• Title/Summary/Keyword: Systematic literature review

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Significant Efficacy of Additional Concurrent Chemotherapy with Radiotherapy for Postoperative Cervical Cancer with Risk Factors: a Systematic Review and Meta-analysis

  • Qin, Ai-Qiu;Liang, Zhong-Guo;Ye, Jia-Xiang;Li, Jing;Wang, Jian-Li;Chen, Chang-Xian;Song, Hong-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3945-3951
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    • 2016
  • Background: Whether concurrent chemotherapy treatment is superior to radiotherapy alone as an adjuvant regimen for postoperative cervical carcinoma with risk factors remains controversial. Materials and Methods: A literature search strategy examined Pubmed, Embase, the Cochrane Library, the China National Knowledge Internet Web, the Chinese Biomedical Database and the Wanfang Database. Article reference lists and scientific meeting abstracts were also screened. Controlled trials comparing concurrent chemoradiotherapy versus radiotherapy alone in postoperative cervical cancer were included. The methodological quality of non-randomized controlled trials was evaluated using the Newcastle-Ottawa Scale. Randomized controlled studies were evaluated with the Cochrane handbook. A meta-analysis was performed with RevMan 5.3. Results: A total of 1,073 patients from 11 clinical trials were analysed, with 582 patients in the concurrent chemoradiotherapy group and 491 patients in the radiotherapy group. Hazard ratios (HR) of 0.47 (95% CI 0.31-0.72) and 0.50 (95% CI 0.35-0.72) were observed for overall survival and progression-free survival, indicating a benefit from the additional use of concurrent chemotherapy. Subgroup analyses demonstrated that cervical cancer with high risk factors significantly benefitted from concurrent chemotherapy when examining overall survival (HR 0.44, 95% CI 0.28-0.67) and progression-free survival (HR 0.48, 95% CI 0.33-0.70), but patients with intermediate risk factors showed no benefit from concurrent chemotherapy in overall survival (HR 1.72, 95% CI 0.28-10.41) and progression-free survival (HR 1.09, 95% CI 0.19-6.14). No significant differences were observed for grade 3-4 anaemia (risk ratio (RR) 3.87, 95% CI 0.69-21.84), grade 3-4 thrombocytopenia (RR 3.04, 95% CI 0.88-10.58), grade 3-4 vomiting or nausea (RR 1.71, 95% CI 0.27-10.96), or grade 3-4 diarrhoea (RR 1.40, 95% CI 0.69-2.83). Significant differences were observed for grade 3-4 neutropenia in favour of the radiotherapy group (RR 7.23, 95% CI 3.94-13.26). Conclusions: In conclusion, concurrent chemoradiotherapy improves survival in postoperative cervical cancer with high risk factors but not in those with intermediate risk factors.

A Study on the Selection of Health topic areas and major concepts for Health Education in Primary and Junior High Schools (초.중학생을 위한 보건교육의 영역 및 주요개념 선정을 위한 일 연구)

  • 이경자
    • Korean Journal of Health Education and Promotion
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    • v.7 no.1
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    • pp.10-26
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    • 1990
  • In Korean education, the health contents are scattered in various course subjects throughtout the primary and junior high school curriculum. So it is very difficult to provide systematic health education. The purpose of this study was to provide a guide for health education using health topic areas and major concepts that represent the scope of material that should be covered in health instruction. The steps used in selecting these health topic areas and major concepts were as follows: 1. A review of the literature related to health and health education was done to develop the rationale underlying this study. 2. Health topic areas basic to the growth and development characteristics of children, to human needs and to societal needs for healthful living were indentified. 3. The major concepts for each health topic area based on health sciences and children's growth and development levels were selected. 4. The major concepts selected were organized in sequence to guide health education from grade one to grade nine. The results of this study were as follows: 1. The identification of eleven health topic areas essential for health education. These include: personal habits and health healthy growth and development nutrition and health prevention of disease and disorders drugs and health mental health family life and health sex education accident prevention consumer health community health 2. The identification of the major concepts(generalizations) for each health topic area: 33 major concepts were identified as a guide in determining the health content of health education programs. These are 1) body cleaniness, 2) health of the sensory organs, 3) dental health, 4) exercise and rest, 5) growth and development, 6) body structure and function, 7) developmental tasks, 8) balanced nutrition, 9) eating habits, 10) food preparation and food storage, 11) sources of disease and disorders, 12) disease preventive behavior, 13) care during illness, 14) drug use and misuse, 15) drug addiction, 16) emotional responses, 17) human relationship, 18) self concept, 19) social adjustment, 20) health habits of the family, 21) interdependence of family members, 22) origin of life, 23) characteristics of man and woman, 24) sexual instinct, 25) safety behavior, 26) emergency measures, 27) criteria for selection of health products, 28) proper use of health information, 29) utilization of health and medical services, 30) environmental conservation, 31) environmental pollution, 32) population control, 33) function of public health services. 3. The organization of the concepts(generalizations) in sequence and for continuity in health instruction at the primary and junior high school level.

