• 제목/요약/키워드: Intervention trial

검색결과 566건 처리시간 0.023초

Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial

  • Chawisa Nampoolsuksan;Thawatchai Akaraviputh;Asada Methasate;Jirawat Swangsri;Atthaphorn Trakarnsanga;Chainarong Phalanusitthepha;Thammawat Parakonthun;Voraboot Taweerutchana;Nicha Srisuworanan;Tharathorn Suwatthanarak;Thikhamporn Tawantanakorn;Varut Lohsiriwat;Vitoon Chinswangwatanakul
    • Clinical Endoscopy
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    • 제57권3호
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    • pp.335-341
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    • 2024
  • Background/Aims: The coronavirus disease 2019 pandemic has affected the worldwide practice of upper gastrointestinal endoscopy. Here we designed a modified N95 respirator with a channel for endoscope insertion and evaluated its efficacy in upper gastrointestinal endoscopy. Methods: Thirty patients scheduled for upper gastrointestinal endoscopy were randomized into the modified N95 (n=15) or control (n=15) group. The mask was placed on the patient after anesthesia administration and particles were counted every minute before (baseline) and during the procedure by a TSI AeroTrak particle counter (9306-04; TSI Inc.) and categorized by size (0.3, 0.5, 1, 3, 5, and 10 ㎛). Differences in particle counts between time points were recorded. Results: During the procedure, the modified N95 group displayed significantly smaller overall particle sizes than the control group (median [interquartile range], 231 [54-385] vs. 579 [213-1,379]×103/m3; p=0.056). However, the intervention group had a significant decrease in 0.3-㎛ particles (68 [-25 to 185] vs. 242 [72-588] ×103/m3; p=0.045). No adverse events occurred in either group. The device did not cause any inconvenience to the endoscopists or patients. Conclusions: This modified N95 respirator reduced the number of particles, especially 0.3-㎛ particles, generated during upper gastrointestinal endoscopy.

Effectiveness of Aromatherapy with Light Thai Massage for Cellular Immunity Improvement in Colorectal Cancer Patients Receiving Chemotherapy

  • Khiewkhern, Santisith;Promthet, Supannee;Sukprasert, Aemkhea;Eunhpinitpong, Wichai;Bradshaw, Peter
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3903-3907
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    • 2013
  • Background: Patients with colorectal cancer are usually treated with chemotherapy, which reduces the number of blood cells, especially white blood cells, and consequently increases the risk of infections. Some research studies have reported that aromatherapy massage affects the immune system and improves immune function by, for example, increasing the numbers of natural killer cells and peripheral blood lymphocytes. However, there has been no report of any study which provided good evidence as to whether aromatherapy with Thai massage could improve the immune system in patients with colorectal cancer. The objectives of this study were to determine whether the use of aromatherapy with light Thai massage in patients with colorectal cancer, who have received chemotherapy, can result in improvement of the cellular immunity and reduce the severity of the common symptoms of side effects. Materials and Methods: Sixty-six patients with colorectal cancer in Phichit Hospital, Thailand, were enrolled in a single-blind, randomised-controlled trial. The intervention consisted of three massage sessions with ginger and coconut oil over a 1-week period. The control group received standard supportive care only. Assessments were conducted at pre-assessment and at the end of one week of massage or standard care. Changes from pre-assessment to the end of treatment were measured in terms of white blood cells, neutrophils, lymphocytes, CD4 and CD8 cells and the CD4/CD8 ratio and also the severity of self-rated symptom scores. Results: The main finding was that after adjusting for pre-assessment values the mean lymphocyte count at the post-assessment was significantly higher (P=0.04) in the treatment group than in the controls. The size of this difference suggested that aromatherapy with Thai massage could boost lymphocyte numbers by 11%. The secondary outcomes were that at the post assessment the symptom severity scores for fatigue, presenting symptom, pain and stress were significantly lower in the massage group than in the standard care controls. Conclusions: Aromatherapy with light Thai massage can be beneficial for the immune systems of cancer patients who are undergoing chemotherapy by increasing the number of lymphocytes and can help to reduce the severity of common symptoms.

