• Title/Summary/Keyword: 객관성

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Meta-Analysis on Effectiveness of Intervention to Improve Patient Compliance in Korean (한국인 치료순응도 향상을 위한 개입 효과에 대한 메타분석)

  • 김춘배;조희숙;현숙정;박애화
    • Health Policy and Management
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    • v.12 no.2
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    • pp.23-42
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    • 2002
  • The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.

Analysis of Ecological Index of Plant Using Flora Distributed in Temple Forest (사찰림에 분포하는 식물상을 이용한 식물생태지수 분석)

  • Oh, Hyunkyung;Choi, Yeonho;You, Juhan
    • Journal of Environmental Impact Assessment
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    • v.23 no.4
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    • pp.251-270
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    • 2014
  • The purpose of this study is to offer the basic data and method for assessing the naturaliness of temple environment by applying the ecological index of plant to quantitatively and objectively assess the flora and to understand the flora distributed in major temple forest. The ecological index of plant was based in the surveyed flora. The whole flora were summarized as 535 taxa including 103 families, 310 genera, 426 species, 5 subspecies, 82 varieties and 22 forms. And, the numbers of taxa in the Beopheungsa were 267 taxa, 314 taxa of the Daeseungsa and 296 taxa of the Seongjusa. The rare plants were 9 taxa including Aristolochia contorta, Viola albida, Arisaema heterophyllumand so forth, and the Korean endemic plants were 11 taxa including Clematis trichotoma, Stewartia pseudocamellia, Vicia chosenensis and so forth. The specific plants by floristic region were 51 taxa including Wistaria floribunda, Celtis aurantiaca, Angelica gigas and so forth, and the pteridophyta were 26 taxa including Osmunda japonica, Polystichum braunii, Onoclea orientalis and so forth. The naturalized plants were 35 taxa including Fallopia dumetorum, Conyza canadensis, Xanthium strumarium and so forth, the invasive alien plants were 3 taxa including Ambrosia artemisiifolia, Aster pilosus and Eupatorium rugosum. In the results of analysing the ecological index of plant in whole temple forests, RI(Rare Index) was 1.7%, 2.1% of EI(Endemic Index), 9.5% of SI(Specific Index), 1.2 of PI(Pteridophyta Index) and 6.5% of NI(Naturalized Index) in narrow sense. In broad sense, FI(Flora Index) was 11.0%, 1.5% of RI, 3.4% of EI, 4.8% of SI, 10.1% of PI, 10.9% of UI(Urbanized Index) and 25.0% of DI(Disturbed Index). The FI of the Daeseungsa was the highest among the three temple forests. In narrow sense, the RI, SI, NI and DI of the Beopheungsa was high, the seongjusa was higher the EI and SI. In broad sense, the RI and SI of the Beopheungsa, the EI, SI and PI of the Seongjusa, the UI is high in the Daeseungsa. In future, if we will analyze ecological index of plant in other temple forests, we will offer the help to establishing the plan of conservation and restoration on ecosystem in whole temple forests.Environmental Specimen Banks (ESBs) are playing pivotal role in monitoring the effect of environmental pollution on the ecosystem based on the retrospective analysis of the representative samples collected regularly and stored in cryogenic condition.

The Influence of Botulinum Toxin Type A Masticatory Efficiency (보툴리눔 A형 독소가 저작효율에 미치는 영향)

  • Park, Hyung-Uk;Kwon, Jeong-Seung;Kim, Seong Taek;Choi, Jong-Hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.53-67
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    • 2013
  • This study was aimed to evaluate the masticatory efficiency after botulinum toxin type A (BTX-A) injection during 12 weeks using objective and subjective test. Also, we compared the difference of masticatory efficiency between group that injected into the masseter muscle only (M-group) and group that injected into the masseter and temporalis muscle (M-T group). The mixing ability index (MAI) was used as the objective indicator, and visual analogue scale (VAS) and food intake ability (FIA) index were used as the subjective indicators. It was concluded that masticatory efficiency was significantly lowered after a BTX-A injection into the masticatory muscle, but it gradually recovered in a predictable pattern by the 12 weeks. The disturbance of subjective masticatory efficiency was lasted longer than objective masticatory efficiency. The masticatory efficiency was lower in M-T group than M group. It was statistically significant in the VAS and FIA at 4 weeks, but the MAI showed no significancy. After 4weeks, there was rapid recovery of muscle function in M-T group, and the difference between two groups was not significant. It could be concluded that there will be no serious disturbance of mastication compared to injection is done only into the masseter muscle, even if injection is done into the masseter and temporalis muscle in dose of this study. According to the food properties, it was confirmed that people feel more discomfort on taking hard and tough foods after BTX-A injection and not only hard foods, but also intake of soft and runny foods were influenced by botulinum toxin injection.

