• 제목/요약/키워드: Physical evidence quality

검색결과 139건 처리시간 0.03초

화병치료에 대한 침과 한약의 효과에 대한 메타분석 (The Effects of Acupuncture and Herbal Medicine for the Treatment of Whabyung: A Meta-analysis)

  • 김예리;정선용;최은지;조은
    • 한국임상약학회지
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    • 제27권4호
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    • pp.267-275
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    • 2017
  • Background and Objective: Whabyung is a Korean cultural disorder characterized by a combination of emotional stress and physical symptoms. Acupuncture, herbal medicines and other complementary medicinal treatments are used to treat the symptoms of whabyung. The purpose of this study is to investigate the effects of acupuncture treatment and herbal medicine treatments on anger, anxiety and depression of whabyung. Methods: Using PubMed, CENTRAL, AMED, MEDLINE, EMBASE, MEDLINE, CINAHL, Cnii, CNKI, J-SATGE, PsycArticles, KISS, KoreaMed, kmbase, NDSL, RISS, OASIS and Korean Traditional Knowledge Portal, articles published by March 2017 for whabyung or whabyung-related syndrome were searched. The quality of selected articles was evaluated using RoB and RoBANS. The effects of acupuncture and herbal medicines on anger, anxiety, and depression levels of whabyung patients were considered for meta-analyses. Results: Of the total 2408 articles retrieved from the database, 11 were finally selected and 4 articles were used for meta-analyses. Acupuncture reduced whabyung patients' anger and anxiety. Especially, the state anxiety was significantly reduced (effect size= -0.676, p= .026). Herbal medicine had effects on reducing anxiety and state anger while trait anger was increased without statistical significance. Conclusion: The present study showed the effectiveness of acupuncture and herbal medicines for whabyung patients in general. However, considering the limited availability of articles and the heterogeneity between them included for the meta-analysis, the results should be generalized with caution. In the future, more studies within the structure of evidence-based medicine need to be conducted to generate objective and valid evidences of korean medicine.

Neurotization from Two Medial Pectoral Nerves to Musculocutaneous Nerve in a Pediatric Brachial Plexus Injury

  • Yu, Dong-Woo;Kim, Min-Su;Jung, Young-Jin;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제52권3호
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    • pp.267-269
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    • 2012
  • Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

Investigating Sexual Function and Affecting Factors in Women with Breast Cancer in Iran

  • Shandiz, Fatemeh Homaee;Karimi, Fatemeh Zahra;Rahimi, Nafiseh;Abdolahi, Mahboubeh;Anbaran, Zahra Khosravi;Ghasemi, Mina;Mazlom, Seyed Reza;Kheirabadi, Aghileh Nasaghchi
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3583-3586
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    • 2016
  • Background: Since the breast is strongly relevant to sexual desire, and physical and sexual attractiveness, the high prevalence of breast cancer (BC) in Iran and long-term survival of patients experiencing side effects means that measures to identify associated sexual problems are necessary. Therefore, this study was conducted to assess sexual function and affecting factors in women with BC. Materials and Methods: This cross-sectional study was performed on 94 women with BC, referred to Imam Reza (AS) Hospital, Mashhad, Iran, in 2014. The data were collected through demographic and clinical questionnaires and also a sexual function questionnaire and analyzed using SPSS version 16. Results: The total score of women's sexual function was about $24.3{\pm}4.41$. Of the total, 63 (71.3%) reported sexual dysfunction, for example reduced satisfaction or more pain. Age was the only significantly related factor. Conclusions: Breast cancer can adversely affect women's sexual function and decrease quality of life. Thus, taking measures to overcome women's sexual problems are necessary.

노인의 고독이 건강상태에 미치는 영향: 우울의 매개효과 검증 (The Effect of Loneliness on Health Status in Older Adults: An Examination of the Mediating Role of Depression)

  • 황환;이선혜
    • 한국사회복지학
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    • 제66권4호
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    • pp.207-232
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    • 2014
  • 본 연구는 노인의 주관적 고독감이 건강에 영향을 미치는 영향의 메커니즘을 이해하기 위해 고독, 우울, 건강상태의 관계로 이루어진 연구모형을 수립하고 구조방정식 모형 분석을 통해 그 관계를 검증하고자 하였다. 이를 위해 수도권에 위치한 노인복지기관 이용 노인 329명을 대상으로 일대일 설문조사를 실시하고, 노인의 고독과 우울이 노인의 건강상태에 미치는 영향과 그 과정에서 우울이 수행하는 역할을 살펴보았다. 자료 분석 결과, 고독, 우울, 건강상태의 구조적 관계로 이루어진 연구모형은 양호한 적합성을 보였으며 우울은 고독이 건강상태에 미치는 영향을 완전 매개하는 것으로 나타났다. 이러한 결과는 기존의 서비스가 사회적 활동의 양을 증가시키는데 치중하는 점을 지양하고 주관적 고독감과 대인관계의 질을 개선하는데 초점을 두어야 할 필요성이 있음을 시사하는 것이다.

