IntroductIonDelirium management is still a very complex problem, and therefore the range of pharmacological treatment is limited and the effects of nonpharmacological interventions are controversial [1,2].Antipsychotic drugs help to manage some specific symptoms of hyperactive delirium, known as intensive care unit (ICU) psychosis [3].Anxiety and pain can cause delirium, while medications used to relieve these two symptoms can also induce delirium [4,5].Therefore, it is very difficult to maintain a proper balance.The effects of nonpharmacological treatments have also been controversial.
Objectives Dehospitalization of long-term inpatients with schizophrenia can be difficult because of complex factors such as chronic symptoms and low family and social support. The aim of this study was to identify factors related to dehospitalization and readmission of long-term inpatients with schizophrenia. Methods This retrospective study reviewed the medical records of patients discharged from a psychiatric hospital in Yongin, South Korea, from February 1, 2016, to July 31, 2017. Patients who were hospitalized for over 3 months were divided into two groups: readmission (n=47) and dehospitalization (n=55). Differences in sociodemographic and clinical factors were analyzed between the two groups. Results Regarding sociodemographic characteristics, female sex, familylessness, discharge to nursing homes, and discharge after symptom improvement were more prevalent in the dehospitalization group, whereas male sex, having a sibling as next of kin, and discharge because of other problems were more prevalent in the readmission group. Among clinical characteristics, hospital stay was longer in the readmission group. Conclusion In this study, patients without a family showed a tendency to not be readmitted when they were discharged to nursing homes after symptom improvement. Expansion of social welfare support may encourage dehospitalization of long-term inpatients with schizophrenia. Key Words: Dehospitalization · Re-admission · Schizophrenia · Social welfare service ì¤ì¬ ë¨ì´: ì¬íë³µì§ìë¹ì¤ · ì¬ì ì · ì¡°íë³ Â· íìí
본 연구는 웹기반 영양상담 프로그램을 이용하여 당뇨병 환자들을 대상으로 8주 동안 6회의 영양상담을 실시한 후웹기반 영양상담이 당뇨병 환자의 식행동 및 식품섭취양상의 변화에 미치는 영향과 영양상담 프로그램을 평가하였다. 웹기반 영양상담 프로그램은 식사관리, 영양상담, 영양평가, 추후관리 프로그램으로 구성되었다. 추후관리 프로그램은 혈당수첩, 식습관 조사, 식품섭취빈도 조사, 온라인 상담파일로 구성되었으며 온라인 상담파일에 대화방을 두어 환자와 실시간으로 상담할 수 있도록 하였다. 웹기반 영양상담후 운동습관은 상당히 개선되었으며 음주와 흡연은 상담 전 이미 그 빈도가 매우 낮음에 기인하여 큰 차이를 보이지 않았다. 식사요법에 대한 지식의 변화는 모든 항목에서 식사요법 지식이 향상되었으며 전체적으로도 비합병증군과 합병증군 두군 모두에서 유의(p＜0.001)하게 높아졌다. 식행동 변화는 영양상담 후 두군 모두에서 유의(p＜0.001)하게 개선됨 으로서, 8주 동안의 지속적인 영양상담이 환자 스스로 올바른 식행동 형성의 의지를 갖게 함으로서 당뇨병 관리의 가능성을 보여주었다. 식품섭취빈도의 변화는 두군 모두에서 어패류, 채소류, 해조류의 섭취빈도가 영양상담 후에 유의하게 높아졌으며 당류, 가공식품, 감자류, 빵류의 섭취빈도가 낮아져 환자들의 식품섭취패턴이 바람직하게 개선되었다. 웹기반 프로그램 및 영양상담에 대한 평가점수는 연령이 낮을수록 평가점수가 높게 나타났으며, 컴퓨터 사용이 익숙하지 않아 보호자의 도움을 필요로 하고 있는 60대 이상에서는 상대적으로 낮은 점수를 보였다. 따라서 본 연구의 결과는 웹상에서의 영양상담을 통하여 지속적이고 반복적인 추후관리를 하는 것이 당뇨병 환자의 바람직한 식품섭취양상 및 식행동 변화를 정착시켜 질병을 관리하는데 기여할 수 있음을 제시한다. 또한 웹을 이용한 프로그램 및 상담에 대한 평가결과도 연령에 따라 차이는 있지만 긍정적으로 나타남으로서 정보화시대에 맞는 새로운 영양상담 매체로서의 인터넷의 가능성을 제시한다.
