• Title/Summary/Keyword: Evidence level

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A Systematic Review of Constraint Induced Movement Therapy about Upper Extremity in Stroke (뇌졸중 환자의 상지 강제유도운동치료에 관한 체계적 고찰)

  • Park, Su-Hyang;Baek, Soon-Hyung;Shin, Joong-il
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.149-161
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    • 2016
  • The purpose of this study is provided to useful data to establish the Constraint Induced Movement Therapy(CIMT) in clinical plan to more specific for stroke patients. Also It is provided way for further study about CIMT. Methods used a systematic review. Systematic review is a research method that can be presented to the scientific evidence. Data were organized by PICO(Patient, Intervention, Comparison, Outcome). Research using the database Embase and Medline, It was searched for CIMT and Stroke. We selected for a total of 42 studies that meet the purpose of the present study. We was selected for a total of 42 studies that meet the purpose of the present study. Results was that the quality of the study is a systematic review, meta-analyzes, randomized controlled. CIMT studies was based on a high quality level of 50% of the total. The difference between the study period was 42.8%, more research was conducted prior to 2010. CIMT has been used more than mCIMT by to differ 40.5%. It is effective in over 75% of study, regardless of the CIMT intervention. In conclusion, CIMT has an effect on the upper limbs of stroke patients damaged, results will be used as a useful material to develop a CIMT in the clinical treatment plan. In future studies will need to validate studies on the effectiveness of the mCIMT, It will require a review of the effectiveness of validation studies.

Comparative Analysis on Health Care Expenditure and Its Improvement Effect for Social Welfare: An Application of Principal Component Analysis (보건의료비의 사회후생 증대효과 비교분석: 주성분분석을 중심으로)

  • Rhee, Hyun-Jae
    • The Journal of the Korea Contents Association
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    • v.13 no.2
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    • pp.378-389
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    • 2013
  • Health care expenditure might be understood as a core source of social welfare. It is mainly due to the fact that the health care expenditure is closely related to the level of social welfare. And, therefore, the paper is basically designed to investigate the effect of social welfare improvement resulted from an increasing in per capita, private, public, and total health care expenditures during 1995-2009 periods. Empirical evidence reveals that the improvement of social welfare in middle income group reveals the highest improvement in social welfare, and the other income groups maintain a quite similar pattern in improvement of social welfare. As far as category of health care expenditure concerns, the effect of social welfare improvement by per capita health care expenditure is in general lower in all case. And, private sector achieves the highest improvement of social welfare in comparing with public and total health care expenditures. To this end, it could be tentatively concluded that the private health care expenditure has to be substituted for the public sector to induce market-oriented operational system. Accordingly, it would be better to build an institutional basis more elaborately in setting up the market system.

The Relationship between Explicit/Implicit Dependency and Depression (외현적/암묵적 의존성과 우울과의 관계)

  • Park, Sunhee;Oh, Kyung Ja
    • Korean Journal of Cognitive Science
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    • v.27 no.4
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    • pp.599-618
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    • 2016
  • The relationship between dependent personality traits and depression has been widely studied in the field of psychology. However, the existing evidence is mixed and often contradictory, obscuring the precise nature of this relationship. Given that the most common method of measuring the construct of dependency has been to administer self-report instruments, it is possible that implicit dependency, another parameter of dependency that is distinct from explicit dependency measured via self-report, is confounding these results. The current study aimed to clarify the relationship between dependency and depression by comparing the effect of implicit and explicit dependency. Implicit dependency was measured via the Single Category-Implicit Association Test (SC-IAT), a test of implicit personality that has shown to have good validity and reliability in previous studies. In addition, we examined the effect of gender on this relationship, given the potential role of gender stereotype that may make male participants show lower levels of dependency when measured through self-report (vs. SC-IAT). Results showed that implicit and explicit dependency indeed had separate and distinct relationships, and the relationships depends on participants' gender. Among female participants, increased explicit dependency predicted depression only when implicit dependency was also elevated. In contrast, explicit dependency predicted depression regardless of the level of implicit dependency in male participants. These findings suggest that implicit and explicit dependency may be separate parameters capturing different aspects of dependent personality traits, further supporting the need to consider the implicit aspect of personality in personality assessment research. Implications and limitations of the current findings and directions for future research are discussed.