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우리나라 노인의 우울증과 관련 요인 - 생활습관, 정신건강, 만성질환 및 영양상태 중심으로 - : 2014 국민건강영양조사 자료 (Depression and Related Risk Factors in the Elderly with a Focused on Health Habits, Mental Health, Chronic Diseases, and Nutrient Intake Status: Data from the 2014 Korea National Health and Nutrition Examination Survey)

  • 이혜상
    • 대한영양사협회학술지
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    • 제24권2호
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    • pp.169-180
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    • 2018
  • Depression is a major health problem that can lead to mortality. This study was conducted to assess the risk factors associated with depression in a group aged over 65 years by analyzing nationally representative Korean survey data. A total of 1,209 subjects were analyzed among the participants of the 2014 Korean National Health and Nutrition Examination Survey. Statistical methods for a complex sample were applied by using SPSS program(windows ver. 24.0). Depression assessments were carried out by using the 9-item depression module of the Patient Health Questionnaire-9 (PHQ-9). Depression ($PHQ-9{\geq}5$) was more frequently found in females (33.2%) compared to males (16.1%). However, there was no evidence suggesting that characteristics such as residence area, income level and age, except for educational level, were related with depression. The results of the logistic regression analysis showed that i) health habits such as smoking (OR: 2.26) and lack of aerobic physical activity (OR: 1.62), ii) mental health status such as bad self-rating of health status (OR: 4.30), more stress (OR: 8.31), and bad health-related quality of life (by EQ_5D, OR: 3.41), iii) chronic diseases such as obesity (OR: 0.66), hypercholesterolemia (OR: 1.57), anemia (OR: 1.91), and iv) low intake of energy (OR: 1.84) and calcium (OR: 1.71) were significantly associated with depression. This study suggests that certain characteristics of health habits, mental health status, chronic diseases and nutrient intake may be associated with depression. Prospective research on long-term control is needed to establish causal connections among those factors with depression.

항암화학요법 관련 말초신경병증에 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석 (Effectiveness of Non-Pharmacologic Interventions in Chemotherapy Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis)

  • 오복자;김유림
    • 대한간호학회지
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    • 제48권2호
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    • pp.123-142
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    • 2018
  • Purpose: This study was conducted to evaluate the effectiveness of non-pharmacologic interventions in chemotherapy-induced peripheral neuropathy (CIPN). Methods: PubMed, Cochrane Library CENTRAL, EMBASE, CINAHL, and several Korean databases (Until August 2017) were searched. The main search strategy combined terms for peripheral neuropathy and presence of neoplasms. The risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies and the Risk of Bias Assessment tool for non-randomized studies. To estimate the effect size, a meta-analysis of the studies was performed using the Rev Man 5.3 program of the Cochrane Library random-effects models were used in the analyses. Results: Twenty-two studies with a total of 954 participants met the inclusion criteria. Of the 22 studies, 12 were used to estimate the effect size of the non-pharmacologic interventions. The non-pharmacologic interventions used in patients with CIPN were exercise, acupuncture, massage, and foot bath. The acupuncture significantly reduced CIPN symptoms and signs (d=-0.71) and CIPN pain (d=-0.73) (p<.001). Massage and foot bath were also effective in reducing CIPN symptoms (d=-0.68; 95% CI=-1.05, -0.30; p<.001; $I^2=19%$).Exercises were effective in improving muscle strength and endurance(d=-0.55) and quality of life (d=-2.96), but they were not significantly effective in improving CIPN. Conclusion: Although these results provide little evidence of the effectiveness of acupuncture, massage, and foot bath in the treatment of CIPN, they suggest that these interventions can reduce CIPN symptoms in patients with cancer. However, the findings of this study should be interpreted with caution as there is a relative lack of data in this field, and additional well-designed studies are needed. PROSPERO registration: CRD42017076278.