THE INDUCTION OF BONE REGENERATION AT FURCATION LESIONS WITH PULPECTOMY AND FURCATION CURETTAGE IN PRIMARY MOLARS (유구치 치근분지부 병소의 치수절제술과 소파술에 의한 골재생)

  • Lee, Seung-Hyun;Woo, Youn-Sun;Kim, Jae-Moon;Jeong, Tae-Sung;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.628-633
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    • 2005
  • Deep caries in primary molars without early intervention frequently induce a pulpal disease and consequent furcation lesion with fistulous openings Up to now, majority of the textbooks on pediatric dentistry and literatures have described that extraction of the inflicted teeth is indicated for these cases and in reality these teeth have usually been extracted in the dental clinics. However when we recognize the excellent capacity of bone regeneration in children and the presence of numerous accessory canals at furcation areas, the removal of infection source in pulp by pulpectomy and inflammatory granulation tissues at furcation areas by furcal curettage might open the possibility of rapid healing at the furcation regions. In this report, 10 cases of primary molars in 3 to 6-year-old children with fistulous openings and furcation lesions in moderate size of 2 to 4mm in depth radiolucency at furcation lesion have been chosen. After pulpectomy and furcal curettage, evident bone regeneration was detected radiographically in all cases. Through the cases, we came to realize that all the cases previously described are not the indications of extraction and this approach could make many cases with pulp and furca combined lesions survive and remain healthy in the children's dental arches. However, in order for this approach to acquire objective appropriateness, it is thought that more scrupulous evaluation is desirable on the various factors regarding the indication such as the extent of furcation lesions, absorption status of teeth, amount of covering bone on succeeding teeth and so on.

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The Effects of Cooperative Learning to Study the Unit 'Metabolism' in High School: Application of STAD Model (고등학교 생물 '물질대사' 단원에서 협동학습의 효과: STAD 모형의 적용)

  • Chung, Young-Lan;Lee, Hye-Won
    • Journal of The Korean Association For Science Education
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    • v.23 no.1
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    • pp.35-46
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    • 2003
  • Problem solving ability, having been thought as one of the most important goals of science education is also a primary task for the current education. Indeed, the students' problem solving ability has shown almost no actual progress, despite our long accumulated science education. Under this circumstances, cooperative learning, a way to grow students' positive inter-dependence and problem solving ability in the basis of their active participation and discussion, was proposed as an effective teaching method. But, results have not consistently shown the advantage of cooperative learning over traditional learning for promoting academic achievement in science. Studies have consistently shown greater effectiveness on affective aspects. But, relatively few have focused on biology in Korea. The purpose of this study was to examine the effects of cooperative learning on the achievement and attitude of high school biology students. The pretest-posttest control group design was applied. The sample consisted of 50 11th-grade female students in experimental group(cooperative learning Student Team Achievement Division model) and 50 students in control group(traditional learning). Students in both groups recieved identical content instruction on the unit 'II. Methabolism'. These groups were treated for 13 hours during 5 weeks. Achievement data were collected using a 24-item multiple-choice test(content validity= .85). Science attitude was measured by an instrument which adapted by Kim In Hee(1994). The instrument(Cronbach $\alpha$=.89) included 40 items in four subscales: attitude toward science, social meaning of science, attitude toward science class, and scientific attitude. An analysis of covariance (ANCOVA) was used as the data analysis procedure. For the achievement data, no significant difference exists between the cooperative and traditional groups (p> .05). But, cooperative learning was effective in low-ability students(p < .05). For the science learning attitude data, cooperative learning was more effective than the traditional one(p< .05). Students in the cooperative group acheived better than those in traditional one especially in the subscale of attitude toward science class. There was no meaningful difference of the two methods in both high and average ability students, while cooperative learning was more effective than the traditional one in low ability students(p<.05).

Comparison between Conservative Treatment of partial ACL Rupture and Reconstructive Surgery with BPTB Autograft in ACL Rupture (전방 십자 인대 파열후 자가 슬개건을 이용한 재건술군과 부분 손상후 보존적 치료군의 비교)

  • Lee Dong Chul;Lee Su Ho;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.131-137
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    • 2002
  • Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

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Clinical Characteristics of Patients with Taste Disorders (미각 장애 환자의 임상적 특성에 관한 연구)

  • Lee, Eun-Jin;Park, Won-Kyu;Nam, Jin-Woo;Yun, Jong-Il;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.341-351
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    • 2009
  • There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.

Negligence theory of Aviation accident with reference to the japanese aviation accident precedent (항공 사고에서의 과실 이론 - 일본 항공 사고 판례를 중심으로 -)

