• Title/Summary/Keyword: Intervention trial

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

  • Lee, Jung-Su;Lee, Won-Chul;Lee, Kyeong-Soo;Koh, Kwang-Wook;Choi, Eun-Jin;Park, Chun-Man
    • Korean Journal of Health Education and Promotion
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    • v.25 no.3
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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.

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

  • Kim, Dong-Hee;Lee, Seung-Hwan;Lim, Jung-Hwa;Kim, Sang-Ho;Lee, Sang-Hyup;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.4
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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.

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

  • Bae, Ik Lyul;Song, Ji Ah
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.7
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    • pp.54-65
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    • 2020
  • This randomized pre-post-controlled experimental study determined the effect on patients' anxiety, stress, systolic blood pressure, heart rate and Bis index when the Healing Beats program is applied after epidural blockage. The subjects were selected from the patients who visited the Department of Anesthesiology and Pain for the treatment of epidural blockage and volunteered through the recruitment announcement. A total of 74 sets of data were collected and analyzed with 25 subjects in the experimental group, 24 in the placebo group, and 25 in the control group. The data was analyzed using descriptive statistics, x2-tests, F-tests and repeated measures of ANOVA. As a result of the study, the general characteristics and variables of the experimental group, placebo group, and control group were all the same, and anxiety was measured twice before and after the study. There were significant differences between groups (F=27.175, p<.001), and stress (F=4.78, p<.001), heart rate (F=4.22, p<.001) and the Bis index (F=7.96, p<.001) were analyzed by variance according to population and time. There was a significant difference. However, there was no significant difference in systolic blood pressure (F=1.23, p=.298). In conclusion, the Healing Beats program can be used as an effective and effective intervention for sedation in clinical situations or stressful situations.

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 (탄성밴드운동과 스트레칭을 이용한 교정운동프로그램이 내반슬 대학생들의 무릎간 간격, Q-각 및 족압의 변화에 미치는 영향)

  • Yu, Byong-Kyu;Kim, Eun-Hye
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.3
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    • pp.2064-2072
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    • 2015
  • The aim of this study is to identify the effects of the correction exercise program on femoral intercondylar distance, Q-angle and plantar pressure in undergraduate with genu varum. A experimental study with a randomized controlled trial design was used. Thirty subjects with genu varum were allocated in two groups: the experimental group (n=15) or the control group (n=15). The experimental group conducted correction exercise program for 30 minutes a day, 5 times a week, for 6 weeks, while the control group did not perform any exercise. The correction exercise program group showed a significant decreased femoral intercondylar distance, plantar pressure of M 4, M 5 (Metatarsal 4, 5). Also the correction exercise program group significantly increased Q-angle, plantar pressure of Toe 2-5 and M 1, M 2, M 3 (Metatarsal 1, 2, 3) (Rt, Lt) (p<.05). Thus, we suggested that the correction exercise program may be suitable intervention to improve normal alignment in undergraduate with genu varum.

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

  • Shin, Hyeon-Hee;Shin, Yeong-Hee;Kim, Ga-Eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.271-284
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    • 2016
  • This study was carried out to evaluate the efficacy of CBT for perinatal depression through systematic literature review and meta-analysis. The following databases were used to search the literature: CINAHL, PubMed, EMBASE, Koreamed, Library of Korean Congress, KISS, and Korean Academic Publication Database. Keywords included 'perinatal depression,' 'pregnant women,' and 'cognitive behavioral therapy,' and the evaluated articles were published up to May 2016. Using the R program, the effect size of perinatal depression and anxiety were calculated by random-effects model. The heterogeneity of the effect size was analyzed by data moderator analysis using the meta-ANOVA. Furthermore, the funnel plot, Egger's regression test, fail-safe N, trim-and-fill test, and publication bias analysis were conducted and used to verify the results. Out of the 180 selected articles, 16 clinical trial studies were meta-analyzed. Each articles were evaluated for the risk of bias by the checklist of SIGN; the overall risk of bias was low. The effect size of CBT for perinatal depression was Hedges' g=-0.55 (95% CI: -0.76~-0.33), which was a moderate level, while for anxiety reduction, Hedges' g=-0.20 (95% CI: -0.48~-0.08) and it was not statistically significant. Heterogeneity or risk of publication bias were low. This meta-analytic study found that CBT is moderately effective in reducing perinatal depression in pregnant women.

