and tibial condyles of the high‐dose group. Arthroscopy showed that the size of cartilage defect decreased in the medial femoral and medial tibial condyles of the high‐dose group. Histology demonstrated thick, hyaline‐like cartilage regeneration. These results showed that intra‐articular injection of 1.0 × 108 AD MSCs into the osteoarthritic knee improved function and pain of the knee joint without causing adverse events, and reduced cartilage defects by regeneration of hyaline‐like articular cartilage. Stem Cells 2014;32:1254–1266
This study explored nursing home staff's barriers and needs in implementing person-centred care for people with dementia.Person-centred care is an imperative international policy and the best-practice standard for dementia care. However, a gap exists between policy and practice. Moreover, there is a lack of qualitative studies that explored nursing home staff's barriers and needs in implementing person-centred care for people living with dementia.A qualitative descriptive approach was adopted.Using convenience sampling method, a total of 24 staff members (nurses, nurse's aides, or care workers) were recruited from six nursing homes in Korea. Two in-depth, face-to-face, one-to-one interviews were conducted with all participants (a total of 48 interviews). A semi-structured interview guide was used and field notes were written after each interview. Data were collected until data saturation was reached. Qualitative content analysis was used. This study followed the COREQ guidelines.Four themes emerged from data analysis: insufficient resources, lack of education, negative mindset and poor relationships. This study showed that nursing home staff experienced many barriers and unmet needs in implementing person-centred care for people with dementia.The findings indicated that nursing home staff faced many barriers and needs in implementing person-centred care for people with dementia. Nursing home staff need more legitimate, financial, educational and emotional support.The study indicates more national and organisational support are needed for nursing home staff to successfully implement person-centred care for people living with dementia. Nursing home leaders need to recognise the importance of their role in overcoming the barriers and provide effective support for staff in implementing person-centred dementia care.
Abstract Objectives This systematic review of longitudinal studies, assessing subjective cognitive impairment (SCI) reported by adult cancer patients, aimed to summarize evidence on the impact of chemotherapy on SCI, identify moderators of SCI, and evaluate methodological issues. Methods Data accrued from Pubmed, EMBASE, CINAHL, PsychInfo, and the Cochrane library. Inclusion criteria were original studies, an exclusively adult sample, valid and reliable subjective cognitive measures, and at least one baseline data point prior to and another after the initiation of chemotherapy. Data were collected on the sample composition, data‐collection time points, outcome measures, statistical analysis, and major findings (ie, longitudinal changes in prevalence, severity, and associated factors). Results Forty articles published between 2004 and 2019 were retained: 21 examined chemotherapy‐treated patients only, and 19 employed control groups. Findings were mixed, with slightly more studies supporting the impact of chemotherapy on SCI. SCI tended to be more prevalent and severe after initiating chemotherapy, compared with patients' own baseline and controls not treated with chemotherapy. Impact appeared to be acute and more likely limited to subsamples. Most studies examining non–breast‐cancer samples reported the lack or limited impact of chemotherapy on SCI. The most consistent moderators were depression and fatigue. Methodological issues regarding sampling design, measurement, and statistical analysis were discussed. Conclusion More rigorously designed longitudinal studies would clarify direct and indirect effects of chemotherapy on SCI.
Purpose: The purpose of this study was to test the effect of pleasant guided imagery on the vital signs of elderly. Method: The subjects of this study were 15 elderly women. Collecting data were blood pressure, pulse rate, body temperature, the degree of imagination and relaxation. Data were analyzed using SPSS PC+ program with percentage, paired t-test. Result: After practicing of pleasant guided imagery, systolic blood pressure and pulse rate were significantly lowered than before practicing of pleasant guided imagery. After practicing of pleasant guided imagery, Diastolic blood pressure and body temperature were not significantly changed. After practicing of pleasant guided imagery, the degree of imagination and relaxation were relatively higher in old women. Conclusion: Pleasant guided imagery can be used for elderly patients with hypertension. And it can be used to promote relaxation of elderly with stress.
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.
Multiple channeling is a straightforward additional procedure for rotator cuff repair that creates multiple channels in the greater tuberosity, through which bone marrow of the proximal humerus communicates with the repair site.To investigate the effect of multiple channeling on clinical and structural outcomes of arthroscopic rotator cuff repair.Cohort study; Level of evidence, 3.A total of 124 patients with a full-thickness rotator cuff tear were included in the study. Fifty-seven patients underwent arthroscopic rotator cuff repair with multiple channeling (the multiple channeling group) and 67 without it (the conventional group). Analysis of surface markers was performed to characterize the cells recruited by multiple channeling using flow cytometry. Clinical outcomes were evaluated preoperatively and at a minimum of 2 years after surgery (average, 36.79 ± 13.69 months) with respect to pain, range of motion, muscle strength, overall satisfaction, and commonly used functional scores. At a minimum of 9 months after surgery, structural integrity was assessed by magnetic resonance imaging or computed tomography arthrography.Mesenchymal stem cells (MSCs) positive for CD73, CD90, and CD105 and negative for CD45 could be isolated and cultured from bone marrow mononuclear cells of the proximal humerus. Clinical outcomes, including pain, range of motion, strength, overall satisfaction, and functional scores, showed no statistical difference between the 2 groups (all P > .05). The retear rate of the multiple channeling group (22.2%) was significantly lower than that of the conventional group (45.2%) (P = .023).The findings of the study showed that multiple channeling significantly decreased the retear rate after arthroscopic rotator cuff repair, probably via the recruitment of endogenous MSCs from the proximal humerus. Although the results did not show significant differences in the clinical outcomes between the 2 groups, better clinical outcomes might be anticipated in the multiple channeling group via improved structural integrity in a long-term follow-up.
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