상지 협응 움직임을 기반으로 한 과제중심적 접근 훈련이 발달성 협응 장애아동의 글씨쓰기 능력에 미치는 효과 (The Effects of Upper Limb Coordinated Movement Based Task Oriented Approach on Improving Handwriting Performance in Children With Developmental Coordination Disorder)

  • 김미지
    • 재활치료과학
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    • 제5권1호
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    • pp.77-87
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    • 2016
  • 목적 : 상지 협응 움직임을 기반으로 한 과제중심적 접근 훈련이 발달성 협응 장애아동의 한글 글씨쓰기 능력에 미치는 영향을 알아보며 각 접근이 한글 글씨 쓰기 수행의 질과 글씨쓰기 준비기술에 미치는 영향을 비교하고자 한다. 연구방법 : 본 연구는 5~10세의 발달성 협응장애 아동 40명을 대상으로 무작위 추출을 통해 두 집단으로 나뉘어 사전-사후 검사로 진행하였다. 두 집단은 과제중심접근 중재군과 과정중심접근 중재군으로 5주 동안 40분씩 주 2회 중재를 받았다. 글씨쓰기 수행은 한글 자모 쓰기 검사로 측정하고, 글씨쓰기 준비요소인 상지 운동 기능, 시 지각 기능과 시 운동기능은 각각 운동 유창성 평가(Bruininks-Oseretsky Test of Motor Proficiency-2: BOT-2)중 미세운동조절의 하위검사 일부, 한국판 시 지각 발달 검사(Korean-Developmental Test of Visual Perception-2: K-DTVP-2), 개정된 시 운동기술 평가(Test of Visual Motor Skills-Revised: TVMS-R)로 평가하였다. 고찰 : 본 연구는 과제중심접근법을 적용하여 발달성 협응 장애아동의 글씨쓰기 수행도를 향상시킨다는 임상적 근거를 제공하는데 의의가 있다. 또한 과정중심접근법과 과제중심접근법이 글씨쓰기 준비기술의 향상에 어떠한 영향을 끼치는 지에 대한 결과를 확인하여 보다 효과적인 글씨쓰기 중재방법을 제시하는 초석이 될 수 있을 것이라 생각한다.

전침이 복부비만 성인의 비만관련 지표에 미치는 영향-무작위배정 단일 맹검 예비연구- (Effects of Electroacupuncture on Parameters Related to Obesity in Adults with Abdominal Obesity:Three arm Randomized Single Blind Pilot Study)

  • 정지윤;김종인;이상훈;강성길
    • Journal of Acupuncture Research
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    • 제27권6호
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    • pp.43-57
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    • 2010
  • Objectives : To investigate the effects of electroacupuncture on parameters related to obesity in adults with abdominal obesity. Methods : A three arm randomized single blind pilot study was conducted from Jan 4 to March 25, 2010 in Kyung Hee Oriental Medical Hospital. The subjects were 39 adults with abdominal obesity and were randomly divided by computer generated random table into 3 groups; EA(electroacupuncture), sham EA(sham electroacupuncture) and waitlist groups. Acupuncture points located at abdomen($CV_{12}$, $CV_6$, $ST_{25}$, $SP_{15}$, $SP_{14}$) and extremities($LI_4$, $LI_{11}$, $ST_{36}$, $ST_{44}$) were inserted by disposable stainless steel needles and were stimulated 30 minutes with 24Hz, 0.27~1.3mA(tolerable strength), asymmetric biphasic continuous pulse wave form by STN-111 Stratek device in EA group. Two treatment sessions per week for 5 weeks(10 sessions in total) were done in EA and sham EA groups. The primary outcome measurement was WC(waist circumference), and the secondary outcome measurements included WHR(waist hip ratio), ASF(thickness of abdominal subcutaneous fat), and inbody measurements of BW(body weight), BMI(body mass index), BFR(body fat ratio) and VFA(visceral fat area), and also scores of BULIT-R(bulimia test revised), KoQoL(Korean obesity of QoL) and BSQ(body shape questionnaire). Results : All of 39 subjects were included in ITT(intention-to-treat) analysis. There were significant reductions in WC, WHR and ASF after 5-week electroacupuncture treatments and the percentage reductions were significantly greater than sham EA or waitlist group. There were no significant differences between groups in percentage reductions of other parameters(BW, BMI, BFR, VFA, BULIT-R, KoQoL and BSQ). But, there were continuous reductions in BW, BMI, BFR and VFA at 3 weeks after the end of treatment and there was significant reduction in BW compared with the baseline value in EA group. No seriously adverse effects were reported during the period. Conclusions : Electroacupuncture was more effective than sham electroacupuncture or no intervention on the reduction of WC, WHR and ASF in adults with abdominal obesity.