장기요양시설 거주 노인 대상 테크놀로지 활용 중재에 관한 체계적 문헌고찰 (Interventions Using Technologies for Older Adults in Long-term Care Facilities: A Systematic Review)

  • 김다은;김향;현정희;이효진;성혜현;배소영;탁성희;박연환;윤주영
    • 지역사회간호학회지
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    • 제29권2호
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    • pp.170-183
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    • 2018
  • Purpose: Although innovative interventions using technologies have been introduced in long-term care settings, available evidence is still anecdotal. The purpose of this study is to investigate and synthesize the outcomes of interventions using technologies delivered to nursing home residents. Methods: Published clinical trials were identified through PubMed, CINHAL, Cochrane and PsycINFO databases and manually hand-searching. Eligible studies were articles published between 1997-2016 in English or Korean with a randomized controlled trial or quasi-experimental design in which interventions using technologies were delivered to nursing home residents. Results: A total of 20 studies were selected for this review. Types of interventions using technologies were classified into the electronic documentation technology (n=1), the clinical decision support system (n=1), the safety technology (n=1), the health and wellness technology (n=10), and the social connectedness technology (n=7). Overall resident outcomes indicated that interventions using technologies improved behavioral symptoms and psycho-social outcomes, but mixed results were shown in the aspects of physical function, cognitive function, social relationship and quality of service. Conclusion: This review demonstrates that incorporating technologies into nursing home care have positive effects on residents' psycho-social outcomes and behavioral symptoms. To disseminate the effectiveness of interventions using technologies, further research is needed to determine what mechanisms underlying such relationships exist.

반응표면 데이터마이닝 기법을 이용한 원전 종사자의 강건 직무 스트레스 관리 방법에 관한 연구 (A Study on the Methods for the Robust Job Stress Management for Nuclear Power Plant Workers using Response Surface Data Mining)

  • 이용희;장통일;이용희
    • 한국안전학회지
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    • 제28권1호
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    • pp.158-163
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    • 2013
  • While job stress evaluations are reported in the recent surveys upon the nuclear power plants(NPPs), any significant advance in the types of questionnaires is not currently found. There are limitations to their usefulness as analytic tools for the management of safety resources in NPPs. Data mining(DM) has emerged as one of the key features for data computing and analysis to conduct a survey analysis. There are still limitations to its capability such as dimensionality associated with many survey questions and quality of information. Even though some survey methods may have significant advantages, often these methods do not provide enough evidence of causal relationships and the statistical inferences among a large number of input factors and responses. In order to address these limitations on the data computing and analysis capabilities, we propose an advanced procedure of survey analysis incorporating the DM method into a statistical analysis. The DM method can reduce dimensionality of risk factors, but DM method may not discuss the robustness of solutions, either by considering data preprocesses for outliers and missing values, or by considering uncontrollable noise factors. We propose three steps to address these limitations. The first step shows data mining with response surface method(RSM), to deal with specific situations by creating a new method called response surface data mining(RSDM). The second step follows the RSDM with detailed statistical relationships between the risk factors and the response of interest, and shows the demonstration the proposed RSDM can effectively find significant physical, psycho-social, and environmental risk factors by reducing the dimensionality with the process providing detailed statistical inferences. The final step suggest a robust stress management system which effectively manage job stress of the workers in NPPs as a part of a safety resource management using the surrogate variable concept.

대학생의 주관적 건강인지수준과 건강증진행동, 정신건강수준 간의 관련성: 일개 대학의 건강조사를 중심으로 (Association between self-rated health, health promotion behaviors, and mental health factors among university students: Focusing on the health survey results in a university)

  • 김영복
    • 한국학교ㆍ지역보건교육학회지
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    • 제23권1호
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    • pp.1-16
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    • 2022
  • Background & Objectives: Self-rated health has been widely used to evaluate health status and accepted as a subjective measurement of quality of life. This study aimed to analyze the associations between self-rated health, health promotion behaviors, and mental health factors and suggest the approaches to improve health status among university students. Methods: Two thousand six hundred seventy-seven students who had stayed at dormitories on campus participated in the DU health survey by self-reported questionnaire from April 10 to 14, 2017. Multivariate logistic regression analysis was performed to estimate the odds ratios and 95% confidence intervals of association of self-rated health with health-related factors among male and female students. Results: 38.6% of the respondents reported good self-rated health. Male and first-year students were more likely to report good self-rated health than female and third-year students. There were significant differences in sex, grade, health problems, BMI, sleeping hours, eating breakfast, consumption of fruits and vegetables, physical activity (regular walking, strength exercise, moderate exercise, vigorous exercise), perceived stress, depression, and suicide thought (p<0.05). Conclusion: Although health promotion programs for university students are essential to support their adaptation to campus life and academic achievement, evidence-based health programs to encourage their participation are still insufficient. Therefore, it should establish a campus-based health policy and develop health promotion programs to increase self-rated health levels and prevent mental health problems for university students.

Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

  • Giorgio Breda;Gianluca De Marco;Pierfranco Cesaraccio;Paolo Pillastrini
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.182-190
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    • 2023
  • Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.