Fatty acids have diverse functions in the vast majority of cells. At high doses, they act as antimicrobials while, at low doses, they exhibit antibiofilm and antivirulence activities. In this study, the synergistic antibacterial and antibiofilm activities of 30 fatty acids and 11 antibiotics were investigated against methicillin-sensitive and methicillin-resistant Staphylococcus aureus strains. Of the 15 saturated and 15 unsaturated fatty acids examined, 16 enhanced the antibacterial activity of tobramycin. Combinatorial treatment with myristoleic acid (the most active) at 10 μg/ml and tobramycin at 10 μg/ml decreased cell survival by >4 log as compared with tobramycin treatment alone. Notably, aminoglycoside antibiotics, such as tobramycin, kanamycin, gentamicin, and streptomycin exhibited antimicrobial synergy with myristoleic acid. Co-treatment with myristoleic acid and antibiotics markedly decreased biofilm formation. Interestingly, co-treatment with tobramycin and myristoleic acid induced a reduction in S. aureus cell size. These results suggest that fatty acids, particularly myristoleic acid, can be used as aminoglycoside antibiotic adjuvants against recalcitrant S. aureus infections.
Few studies have evaluated risk factors for behavioral and psychological symptoms of dementia at the initial assessment for Alzheimer disease in large patient samples. In this study, the factors influencing Alzheimer disease were examined using the Clinical Research of Dementia of South Korea data.This cross-sectional study was conducted using data of 1,128 patients with Alzheimer disease. The behavioral and psychological symptoms of dementia were examined using the Korean version of the Neuropsychiatric Inventory. Demographic characteristics, health-related behavior, neuropsychological tests, comorbidities, blood test results, and caregiver characteristics were assessed. Median logistic regression analysis with adjustment for covariates was conducted.The behavioral and psychological symptoms of dementia were negatively associated with memory (P=0.022) and frontal/executive (P<0.001) function in the Seoul Neuropsychological Screening Battery-dementia, Barthel Index for Activities of Daily Living (P<0.001), Korean version of the Mini-Mental State Examination score (P=0.003), and caregiver age (P=0.005) after adjustment for confounding factors, and positively associated with the Seoul-Instrumental Activities of Daily Living score (P<0.001), Clinical Dementia Rating Sum of Box (P<0.001), Global Deterioration Scale score (P<0.001), abnormality of free T4 level (P<0.001), anemia (P<0.001), and family history of stroke (P=0.001). Patients with female caregivers exhibited more severe behavioral and psychological symptoms of dementia than those with male caregivers.Behavioral and psychological symptoms of dementia in Alzheimer disease patients were associated with various risk factors including the inability to live independently and Alzheimer disease severity. These findings suggest that prevention and treatment strategies for the behavioral and psychological symptoms of dementia should be comprehensive.
Background This study used ChatGPT for sentiment analysis to investigate the possible links between online sentiments and COVID-19 vaccination rates. It also examines Internet posts to understand the attitudes and reasons associated with vaccine-related opinions. Methods We collected 500,558 posts over 60 weeks from the Blind platform, mainly used by working individuals, and 854 relevant posts were analyzed. After excluding duplicates and irrelevant content, attitudes toward and reasons for vaccine opinions were studied through sentiment analysis. The study further correlated these categorized attitudes with the actual vaccination data. Results The proportions of posts expressing positive, negative, and neutral attitudes toward COVID-19 vaccines were 5%, 83%, and 12%, respectively. The total post count showed a positive correlation with the vaccination rate, indicating a high correlation between the number of negative posts about the vaccine and the vaccination rate. Negative attitudes were predominantly associated with societal distrust and perceived oppression. Conclusions This study demonstrates the interplay between public perceptions of COVID-19 vaccines as expressed through social media and vaccination behavior. These correlations can serve as useful clues for devising effective vaccination strategies.