일본의 건강증진 정책의 방향 -생활습관병 대책을 중심으로- (The New Health Promotion Strategy in Japan-focusing on life-style related diseases)

  • 이정수;이원철;이경수;고광욱;최은진;박천만
    • 보건교육건강증진학회지
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    • 제25권3호
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    • pp.167-181
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    • 2008
  • The prevention of life-style related diseases is an increasingly important issue in Japan, because not only have the number of patients with life-style related diseases increased but also medical care costs. This paper gives recent strategies for the prevention of cardiovascular diseases through life-style modification. Health objectives for the year 2010, called "Healthy Japan 21", were established in 2000 by the Ministry of Health, Labour and Welfare and the Health Promotion Act was enacted in 2002 to promote this health policy. However, the prevention efforts for life-style related diseases have not been effective in regard to the evaluation of the strategy objectives. The reform of the medical care system which included a new nationwide prevention strategy for life-style related diseases was presented in 2006. The new strategy starting from April 2008 included a "specific health checkup" and "specific health education" for those with metabolic syndrome. The specific health checkup is used to screen people according to criteria of the metabolic syndrome and divide them into 3 groups. These groups will receive specific health education. The purpose of this strategy is the early detection of those who have cardiovascular risk factors, and the early management of the clustering of cardiovascular risk factors of obese people aged 40-74 years old. It is mandatory for every insurer to conduct a specific health checkup and specific health education under the new Act. The implementation rate of the specific health checkup and the specific health education, and a reduction rate of individuals with metabolic syndrome among insured people will be evaluated every year. The national objective is to increase the rate of those undergoing the specific health checkup to 80% and the rate of those receiving the specific health education to 60% by the year 2015. The national objective also targeted a reduction rate of 25% for those with metabolic syndrome. This new strategy will be the biggest intervention trial in the world, and it will produce a big health care market in Japan. Not only public administrative institutions but also private institutions are now preparing to take part in this new strategy. However, various tasks remain, such as training more professionals in health education, developing more evidence based practices, and encouraging cooperation with various sectors, to enforce this new strategy.