  • Hwang, Ho-Won;Ham, Se-Hun
    • The Korean Journal of Air & Space Law and Policy
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    • v.23 no.2
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    • pp.115-136
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    • 2008
  • The development of the aviation technology is beyond the people's imagination. For example, with some exaggeration, If the autopilot engage upon take off, You will realize that you are on the centerline of the foggy JFK runway 13R after 15 hours with only once or twice of intervention. But the more aviation technology develops, the more responsible the pilot will be who has the final authority of the aviation safety. In the JAL 706 accident caused by unidentified reason, the pilot increased pitch abruptly and overrode the control from the autopilot. The result of this process made the death of a flight attendant and some injuries of a few passengers. The district court found the pilot not guilty at the first trial on the ground that the control override was not connected to the possibility of foresight and avoidance of the human death. The pilot was proved to be innocent through the analysis of the DFDR and ADAS that the override did not precede the unidentified pitch up motion. The judicial precedent related to aviation accidents in Korea requires pilots' absolute and extended care compared to the ordinarily prudent or reasonably careful behaviors in the vehicle and medical accidents. Although there is some controversy about the standard care, the care required in the actual operation of high tech aircraft by a pilot should include objective and standard care and be judged by analysis of the scientific data. Although the pilot maintained the unusual hi speed that doesn't have safety margin and descended under turbulence in case of the JAL 706 accident, the court negatived its relation to the cause of pitch up. Also, the override of the control after initial pitch up might have caused the possibility of the death and injury, but the court denied it. Because of this complex cause of the aviation accidents, it is important for a court to figure out the core reason of the event and casual relationship with the pilot Now, It is required that the judgement of negligence in the aviation accidents should include an objective care with scientific data from simulated circumstances(or a simulator) as the Japanese court not from the theory of vehicle's negligence.

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High VPP Combination Chemotherapy for Advanced Non-Small Cell Lung Cancer (진행된 비소세포 폐암에 대한 High-VPP 복합화학요법의 효과)

  • Hong, Seok-Cheol;Han, Pyo-Seong;Lee, Jong-Jin;Cho, Hai-Jeong;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.367-377
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    • 1993
  • Background: The benefits of combination chemotherapy in unresectable non-small cell lung cancer remain uncertain. But, according to the recent reports, the response rates of cisplatin-based polychemotherapy regimens are higher than those of single agent. Also, the response rates of high-dose cisplatin group are higher than those of low-dose cisplatin group. In attemp to answer the question whether treatments, combination chemotherapy (high VPP) and combination chemotherapy with radiation therapy, improve survival in advanced non-small cell lung cancer, we begin to study. Method: Thirty-five patients above stage III, diagnosed histologically as non-small cell lung cancer, were enrolled. Among them, nineteen received a combination chemotherapy consisting of VP-16 & high-dose cisplatin (100 $mg/m^2$) and/or radiation therapy. The other group (16 subjects) received no therapy. To investigate the differences of survival and response rates between two groups and the side effects related to therapy, we reviewed patients' records. Results: 1) The overall objective response rate was 47%(9/19) with one complete remission. 2) In patients who received polychemotherapy and radiation therapy, the response rate was 60%(6/10) with one complete remission and survival rates of 3 months, 6 months and 12 months were 100%, 70% and 40%. 3) In patients who received polychemotherapy, the response rate was 33% (3/9) with no complete remission and survival rates of 3 months, 6 months and 12 months were 78%, 67% and 33%. 4) Overall, treated patients survived significantly longer (p<0.05) than non-treated patients (median survival 307 days versus 95 days). 5) Analysis of the various prognostic factors disclosed that good performance status, stage III and squamous cell type showed the good response rates. 6) The toxicities were nausea and/or vomiting (100%), alopecia (90%), anemia (79%), leukopenia (69%), thrombocytopenia (2%), increased creatinine (16%) and neurotoxicity (5%). Conclusion: According to above results, there are relatively good results that high VPP combination chemotherapy in advanced non-small cell lung cancer improves survival in the treated group than in the non-treated group. Thus, it is considerd that we select the patients with proper indications and treat them with effective chemotherpy and radiation therapy. But, because improvement related to high VPP ploychemotherapy is not marked in this study, it is necessary that we should investigate follow-up studies in many cases.

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Communication and Enjoyment of Sijo through the Mass Media in the First Half of the 20th Century (유성기음반과 라디오방송을 통해 향유된 시조의 양상과 특징)

  • Park, Jee-Ae
    • Sijohaknonchong
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    • v.44
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    • pp.7-28
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    • 2016
  • Music was made popular through the modern mass media. Nonetheless, if a period of high standard performances and appreciation by a minority of culture connoisseurs can be qualified with the expression "gentrification of culture", then a period when anyone can access culture through the mass media can be qualified with the terms "popularization of culture" and in this period the reorganization of performance culture can only be driven by the public. In fact, the Jabga, which is a type of traditional song that received strong public adhesion by means of phonograph records and radio broadcasts at the time, stands as a typical example to it. Gagok and Sijo up until the 1920s and even the 1930s are believed to engage actively in the changing media environment and the new modes of music enjoyment and transmission. The Album recording of faster rhythm music and the inclusion of the Sijo, Jabga, and folk songs in one broadcast programme can be seen as reflecting such an effort. However, it can only be hard for the Sijo and Gagok to challenge the predominance of the Jabga which made its lyrics more popular and the new songs written in accordance with the new media environment. Until the 1930s in this changing environment of music enjoyment, Gagok and Sijo performers rather sought to distinguish themselves from the existing popular song style by reproducing traditional forms. The album recording and broadcasting of Lee Wangjik Aakbu, the beginnings of local singers, the participation of male performers not only contributed to the diversification the enjoyment culture of songs and sijo, but also made the 'difference in standard' with the popular songs even more salient.

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