The Return to Education and Sheepskin Effect in Korea: Comparison of Male and Female Workers (한국의 교육투자수익률 및 학위효과 : 남녀 비교)

  • Han, Sung Shin;Cho, In Sook
    • Journal of Labour Economics
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    • v.30 no.1
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    • pp.1-30
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    • 2007
  • Using the Korean Labor and Income Panel Study 2001 (KLIPS 2001), this paper examines gender differences in the return to education in Korea. On average, there is little difference in return to education between male and female workers. However, this paper provides evidence that the impact of education on wages is greater for female workers compared to that for male workers using three different estimation strategies. First, a simple cohort analysis shows that the estimated returns to education for male and female workers have different patterns by age cohort and this is the main reason we observe little gap in average returns to education between men and women. Second, we find that college degree has a significant impact on women's labor market outcomes, while there is little gain for men in terms of wage levels by having college degree. Finally, when controlling unobservable individual ability level with test scores, education has no significant impact on male workers' wage levels, while the impact of education on wages is considerably large for female workers. All three findings support that the impact of education on labor market outcomes is greater for female workers compared to that for male workers as many researchers have found in other OECD countries.

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Establishment of Total Sugar Reference Value for Koreans (한국인 총당류 섭취기준 설정)

  • Cho, Sung-Hee;Chung, Chin-Eun;Kim, Sun-Hee;Chung, Hye-Kyung
    • Journal of Nutrition and Health
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    • v.40 no.sup
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    • pp.3-8
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    • 2007
  • Sugars are a ubiquitous component of our food supply and are consumed as a naturally occurring component of many foods and as additions to foods during processing, preparation, or at the table. Most fruits and dairy products are high in sugars and thus naturally occurring sugars are consumed as part of a healthy diet. Some countries developed recommended daily intake figures(daily values : DVs or guideline daily amounts: GDA) for nutrients, and some countries, but not most have developed DV/GDA for total sugars. Dietary Reference Intakes for Koreans established by the Korean Nutrition Society in 2005, did not include the reference values for total sugar or added sugar. The committee on Dietary Reference Intakes for sugar was constituted in 2006 and discussed whether to special added sugars or total sugar. Although added sugars are not chemically or physiologically different from naturally occurring sugars, many foods and beverages that are major sources of added sugars have lower micronutrient densities compared with foods and beverages that are major sources of naturally occuring sugars. But it was so hard to calculate a dietary intake of added sugar for Korean people, because there was insufficient information about contents of added sugar during processing or preparation of Korean food. Currently Korean or US food labels contain information on total sugars per serving but do not distinguish between sugars naturally present in food and added sugars. Therefore the committee decided to set the reference value for total sugar for Koreans. According to the recommended diet pattern for Koreans suggested by the Korean Nutrition Society, estimated sugar intake from the sugar containing food based on 2,000 kilocalories is 67 g or 13% of total energy. Based on the data available on risk of obesity, hypertension, hyperlipidemia, insulin resistance, and metabolic syndrome from the analysis of Korean NHANES, it was insufficient evidence to set a UL for total sugar, but tended to increase serum LDL cholesterol and obesity at over 20-25% of energy from total sugar when consumed with high carbohydrates. Therefore the committee on Dietary Reference Intakes for sugar set the Acceptable Macronutrient Distribution Range for total sugar as 10-20% of total energy intake.

The effect of walnut (Juglans regia L.) intake on improvement of blood lipid levels and vascular health: A meta-analysis (호두의 혈중 지질 수준 및 혈관 건강 개선 기능성 평가: 메타분석)

  • Kwak, Jin Sook;Park, Min Young;Kwon, Oran
    • Journal of Nutrition and Health
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    • v.47 no.4
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    • pp.236-246
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    • 2014
  • Purpose: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. Methods: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). Results: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). Conclusion: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.