불면장애에 대한 혈부축어탕의 체계적 문헌 고찰 및 메타분석 연구 (Herbal Medicine (Hyeolbuchukeo-tang, Xuefu Zhuyu Decoction) for Insomnia Disorder: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 김동희;이승환;임정화;김상호;이상협;김보경
    • 동의신경정신과학회지
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    • 제28권4호
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    • pp.319-332
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    • 2017
  • Objectives: The present study aimed to provide clinical evidence on the effect of herbal medicine, Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia using a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: This study included RCTs that verified the effects of Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia. Literature searches of English, Chinese and Korean databases were performed, and the selected literature was assessed for investigating the risk of bias. Results: The analysis included 10 RCTs. The Chinese Classification of Mental Disorders-3 was most frequently used to define the diagnostic criteria for Hyeolbuchukeo-tang or Xuefu Zhuyu decoction intervention in patients with primary insomnia. The effective rate was the most commonly used outcome measure. A meta-analysis revealed that the effective rate, the Pittsburgh Sleep Quality Index, and the Athens Insomnia Scale in the Modified Xuefu Zhuyu decoction (MXZD) group were higher compared to Western Medicine (WM) group (RR: 1.17, 95% Cl: 1.08 to 1.26, p<0.0001, $I^2$=0/MD: -1.29, 95% Cl: -2.09 to -0.49, p=0.002, $I^2$=0%/MD: -0.99, 95% Cl: -1.81 to -0.18, p=0.02, $I^2$=15%). The effective rate of the MXZD+WM group was significantly different compared to the WM group (RR: 1.28, 95% Cl: 1.11 to 1.47, p=0.0006, $I^2$=2%). The included RCTs were of relatively poor quality and had small sample sizes. Conclusions: Treatment with Hyeolbuchukeo-tang or Xuefu Zhuyu decoction was found to be effective in treating primary insomnia. However, the included RCTs were of relatively poor quality and had small sample sizes. It is hypothesized that this study could serve as a foundation for further clinical studies on the development of diagnosis and treatment methods for primary insomnia based on Korean medicine.

Healing Beats 프로그램이 경막외강차단 시술 후 환자의 불안, 스트레스, 수축기 혈압, 심박동수 및 Bis Index에 미치는 효과 : 무작위대조군 (Effects of Healing Beats program on patients' anxiety, stress, systolic blood pressure, heart rate and Bis Index after epidural blocking : A randomized controlled trial)

  • 배익렬;송지아
    • 한국산학기술학회논문지
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    • 제21권7호
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    • pp.54-65
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    • 2020
  • 본 연구는 경막외강차단 시술 후 Healing Beats 프로그램 적용하였을 때 환자의 불안, 스트레스, 수축기 혈압, 심박동수 및 Bis index에 미치는 효과를 확인하기 위한 무작위 대조군 전후 실험연구이다. 대상자 선정은 경막외강차단 시술을 위해 2018년 12월부터 2019년 5월까지 마취통증의학과를 방문하여 모집공고를 통해 자원한 환자를 대상으로 하였으며, 실험군 25명, 위약군 24명, 대조군 25명으로 총 74명의 자료를 수집하여 분석하였다. 수집된 자료는 x2-test, F-test와 시간에 따른 효과를 검증하기 위하여 repeated measures of ANOVA로 반복측정 분산분석하였다. 연구결과 실험군, 위약군 및 대조군의 일반적 특성 및 변수는 모두 동질하였으며, 불안은 사전 사후 2회 측정한 결과 집단간 유의한 차이가 있었고(F=27.175, p<.001), 스트레스(F=4.78, p<.001), 심박동수(F=4.22, p<.001) 및 Bis index(F=7.96, p<.001)는 반복측정 분산분석한 결과 집단과 시간에 따라 교호작용에서 유의한 차이를 나타냈다. 하지만 수축기 혈압에서는 유의한 차이가 없었다(F=1.23, p=.298). 따라서 Healing Beats는 통증 시술 후 회복실에서 진정을 유도하기 위한 간호 중재로 효과적이며, 시간 흐름에 따른 추적 조사를 통해 중재 시간을 파악할 수 있었다. 결론적으로 Healing Beats 프로그램은 임상현장이나 일상생활의 스트레스 상황에서 진정을 위한 효율적, 효과적인 중재로 사용할 수 있다고 본다.

