Institute of Aerospace Medicine

Medicine, Taiwan

Institute of Aerospace Medicine

Medicine, Taiwan
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Chien L.-Y.,Taipei Medical University | Chien L.-Y.,Taichung Armed Forces General Hospital | Chu H.,Institute of Aerospace Medicine | Chu H.,Tri Service General Hospital | And 6 more authors.
International Journal of Geriatric Psychiatry | Year: 2011

Objectives Meta-analysis studies of specific types of support groups are limited. We conducted a review and assessment of the effectiveness of support groups for caregivers of demented patients, and examined the impact of support group characteristics. Methods A search of multiple, electronic databases including the Cochrane Library, Medline, PUBMED, and others was conducted; studies published between 1998 and 2009 were collected. Thirty quantitative journal articles that were true and quasi-experimental controlled trials on support groups for non-professional caregivers, including mutual support, psychoeducational, and educational groups were analyzed. Outcome indicators were psychological well-being, depression, burden, and social outcomes. Results Support groups showed a significant positive effect on caregivers' psychological well-being (Hedge's g = -0.44, 95% CI = -0.73, -0.15), depression (Hedge's g = -0.40, 95% CI = -0.72, -0.08), burden (Hedge's g = -0.23, 95% CI = -0.33, -0.13), and social outcomes (Hedge's g = 0.40, 95% CI = 0.09, 0.71). The use of theoretical models, and length and intensity of group sessions had a significant impact on the effect sizes for psychological well-being and depression. Ratio of female participation (for psychological well-being and depression) and average age (social outcomes) were significant predictor variables. Conclusions Support groups benefit caregivers and findings of this meta-analysis serve as immediate guidance for group facilitators. Future research should include additional outcome variables with our defined factors on effectiveness collected as demographic characteristic data for comparison. A more comprehensive understanding of the effectiveness of support groups is indicated to enhance outcomes for caregivers and patients. Copyright © 2011 John Wiley & Sons, Ltd.

Moeller R.,Institute of Aerospace Medicine | Vlasic I.,Ruder BonskoviTc Institute | Reitz G.,Institute of Aerospace Medicine | Nicholson W.L.,University of Florida
Archives of Microbiology | Year: 2012

Mutations in the RNA polymerase β-subunit gene rpoB causing resistance to rifampicin (RifR) in Bacillus subtilis were previously shown to lead to alterations in the expression of a number of global phenotypes known to be under transcriptional control. To better understand the inXuence of rpoB mutations on sporulation and spore resistance to heat and chemicals, cells and spores of the wildtype and twelve distinct congenic RifR mutant strains of B. subtilis were tested. DiVerent levels of glucose catabolite repression during sporulation and spore resistance to heat and chemicals were observed in the RifR mutants, indicating the important role played by the RNA polymerase β-subunit, not only in the catalytic aspect of transcription, but also in the initiation of sporulation and in the spore resistance properties of B. subtilis. © Springer-Verlag 2012.

Hsieh C.-J.,National Taipei University of Nursing and Health Sciences | Chu H.,Institute of Aerospace Medicine | Cheng J.J.-S.,Bali Psychiatric Center | Shen W.W.,Taipei Medical University | Lin C.-C.,Taipei Medical University
Psychiatry and Clinical Neurosciences | Year: 2012

Aim: Apathy is a well-recognized symptom of Alzheimer's disease (AD). The aim of the present study was to validate the Taiwanese version of the Apathy Evaluation Scale, clinician version (AES-C) and assess the severity of apathy in patients with AD. Methods: Comprehensive evaluations were conducted in a total of 144 AD patients. This study used a cross-sectional comparative design. Data were collected from clinical interviews using the AES, the Mini-Mental Status Examination (MMSE), the Neuropsychiatric Inventory (NPI), and the Clinical Dementia Rating Scale (CDR). Results: Internal consistency was indicated by Cronbach's alphas of 0.85; test-retest reliability was 0.89 over a period of 3 days. Criterion-related validity was supported by the fact that AES-C significantly correlated with the apathy scores of the NPI. Factor analysis indicated a three-factor structure. Convergent validity was supported by a positive correlation between the AES-C score and the anxiety score of the NPI. Discriminant validity was supported by the fact that the AES-C scores did not correlate with the depression subscale of the NPI, and the correlation between the AES-C score and the euphoria score of the NPI score was negative. Known-group validity was supported by results showing that AD patients in a moderate stage of dementia (CDR = 2) had significantly higher scores on the AES-C than patients with mild-stage dementia (CDR = 1). Conclusion: The AES-C is a reliable and valid instrument for measuring symptoms of apathy among AD patients in Taiwan. © 2012 Japanese Society of Psychiatry and Neurology.