Objectives: This study aims to assess the effectiveness of early interventions in preventing psychosis transition, promoting remission, and reducing hospitalization rates in individuals at high risk for psychosis and those with recent onset psychosis (ROP).Methods: A systematic review and meta-analysis were conducted, comparing early intervention strategies such as cognitive-behavioral therapy and psychosocial support to no intervention. The study focused on outcomes related to psychosis transition, remission rates, and prevention of psychiatric hospitalization.Results: Although only a subset of clinical high risk (CHR) individuals transition to full psychosis, non-pharmacological treatments like cognitive-behavioral therapy are generally recommended as a first-line approach. In ROP patients, early pharmacological treatment reduces relapse rates, while psychosocial interventions aim to improve various functional outcomes. The meta-analysis results of this study did not show a significant reduction in psychosis transition rates with specialized interventions for CHR patients. For ROP patients, early interventions initially reduced hospitalization rates, but this effect was not sustained in mid-term follow-up results.Conclusion: While early interventions offer short-term benefits in reducing psychosis transition and hospitalization, additional research is needed to determine their long-term effectiveness in functional recovery and overall patient outcomes.
Abstract Background Psychiatric patients often exhibit reduced medication adherence due to a lack of understanding, prejudice, and side effects of psychotropic drugs (Marrero et al., 2020). Aims & Objectives This study aims to analyze the emotional valuation of medication by psychiatric patients and their caregivers through posts on internet communities. It seeks to understand the relationship between these sentiments and the medication and its side effects. Method Over a three-month period (from October 1, 2023, to December 31, 2023), posts from an internet community site (https://cafe.naver.com/koreanmania) used by psychiatric patients and caregivers were collected. The posts were web-scraped using the Python Selenium package, adhering to ethical web-scraping guidelines (robots. txt). The collected data was preprocessed to filter relevant information and reduce noise. Language and sentiment analysis were performed on the preprocessed data using the ChatGPT 3.5 turbo model. For statistical analysis of the data, particularly to assess the significance of associations between reported side effects and specific medications, the R programming language was employed. The automated analysis results were manually reviewed by psychiatrists, achieving an 88% concordance rate. Results A total of 9800 posts were collected, with 2522 specifically discussing medications. Of these, 1449 mentions referred to specific drugs, including aripiprazole (12.7%), quetiapine (7.73%), lithium (6.63%), escitalopram (5.38%), fluoxetine (5.24%), methylphenidate (4.83%), risperidone (4.55%), alprazolam (4.49%), and lorazepam (4.35%). The most commonly reported side effects were weight gain (including increase of appetite, 15.78%), numbness (12.3%), and sleep disturbance (9.11%), with olanzapine (p=0.02), quetiapine (p=0.02), mirtazapine (p=0.04), and lithium (p=0.04) showing significant associations with weight gain. Discussion & Conclusion In this study, we examined online posts from psychiatric patients and caregivers, focusing on their experiences and perceptions of psychotropic medications and their side effects. Our analysis revealed that understanding and addressing the most frequent and distressing side effects, such as weight gain (Schwartz et al., 2004), is crucial for enhancing medication adherence in psychiatric patients. This study also underscores the importance of dispelling common misconceptions, further aiding adherence (Kalckreuth et al., 2014; Aref-Adib et al., 2016). Additionally, our use of ChatGPT to analyze and assess sentiments in a variety of real-world contexts highlights its potential as a significant tool for future medical data analysis and application (George et al., 2021). References 1)AREF-ADIB, G., O'HANLON, P., FULLARTON, K., MORANT, N., SOMMERLAD, A, JOHNSON, S. & OSBORN, D. 2016. A qualitative study of online mental health information seeking behaviour by those with psychosis. BMC psychiatry, 16, 1-10. 2)GEORGE, A., JOHNSON, D., CARENINI, G., ESLAMI, A., NG, R. &PORTALES-CASAMAR, E. 2021. Applications of aspect-based sentiment analysis on psychiatric clinical notes to study suicide in youth. AMIA Summits on Translational science Proceedings, 2021, 229. 3)KALCKREUTH, S., TREFFLICH, F. &RUMMEL-KLUGE, C. 2014. Mental health related Internet use among psychiatric patients: a cross-sectional analysis. BMC psychiatry, 14, 1-11. 4)MARRERO, R. J., FUMERO, A., DE MIGUEL, A. &PENATE, W. 2020. Psychological factors involved in psychopharmacological medication adherence in mental health patients: A systemic review. Patients Education and Counseling, 103, 2116-2131. 5)SCHWARTZ, T. L., NIHALANI, N., JINDAL, S., VIRK, S. &JONES, N. 2004. Psychiatric medication-induced obesity: a review. Obesity Reviews, 5, 115-121.
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