탄성밴드운동과 스트레칭을 이용한 교정운동프로그램이 내반슬 대학생들의 무릎간 간격, Q-각 및 족압의 변화에 미치는 영향 (The effects of the correction exercise program combined with stretching and elastic band exercise on femoral intercondylar distance, Q-angle, plantar pressure in undergraduate with genu varum)

  • 유병규;김은혜
    • 한국산학기술학회논문지
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    • 제16권3호
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    • pp.2064-2072
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    • 2015
  • 본 연구는 탄성밴드운동과 스트레칭을 이용한 내반슬 교정운동프로그램이 내반슬 대학생의 무릎간 간격, Q-각, 족압에 미치는 영향에 대해 알아보는데 그 목적이 있다. 총 30명의 내반슬 대학생을 대상으로 실험군과 대조군을 각각 15명씩 무작위 선정하여 실험군은 6주 동안 스트레칭과 탄성밴드를 이용한 교정 운동 프로그램을 실시하였고, 대조군은 일상생활을 유지하게 하였다. 중재 전 후 무릎사이 간격과 Q-각의 변화를 알아보기 위해서 computed radiography X-ray를, 족압 분포변화를 확인하기 위해 RSscan을 사용하여 족압 분포를 측정하였다. 6주간의 교정운동프로그램 실시한 결과, 중재 전보다 중재 후 무릎간 간격이 유의하게 감소하였고, Q-각은 유의하게 증가하였다. 족압 분포는 중재 후에 2-5 지골과 1, 2, 3 중족골 족압이 증가하였으며, 4, 5 중족골 족압은 유의하게 감소하였다 (p<.05). 이러한 결과를 바탕으로 본 연구에서 실시한 내반슬 교정운동프로그램이 신체의 정렬과 족압 분포도의 배열을 맞추는데 효과가 있으며, 이를 통해 내반슬 변형자에게 긍정적인 효과가 있음을 확인하였다.

산전우울 임부를 위한 인지행동치료 프로그램의 효과: 체계적 문헌고찰 및 메타분석 (Effect of Cognitive Behavioral Therapy (CBT) for Perinatal Depression: A Systematic Review and Meta-Analysis)

  • 신현희;신영희;김가은
    • 한국산학기술학회논문지
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    • 제17권11호
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    • pp.271-284
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    • 2016
  • 본 연구는 임부의 산전우울에 대한 인지행동치료 중재의 효과를 검증하기 위해 수행된 체계적 문헌고찰 및 메타분석 연구이다. 데이터베이스는 CINAHL, PubMed, EMBASE 및 Koreamed, 국회도서관, 한국학술정보(Korean studies Information Service System, KISS), 한국의학논문데이터베이스 등 국내외 domain을 활용하였다. 검색은 ((Perinatal OR Antenatal OR Antepartum OR Pregnant) AND Depression) AND Women AND (CBT OR (Cognitive behavioral AND (Therapy OR Treatment)))와 '산전우울', '임부', '인지행동치료' 등의 검색어로 2016년 5월까지 출판된 문헌을 검토하였다. 분석은 R을 이용한 임의효과모형을 적용하여 산전우울과 불안의 효과크기를 각각 산출하였으며, 효과크기의 이질성을 검증하기위해 메타 ANOVA를 활용하여 조절효과분석을 실시하였다. 그리고 funnel plot, Egger's regression test, fail-safe N, trim-and-fill 분석을 활용한 출간오류분석과 민감성 분석을 실시하여 전체 연구 결과의 타당성을 검증하였다. 연구결과 총 180편의 문헌이 검색되었으며, 선택배제기준에 따라 최종적으로는 clinical trials 16편을 분석하였다. 분석에 포함된 개별문헌은 Scottish Intercollegiate Guideline Network (SIGN)의 checklist를 통해 비뚤림 위험을 평가하였으며, 대체로 비뚤림 위험은 낮았다. 연구결과 본 연구에서 중재의 산전우울에 대한 효과크기는 Hedges' g=-0.55(95% CI: -0.76~-0.33)로 통계적으로 유의하게 낮았으며, 불안에 대한 효과크기는 Hedges' g=-0.20(95% CI: -0.48~-0.08)이었으나, 통계적으로 유의한 차이는 없었다. 문헌의 이질성, 출판오류의 위험성 등은 낮았다. 본 메타분석결과에 의하면 인지행동치료는 임신부의 산전우울 증세 완화에 보통 정도의 효과가 있음이 밝혀졌다.

Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • 제23권6호
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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