• The Korean Journal of Emergency Medical Services
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• v.20 no.3
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• pp.69-83
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• 2016

Purpose: The purpose of this study was to explore the factors influencing evidence-based fall prevention nursing performance of hospital nurses. Methods: A self-reported questionnaire was completed by 344 nurses from three general hospitals from January 20 to March 10, 2013. The study instruments included general characteristics of the subjects, and awareness and performance of fall prevention. Data were analyzed by t test, ANOVA, Pearson's correlation, and multiple regression using SPSS v. 20.0. Results: There were statistically significant differences in awareness and performance according to age, marital status, clinical experiences, workplace, experience of fall prevention education, knowledge of fall prevention, compliance with fall prevention, attention level toward prevention, recognition level of potential falls, nurse responsibility for falls, importance of fall prevention, efforts level for fall prevention, and awareness score of falls prevention. There was a positive correlation among awareness and performance of fall prevention. Based on the multiple regression analysis, compliance with fall prevention, efforts level for fall prevention, and awareness score of falls prevention were significant predictors for performance of fall prevention. The explanation power of the model was 64.1%. Conclusion: The findings revealed the need to develop an effective nursing intervention to improve hospital nurses' performance for fall prevention.

• Neonatal Medicine
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• v.16 no.2
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• pp.121-130
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• 2009

Over the past 20 years, neonatal mortality rates for preterm infants, particularly those born extremely preterm and with a very low birth weight, have decreased steadily. As more very immature preterm infants survive, provision of enteral feeding has become a major focus of concern. According to many experts on neonatal nutrition, the goal for the nutrition of preterm infants should be to achieve a postnatal growth rate approximating that of a normal fetus of the same gestational age. Total parenteral nutrition for maintaining nutritional integrity is mandatory before successful transition to enteral feeding. Early initiation of trophic enteral feeding is vital for postnatal adaptation. Recently published randomized controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of necrotizing enterocolitis. Early trophic feeding yields demonstrable benefits and there is currently no evidence of any adverse effects following early feeding. Preterm milk from the infant's own mother is the milk of choice, which can always be supplemented with a human milk fortifier. Here we review over 50 randomized controlled trials and over seven systematic reviews published on neonatal parenteral and enteral feeding of preterm infants. Neonatologists must make use of the evidence from these studies as a reference for feeding protocols for preterm infants in their NICUs are to be based.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.5
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• pp.303-312
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• 2020

Background: Lidocaine is the gold standard local anesthetic (LA) for UK pediatric dental treatment. Recent reports suggest frequent Articaine use in Europe and Canada, with evidence indicating more profound anesthesia. The aim of this study was to examine pediatric dentistry specialist experiences and practices relating to Articaine administration in the UK. Methods: A literature review was followed by a survey using an anonymous 15-item electronic questionnaire, which was sent to 200 registered British Society of Pediatric Dentistry (BSPD) specialists. Descriptive analyses, Z score, chi-squared test, Fisher's exact test, and Spearman's correlation test were performed. Results: Sixty-one (30.5%) participants responded, and 12 (19.7%) indicated Articaine as their first line anesthetic. Articaine was used daily or weekly by 38 (62.3%) respondents, depending on the clinical context. Articaine was commonly used to avoid inferior alveolar nerve blocks and gain more profound anesthesia in abscessed or hypomineralized teeth. Participants reported significantly more adverse effects with lidocaine (Fisher's exact test, P < 0.0001) than with Articaine. Articaine was most often administered in children aged > 4 years via infiltration techniques. Only 15 (24.6%) respondents reported awareness of guidelines for Articaine use in pediatric patients. Conclusions: Articaine use in pediatric dentistry is common; however, evidence supporting its practice is limited. Several specialists follow conventions based on anecdotal evidence. Formulating guidance to aid decision-making when treating pediatric patients under LA would be beneficial.