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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    • v.23 no.6
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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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A study on the Menstrual Pain and Dysmenorrhea, Factors Influenced to Them, and Self-Management Method for Them of College Students (일부 여대생의 생리통 및 월경곤란증과 그 관련요인에 관한 조사연구)

  • Han Sun-Hee;Hur Myung-Haeng
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.359-375
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    • 1999
  • This is a survey in order to provide basic information about menstrual pain management and dysmenorrhea management. Menstrual pain means low abdominal cramps during menstruation and dysmenorrhea means low abdominal pains, and other symtoms as lumbago, fatigue, G-I symptoms, etc. The purposes of this study were (1) to measure the menstrual pain and dysmenorrhea, (2) to determine factors influenced to them, and (3) to know self-management method for them of college students. The subject of this study consisted of 312 college students Data were collected by questionnaire which was to measure the menstrual pain(Visual Analogue Scale(VAS), dysmenorrhea (dysmenorrhea scale) and general informations from May to June, 1999. The results of this study were as follows ; (1) Mean age for subjects was 19.4 yrs, their height was 161.4Cm, weight, 50.9Kg, menarcheal age, 13.5yrs, menstural period, 30.1 days, and menstrual duration was 5.6 days. Most respondents replied that their menstrual bleeding was moderate (72.1%) and occured regularly(55.4%). (2) Mean menstrual pain was 5.20. Menstrual pain didn't be occured 17.4 % of respondents, periodically 46.0%, and intermittently 36.6%, most commonly beginning the first day of menstruation (3) Chief management method was endurance (40.4%), use of analgesics (29.5%) and bed rest(16.5%). (4) Factors influenced to menstrual pain were analgesics use, heavy bleeding, time of menstrual pain, life change during menstruation. (5) Most symptoms of dysmenorrhea were low abdominal pain(22.2%), lumbago (15.9%), fatigue(9.0%). (6) Factors influenced to dysmenorrhea were anlgesics use and menstrual pain. (7) By Pearson's correlation analysis, there was a significant correlation between menstrual pain and menarcheal age, menstrual period. menstrual duration. But there was no correlation between menstrual pain and height, weight (8) By Pearson's correlation analysis, there was a significant correlation between dysmenorrhea and menstrual period But there was no correlation between menstrual pain and menarcheal age, menstrual duration, height, weight The results demonstrate the importance of development and clinical trial of nursing intervention on menstrual pain and dysmenorrhea.

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Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis

  • Yasui, Takahiro;Tozawa, Keiichi;Ando, Ryosuke;Hamakawa, Takashi;Iwatsuki, Shoichiro;Taguchi, Kazumi;Kobayashi, Daichi;Naiki, Taku;Mizuno, Kentaro;Okada, Atsushi;Umemoto, Yukihiro;Kawai, Noriyasu;Sasaki, Shoichi;Hayashi, Yutaro;Kohri, Kenjiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6353-6358
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    • 2015
  • Background: To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. Materials and Methods: From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. Results: Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. Conclusions: Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.

Improvement Effect of Salicornia herbacea L. Diet on the Acne Skin (여드름 피부에 미치는 함초 식이의 피부 개선 효과)

  • Lim, Mi-Ra;Kang, Sang-Mo
    • Journal of the East Asian Society of Dietary Life
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    • v.19 no.5
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    • pp.750-760
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    • 2009
  • In this study, the various effects of Salicornia herbacea, including antioxidative function, antibiotic, and anti-inflammatory effect, and the effect of sebiparous reduction due to intervention of the DHT hormone were investigated using. The result of this study Based on this analysis, the serum total cholesterol, triglyceride, and WBC were found to be significantly decreased and SOD, Ca, K, and Zn were shown to be significantly increased significantly in the group that received the SH pill group after trial fora 12 week trials. Testosterone and DHT were increased in the SH pill group, but it was not statistically significant. In the case of the skin condition measurements, the number of blackhead pores, skin oiliness, keratin and, MIC were significantly decreased, and the pH was decreased to normal pH in the SH pill group. Therefore, it was confirmed that overall skin condition was improved due to Salicornia herbacea diet. The results of this research result can contribute so demonstrate the potential of actively using that the Salicornia herbacea can be actively developed as a health supplement, and a medication.

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Development of morning bread fortified citrus peels powders and its evaluation of biological activity by human trial (귤피가루를 첨가한 모닝빵 개발 및 인체시험을 통한 생리활성 효과 평가)

  • Lee, Ha-Neul;Park, Tae-Sun;Yu, Ok-Kyeong;Byun, Moon-Sun;Cha, Youn-Soo
    • Journal of Nutrition and Health
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    • v.49 no.3
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    • pp.144-152
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    • 2016
  • Purpose: This study was conducted in order to develop morning bread using powdered citrus peels and to examine the effect of its several biological activities for 12 weeks in overweight adults ($$BMI{\geq_-}23$$) living in dormitories of Chonbuk National University. Methods: Control bread was prepared using the same formula except for replacing the wheat flour with 3% citrus peel powder. Subjects were classified according to two groups: Intake group of 3% citrus peel powder fortified morning bread (n = 30) and general morning bread (n = 30). Results: The results of our study showed no significant effects of citrus peel powdered morning bread on anthropometric indices and biochemical characteristics among overweight adults. Despite the slight reduction in total-cholesterol, LDL-cholesterol, GOT, and GPT (p < 0.05), no significant differences in changes of these values were observed between the two groups. Conclusion: The short duration of our intervention might have resulted in the lack of any significant effect. Therefore, conduct of further studies with longer duration is warranted in order that the results from this study can be utilized as a basis for the development of food products with citrus peel powder.