Knezevic B.,University of Zagreb | Milosevic M.,University of Zagreb | Golubic R.,University of Zagreb | Golubic R.,University of Cambridge | And 3 more authors.
Midwifery | Year: 2011

Objective: to explore the sources and levels of stress at work and work ability among Croatian midwives. Background: midwives are subjected to multiple stressors. Among health-care professionals, psychological distress for a prolonged period of time has negative effects on the worker's health, work ability and quality of patient care. 'Work ability' is a term describing a worker's resources related to physical, mental and social demands at work. As a measure of work ability in midwifery, the Work Ability Index (WAI) is considered to be a very predictive instrument; midwives with a poor WAI score usually leave their current job within five years. Setting: university hospitals in Zagreb, Croatia. Design: cross-sectional design survey. Participants: 300 health-care workers (105 qualified midwives and 195 paediatric nurses) were invited to complete the questionnaire. The total response rate was 53% (158/300). The sample included 14.7% of all hospital-based midwives in Zagreb hospitals. Methods: the Occupational Stress Assessment Questionnaire (OSAQ) for health-care workers and the WAI questionnaire. Findings: over three-quarters of the midwives (46/60, 76.7%) believed that their job was stressful, and considered that insufficient work resources caused the most stress. More than half of the midwives associated an insufficient number of coworkers, unexpected situations, inadequate income, night work, incurable patients and poor organisation at work with a high level of stress. The perceived specific stressors differed between midwives and paediatric nurses in the same hospital. Insufficient work resources and poor organisation at work were more common stressors among midwives than paediatric nurses (p<0.05). Midwives and nurses differed significantly with respect to age (p=0.002). Midwives were younger and had spent fewer years working in their current workplace compared with paediatric nurses (p<0.001). Also, midwives had a lower level of education than paediatric nurses (p=0.044). The mean WAI score for midwives was 40.0 [95% confidence interval (CI) 38.4-41.4], compared with 37.5 (95% CI 36.4-38.8) for paediatric nurses, both indicating good work ability. After adjusting for age, the difference in WAI score between the groups of workers was not significant. Conclusions: Croatian midwives experienced work-related stress due to: insufficient work resourses, insufficient number of coworkers, poor organisation at work, communication with superiors and emotional work. Midwives' work ability in relation to the demands of their job was good. These results confirmed that the WAI score decreases significantly with age. Implications for practice: hospital management needs to improve organisational factors and resources, as well as midwives' education and position in the health-care system. © 2009 Elsevier Ltd.

Rajguru R.,Institute of Aerospace Medicine
Indian Journal of Occupational and Environmental Medicine | Year: 2014

Aeromedical implications of stapedotomy like rapid barometric changes and G forces are generally thought to put an end to the aviation career of an aviator. Aviation industry has grown tremendously in the last few decades, and aviation now is not only occupational but also recreational. The Indian Military Aviation rules state that, "Stapedectomy cases will be assessed permanently unfit for flying duties. These cases will be cautioned against flying in an unpressurised aircraft." The basis of this is the aeromedical concerns associated with stapedotomy as clinical conditions which are of minor significance on the ground may become aggravated in the air. With an ever expanding civil and military aviation industry, the number of aviators who have undergone stapedotomy has also increased. Though grounding the aircrew is the safest option, but if medical certification is denied to all, then the majority who can fly safely will also be excluded, thus denying the organization of its trained resources. This paper discusses post otosclerosis and post stapedotomy aeromedical concerns, reviews existing literature concerning post stapedotomy aviation and various post stapedotomy aviation policies.

Rajguru R.,Institute of Aerospace Medicine
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2014

Nasal polyps (NP) are one of the most common inflammatory mass lesions of the nose, affecting up to 4% of the population. They present with nasal obstruction, anosmia, rhinorrhoea, post nasal drip, and less commonly facial pain. Their etiology remains unclear, but they are known to have associations with allergy, asthma, infection, fungus, cystic fibrosis, and aspirin sensitivity. However, the underlying mechanisms interlinking these pathologic conditions to NP formation remain unclear. Also strong genetic factors are implicated in the pathogenesis of NP, but genetic and molecular alterations required for its development and progression are still unclear. Management of NP involves a combination of medical therapy and surgery. There is good evidence for the use of corticosteroids (systemic and topical) both as primary treatment and as postoperative prophylaxis against recurrence, but the prolonged course of the disease and adverse effects of systemic steroids limits their use. Hence several new drugs are under trial. Surgical treatment has been refined significantly over the past 20 years with the advent of endoscopic sinus surgery and, in general, is reserved for cases refractory to medical treatment. Recurrence of the polyposis is common with severe disease recurring in up to 10% of patients. Over the last two decades, increasing insights in the pathophysiology of nasal polyposis opens perspective for new pharmacological treatment options, with eosinophilic inflammation, IgE, fungi and Staphylococcus aureus as potential targets. A better understanding of the pathophysiology underlying the persistent inflammatory state in NP is necessary to ultimately develop novel pharmacotherapeutic approaches. In this paper we present the newer treatment options available for better control and possibly cure of the disease. © 2011 Association of Otolaryngologists of India.