• PNF and Movement
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• v.12 no.2
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• pp.51-61
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• 2014

Purpose: This study aimed to review articles related to PNF and easily provide information to readers who have difficulty reading papers or using PNF in clinics without a background in statistical knowledge. Methods: We used PubMed to collect papers on international studies and we conducted a search on April 28, 2014. Keywords used for the PubMed search were "PNF" and "Proprioceptive Neuromuscular Facilitation". The search results identified 765 papers that had been published since 1954. To target the papers for review, we selected 66 papers, excluding papers that were not published in online journals and papers that were written in a second language. Results: The reviewed papers consisted of studies that addressed basic principles and procedures, combined with other interventions, including PNF stretching concepts, and other diseases with PNF concepts. The articles related to basic procedures and principles reported on optimal contraction intensity, patterns, and irradiation. The articles related to stretching and strengthening reported on stretching the hamstring muscles in healthy subjects, in combination with other interventions such as neuromobilization, clinical massage, kinesio taping, and water immersion. The articles related to specific diseases reported on stroke, low back pain, athletic injury, total knee replacement, etc. Conclusion: In the 66 articles reviewed for this study, there was little evidence that PNF has therapeutic value. However, in future research on the application of PNF, investigators could conduct a more in-depth analysis of this topic and present more objective and useful information on the therapeutic benefits of PNF.

• YAKHAK HOEJI
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• v.58 no.2
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• pp.112-124
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• 2014

This study aimed to develop a regulation system for off-label drug use to secure the safe use of marketed drugs. We searched governmental documents for national and global regulating systems of off-label drug uses and a body of academic literature to explore current regulating trends. We included European Union, United Kingdom, United States of America, Australia and Japan, and critically reviewed the regulation of off-label drug use in four issues, which were a regulatory structure, safety control before and after off-label use, and information management. The findings of the present investigation called for several measures in off-label drug uses: enhancing prescribers' self-regulation, providing up-to-date information to prescribers for evidence-based practice and to patients for their informed consent, making evidence with scientific rigor, building an official registering process for off-label use in good quality and extending the role of pharmaceutical industry in pharmacovigilance. At last, we proposed a new system so as to regulate and evaluate off-label drug uses both at national and institutional level. In the new system, we suggested a clear-cut definition for clinical evidence that applicants would submit. We newly introduced an official 'Off-Label Drug Use Report' to evaluate the safety and clinical efficacy of a given off-label drug use. In addition, we developed an algorism of the regulation of off-label drug use within an institution to help set up the culture of evidence-based practices in off-label drug uses.

• Clinical and Experimental Reproductive Medicine
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• v.48 no.3
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• pp.194-197
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• 2021

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m² for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

• Nutrition Research and Practice
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• v.14 no.3
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• pp.262-275
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• 2020

BACKGROUND/OBJECTIVES: Evidence-based customized nutritional interventions are required for effective treatment of moderate to severe obese children and adolescents. SUBJECTS/METHODS: Sixty six (64.1% of 103) of the eligible participants who joined the usual care or physical activity group in the clinic were involved in 16-week intervention. Customized nutritional intervention was implemented for each participant based on a nutrition care process (NCP) model. Sociodemographic assessment, anthropometrics data, health- and dietary-related behaviors, and dietary intake of the study subjects were assessed at baseline and follow-up. All participants engaged in 30-minute nutritional sessions on a monthly basis. RESULTS: After 16 weeks, there were significant improvements in body composition [BMI (-0.8 ± 0.9, P < 0.05), BMI z-score (-0.3 ± 0.2, P < 0.001), body fat (kg) (-1.3 ± 2.1, P < 0.05), and body fat (%)(-1.5 ± 1.9, P < 0.05)] as well as macronutrient intake [total energy intake (kcal) (-563.7 ± 656.8, P < 0.05), energy (%) (-26.5 ± 30.0, P < 0.05) and fat (g) (-28.3 ± 40.6, P < 0.05)] in the adherent group than the non-adherent group. The SOC was higher in both groups after the intervention (P < 0.001). CONCLUSIONS: Our results highlight the positive effects of an evidence-based approach as a multidisciplinary intervention for people-centered nutritional care and weight management.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.19 no.1
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• pp.87-97
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• 2012