Literature Review Nursing Intervention for Developmental Support on Preterm Infants (미숙아의 발달지지를 위한 간호중재에 관한 문헌연구)

  • Kim, Tae-Im;Sim, Mi-Kyung
    • Korean Parent-Child Health Journal
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    • v.4 no.1
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    • pp.35-55
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    • 2001
  • Recently attention has been focused on the effects of early intervention, or its lack, on both normal and preterm infants. Particularly numerous studies suggest that premature infants are not necessarily understimulated but instead are subjected to inappropriate stimulation. Developmental support and sensory stimulation have become clinical opportunities in which nursing practice can impact on the neurobehavioral outcome of premature infants. Developmental care has been widely accepted and implemented in neonatal intensive care units across the country. Increasingly, attention and concern in caring for low-birth-weight infants and premature infants has led clinicians in the field to explore the effects of a complex of interventions designed to create and maintain a developmentally supportive environment; to provide age-appropriate sensory input; and to protect the infant from inappropriate, excessive and stressful stimulation. The components of developmental care include modifications of the macro-environment to reduce NICU light and sound levels, care clustering, nonnutritive sucking, and containment strategies, such as flexed positioning or swaddling. Sensory stimulation of the premature infants is presented to standardize the modification of a developmental intervention based on physiologic and behavioral cues. The most appropriate type of stimuli are those that are sensitive to infant cues. Evaluation of infant physiological and behavioral responds to specific intervention stimuli may help to identify more appropriate interventions based on infants' cues. A critical question confronting the clinician is that of determining when the evidence supporting a change in practice is sufficient to justify making that change. There are acknowledged limitations in the current studies. Many of the studies examined had small sample sizes; used nonprobability sampling; and used a phase lag design, which introduces the possibility of threats to internal validity and limits the generalizability of the results. Although many issues regarding the effects of developmental interventions remain unresolved, the available research base documents significant benefits of developmental care for LBW infants in consistent outcomes, without significant adverse effects. Particularly, although the individual studies vary somewhat in the definition of specific outcomes measured, instrumentation used, time and method of data collection, and preparaion of the care providers, in all studies, infants receiving the full protocol of individualized developmentally supportive care had improvements in some aspect of four areas of infant functioning: level of respiratory or oxygen support, the establishment of oral feeding; length of hospital stay, and infant behavioral regulation. In summary, based on the available literature, individualized developmental intervention should be incorporated into standard practice in neonatal intensive care. And this implementation needs to be coupled with ongoing research to evaluate the impact of an individualized developmental care programs on the short- and long-tenn health outcomes of LBW infants.

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Analysis of Studies on Ojeok-san for Establishment of Evidence Based Medicine (EBM 기반 구축을 위한 오적산 연구 논문 분석)

  • Lee, Nam-Hun;Ha, Hye-Kyung;Lee, Ho-Young;Jung, Da-Young;Choi, Ji-Yoon;Lee, Jun-Kyoung;Shin, Hyun-Kyoo
    • Herbal Formula Science
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    • v.16 no.2
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    • pp.1-9
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    • 2008
  • Objective : The purpose of this report was to provide the information about activity and safety of Ojeok-san by analyzing domestic/international papers about Ojeok-san. Methods : Domestic/international papers related to Ojeok-san were reviewed and analyzed. These papers were then classified by year, experimental method and subject. Results : The following results were obtained in this study. 1. The studies of Ojeok-san started from 1984 and has continuously increased. The studies were mainly focused on experimental models rather than clinical studies. 2. By subject, papers related to safety were most common with 5 papers among 20 papers. Besides there were papers related to efficacy of analgesic, anti-hyperlipidemic, anti-blood stasis and treatment for uterine myoma. 3. The papers related to safety were mainly focused on the effect of Okeok-san on liver function, renal function or metal concentration of organs such as blood, brain, liver, kidney and bone. Ojeok-san proved to be safe, but more clinical studies regarding the safety are needed hereafter. 4. Papers related to analgesic, anti-pyretic, anti-phlogistic activities of Ojeok-san were in vivo studies, and other papers were about anti-hyperlipidemic activity, apoptosis inducing activity on uterine myeloma cell line and anti blood static activity on hydrocortisone acetate induced blood statis model. 5. Case reports were about anti-lipidemia, analgesic effect for mastalgia/back pain and anxiety disorder due to climacteric changes. Conclusion : Ojeok-san is being used in various ways with analgesic, anti-pyretic, anti-phlogistic, anti-hyperlipidemic, anti-tumor or anti-blood statis activity. However, mechanism study should be conducted at the molecular biology level and more clinical studies on the efficacy of Ojeok-san are needed.