Rajguru R.,Institute of Aerospace Medicine
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2013

With technological improvements in body armour and increasing use of improvised explosive devices, it is the injuries to head, face and neck are the cause for maximum fatalities as military personnel are surviving wounds that would have otherwise been fatal. The priorities of battlefield surgical treatment are to save life, eyesight and limbs and then to give the best functional and aesthetic outcome for other wounds. Modern day battlefields pose unique demands on the deployed surgical teams and management of head and neck wounds demands multispecialty approach. Optimal result will depend on teamwork of head and neck trauma management team, which should also include otolaryngologist. Data collected by various deployed HFN surgical teams is studied and quoted in the article to give factual figures. Otorhinolaryngology becomes a crucial sub-speciality in the care of the injured and military otorhinolaryngologists need to be trained and deployed accordingly. The otolaryngologist's clinical knowledge base and surgical domain allows the ENT surgeon to uniquely contribute in response to mass casualty incident. Military planners need to recognize the felt need and respond by deploying teams of specialist head and neck surgeons which should also include otorhinolaryngologists. © 2012 Association of Otolaryngologists of India.

Rajguru R.,Institute of Aerospace Medicine
Aviation Space and Environmental Medicine | Year: 2013

Modern-day high performance aircraft are more powerful, more effi- cient, and, unfortunately, frequently produce high noise levels, resulting in noise-induced hearing loss (NIHL) in military aircrew. Military pilots are required to perform many flight duties correctly in the midst of many challenges that may affect mission completion as well as aircraft and aircrew safety. NIHL can interfere with successful mission completion. NIHL may also require aircrew to be downgraded from flying duties, with the incumbent re-training costs for downgraded personnel and training costs for new/replacement aircrew. As it is not possible to control the source of the noise without compromising the efficiency of the engine and aircraft, protecting the aircrew from hazards of excessive noise and treating NIHL are of extreme importance. In this article we discuss various personal hearing protection devices and their efficacy, and pharmacological agents for prevention and management of NIHL. © by the Aerospace Medical Association, Alexandria, VA.

Rajguru R.,Institute of Aerospace Medicine
Indian Journal of Otology | Year: 2012

Modern day high-performance machines, weapons, aircrafts and locomotives are more powerful, more efficient, and unfortunately, frequently produce high noise levels resulting in Noise-induced Hearing Loss (NIHL). Mechanical hearing protection is essential and effective; however, inherent limitations allow a significant percentage of permanent hearing loss to occur despite protection. Hence, a pharmacological preventative or rescue agent for NIHL forms an important element of a comprehensive approach to maintaining inner ear functional integrity in individuals exposed to noise. The ideal pharmacologic agent would specifically address known mechanisms of acoustic injury, be orally administered, be exceptionally safe, be effective and affordable. Though currently such a pharmacological agent is not available, but the ongoing research is promising. In this article, we discuss various pharmacological agents for prevention and management of NIHL.

Wu Y.-T.,Tri Service General Hospital | Ho C.-W.,Institute of Aerospace Medicine | Chen Y.-L.,Tri Service General Hospital | Li T.-Y.,Tri Service General Hospital | And 2 more authors.
Anesthesia and Analgesia | Year: 2014

BACKGROUND:: The treatment of adhesive capsulitis (AC) is a well-known, complicated, and long process. Recent studies have shown that pulsed radiofrequency (PRF) lesioning of the suprascapular nerve (SSN) using a fluoroscopy- or computed tomography-guided technique can alleviate shoulder pain. However, there are no studies of PRF lesioning of the SSN in patients with AC using ultrasound-guided (UG) techniques, except for 2 case reports. In this study, we compared the effect of physical therapy alone with physical therapy and PRF lesioning of the SSN using a UG technique. METHODS:: Sixty patients with AC were included in the study. Patients were randomized into the following 2 groups: the intervention group containing patients who received 12 weeks of physical therapy after 1 treatment of PRF lesioning of the SSN, and the control group containing patients who received 12 weeks of physical therapy alone. All outcome measurements including visual analog scale (VAS), shoulder pain and disability index, and passive range of motion (PROM) were performed at 1, 4, 8, and 12 weeks after treatment. RESULTS:: Forty-two patients (21 patients in each group) completed the study. The intervention group had a notably shorter time to onset of significant pain relief (6.1 ± 3.4 vs 28.1 ± 9.2 days; P < 0.001) and noticeable reduction of VAS score at week 1 (40% vs 4.7%) than the control group (P < 0.001). All measured variables in the intervention group and most variables in the control group showed significant improvement from the baseline (P < 0.05). A comparison of the 2 groups indicated significantly greater improvement in the intervention group at all times in VAS and shoulder pain and disability index scores (all P < 0.05), and for most gain of PROM (P < 0.05). There were no serious adverse effects or complications in either group. CONCLUSIONS:: This study indicates that the application of PRF lesioning of the SSN using a UG technique combined with physical therapy provided better and faster relief from pain, reduced disability, and improved PROM when compared with physical therapy alone in patients with AC, an effect that persisted for at least 12 weeks. © 2014 International Anesthesia Research Society.

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