Purpose: This study was done to evaluate nursing guidelines for patients with acute stroke, developed by adapting the guidelines of Registered Nurses Association of Ontario, Canada to clinical settings on a large scale and evaluating the effectiveness as a research study. Method: The general characteristics of the 319 patients and the effectiveness of guideline application were evaluated in terms of structure, process, and outcome using questionnaires on the guidelines application with reference to the medical records of patients with acute stroke hospitalized on a ward of the stroke center of S General Hospital in Seoul. Results: Structures as a guidance system for assessment were consistent with the recommendations. With respect to the process of the guidelines, for items on nursing assessment, improved performance was found to be statistically significant. For outcomes of the guidelines, complications occurred in 8 patients (5.3%) prior to application of the guidelines and 11 patients (6.5%) after application of the guidelines, but this result was not statistically significant (p=.841). Conclusion: The results of the study indicate that for the effectiveness of the guidelines, accessibility to the guidelines and effectiveness of quality improvement need to be evaluated, in addition to complications of a stroke.

• Journal of Korean Academy of Nursing
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• v.43 no.3
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• pp.352-360
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• 2013

Purpose: In this study an examination was done of the effects of the American Society of PeriAnesthesia Nurses (ASPAN) Evidence-Based Clinical Practice Guidelines on body temperature, shivering, thermal discomfort, and time to achieve normothermia in patients undergoing total knee replacement arthroplasty (TKRA) under spinal anesthesia. Methods: This study was an experimental study with a randomized controlled trial design. Participants (n=60) were patients who underwent TKRA between December 2011 and March 2012. Experimental group (n=30) received active and passive warming measures as described in the ASPAN's guidelines. Control group (n=30) received traditional care. Body temperature, shivering, thermal discomfort, time to achieve normothermia were measured in both groups at 30 minute intervals. Results: Experimental group had slightly higher body temperature compared to control group (p=.002). Thermal discomfort was higher in the experimental group before surgery but higher in the control group after surgery (p=.034). It decreased after surgery (p=.041) in both groups. Time to achieve normothermia was shorter in the experimental group (p=.010). Conclusion: ASPAN's guidelines provide guidance on measuring patient body temperature at regular intervals and on individualized and differentiated hypothermia management which can be very useful in nursing care, particularly in protecting patient safety and improving quality of nursing.

• Physical Therapy Korea
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• v.10 no.3
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• pp.91-107
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• 2003

We processed meta-analysis to test if the effects of laser therapy and mobilization techniques are evidence-based practice for treating tennis elbow. By researching and collecting the results of previous studies on tennis elbow, we inquired into the difference in the effects of each treatment methods on pain, grip strength, and ROM. A total of 10 international and domestic articles on the treatments of tennis elbow were selected for this study, including 7 articles on the effect of laser therapy and 3 on mobilization techniques. According to the qualitative meta-analysis, all 7 of the articles on laser therapy and 1 of the mobilization technique were double-blinded and randomized the subjects, and all of the 10 studies were designed in a high quality research, using statistics. The results of the studies on laser therapy showed in terms of statistical significance: 4 out of 7 did not decrease pain after therapy, and 3 out of 5 did not increase grip strength after therapy. In the studies on the effects of mobilization technique, both the 2 studies significantly increased grip strength after therapy. For other studies which measured ROM and tension, the mobilization therapy increased ROM significantly, and decreased tension significantly. The results of our study are shown in a diverse form in terms of the effects of different therapy techniques. This is related to the accuracy of the measurement tools for assessments and diagnoses. Further qualitative studies on the evidence-based practice and researches on tennis elbow are needed.