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Caudal Epidural Injection with a Guidewire-Reinforced Epidural Catheter in Patients with Herniated Nucleosus Pulpose (추간판 탈출증 환자에서 길잡이철사가 삽입된 경막외카테터를 이용한 미추경막외조영술)

  • Ko, Justin Sangwook;Lee, Seok Jin;Hwang, Hee Youn;Sim, Woo Seok;Choi, Soo Joo;Kim, Jie Ae;Kim, Chung Su;Hahm, Tae Soo;Kim, Gaab Soo;Cho, Hyun Sung;Kim, Tae Hyeong
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.207-212
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    • 2006
  • Background: The epidural injection technique is a commonly used intervention in the management of chronic spinal pain, which has the advantage of delivering various drugs, such as local anesthetics or steroids, in higher concentrations to the inflamed nerve root. A guidewire-reinforced epidural catheter was introduced through a Tuohy needle during the caudal epidural procedure, with a catheter threaded into the affected nerve roots and the spread-pattern of contrast agents observed under fluoroscopy. Methods: Sixty-seven patients with low back pain, who showed evidence of a herniated nucleus pulposus on magnetic resonance imaging, were included. All patients received fluoroscopically guided caudal epidural injections, with the guidewire-reinforced epidural catheter introduced through a Tuohy needle and threaded either to the right or left side toward the target nerve roots. After confirming the catheter tip position at the affected nerve root, 2 ml increments of contrast agents (up to 6 ml) were injected, and their corresponding AP fluoroscopic views were obtained. Three radiologists reviewed all the radiographic findings and measured the proportion of the area of contrast spread at the side of target nerve roots. Results: Greater proportion of the area of contrast spread was observed at the side of the target nerve roots (P < 0.0001). At each level of contrast injection (2-⁣, 4- ⁣ and 6 ml), more than 70% of the spread of contrast dye was observed at the side of the target nerve roots in 85%, 70%, and 55% of cases, respectively. Conclusions: The combination of a caudal epidural injection and use of a guidewire-reinforced epidural catheter significantly enhances the target specificity, as revealed by the selective spread of contrast dye at the side of target nerves.

The Domestic Trends of Korean Medicine Treatments on Traffic Accident for Recent 5 Years (최근 5년간 교통사고 후유증의 한의학적 치료에 대한 국내 연구 동향)

  • Choi, Young-Il;Kim, Min-Yeong;Choi, Hee-Seung;Jeong, Yun-Gyu;Ro, Hae-Rin;Kim, Se-Jun;Shin, Dong-Jae
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.8 no.1
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    • pp.27-38
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    • 2013
  • Objectives : The purpose of this study is to investigate the latest trends of korean Medicine treatments on traffic accident for recent 5 years. Methods : We investigated the studies on korean Medicine treatments for traffic accident via searching 6 Korean web databases. As a result, 65 research papers were found to be analyzed according to their published year, the titles of journals, the types of study, the number of cases, the sites of injury, the types of treatments the instruments for assessment and ethics approvals. Results : 65 articles were published since 2008. The studies on korean Medicine treatments about traffic accident were mainly published in Journal of Oriental Rehabilitation Medicine. 10 case studies, 14 case series, 11 non randomized controlled trials, 21 randomized controlled trials and 9 systemic reviews had been under research. The most frequently occurred symptoms were neck pain and low back pain. In most studies, various korean Medicine treatments were used to treat the symptoms. Visual analogue scale(VAS) and neck disability index(NDI) were used as primary assessments. In most clinical studies, there were no mention about approval of institutional review board(IRB). Conclusion : In this study, we analyzed the trends of korean Medicine treatments on traffic accident from 2008 to 2012. Reviewing the domestic trends of studies on korean Medicine treatments for traffic accident and examining the strong and weak points of those treatments are essential for the future studies. It is needed to adopt the qualitative methods of evaluation in order to develop a level of evidence.

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