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Meta-analysis of the Efficacy of Infliximab in Patients with Moderate-Severe Ulcerative Colitis (중등도-중증 궤양성 대장염 환자에서 infliximab의 치료효과에 대한 메타분석)

  • Kim, Jong Yoon;Lee, Sukhyang;Rhew, Ki Yon
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.3
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    • pp.251-259
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    • 2012
  • Ulcerative colitis (UC) is characterized by a life-long chronic course with remissions and exacerbations. Use of biological therapies may reduce or delay the surgical procedures in patients with UC. The aim of this study was to determine the impact of infliximab (IFX) use on the rate of remission, surgical interventions, and the effect on quality of life in patients with moderate to severe UC. Literature was searched for studies that investigated the efficacy of IFX on the rate of remission, colectomy and quality of life (QoL) between January 1990 and June 2012 at MEDLINE, January 1988 and June 2012 at EMbase and others. Eleven trials were included in the meta-analysis; divided into placebo controlled 8 trials and intravenous corticosteroid controlled group 3 trials. In comparison to placebo control groups, patients who received IFX had an odds ratio (OR) of 3.712 (95% CI: 2.714, 5.079) for the short-term clinical remission, and 3.053 (95% CI: 2.044, 4.559) for the rate of long-term remission. In colectomy rate and quality of life (QoL), odds ratio were 0.566(95% CI: 0.387, 0.827) and 0.658 (0.505, 0.811) respectively. Any adverse reactions including infections, infusion reaction, rash and arthralgia were equivalent in both groups. Compared with intravenous corticosteroid controlled group, patients who received IFX had lower remission rate with short-term odds ratio 0.227 (95% CI: 0.033, 1.556) and long-term odds ratio 1.054 (95% CI: 0.317, 3.502) respectively. However, statistical significance was not showed with both two analyses. The higher adverse drug reaction (ADR) rates were occurred in the corticosteroid controlled groups. 73.3% of patients treated corticosteroid reported Cushing-like syndrome with moon face. In conclusion, IFX does increase remission rate and decrease the rate of colectomy in patients with UC without elevating any adverse reactions significantly. IFX also improves QoL in moderate to severe UC patients. It would not exceed the efficacy of intravenous corticosteroid, whereas intravenous corticosteroid also reported high rate of adverse reactions.

Study on Improvement in Operation and Management of Ultra-light flying device Civil Complaints Management System for Ultralight Aircraft (초경량비행장치의 민원처리시스템 운용 및 관리 효율성 개선을 위한 연구)

  • Seok, Geum-chan;Jang, Moon-su;Ryu, Yeon-seung
    • Journal of the Korea Convergence Society
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    • v.11 no.1
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    • pp.237-246
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    • 2020
  • The background of the research is the following: As a result of ultra-light flying device industry development, the utilization of drones and their efficiency have been increasing. However, problems regarding flight permission·approval procedure have not been improved, resulting in increased number of civil complaints. Thus, the purpose of this research is to minimize such civil petition according to the required standards of the two government organizations through enhancing the procedure for managing and employing the system. The research methods entail pinpointing the problems by analysing ultra-light flying device related literature review and by holding focus-interviews with field experts, thereby verifying and providing improved solutions. Under (MLIT) Ministry of Land, Infrastructure and Transport supervision and in accordance with aviation security law, the research provides various updated functions such as improved civil petition processing system's employment and management system, flight approval, integration of names, process, format regarding aviation photographing approval, tool buttons such as the 'Main' button in the system's homepage. This research has the following expected effects : Firstly in the law and regulations section, the clear distinction in the missions and roles of each organization enhances cooperations in tackling civil petition. Secondly the integration of civil petition process reduces time and improves efficiency. And lastly, the improvement of supplementary tools for the public is expected to minimize civil petitions. Future research needs to be conducted under the supervision of the Ministry of National Defense(MND). Factors such as systematic infrastructure for flight photography approval, related unit's reorganization following the defense reform 2.0, and guaranteed conditions for field security action units need to be ameliorated.

Development of a Curriculum for Rehabilitation Nurse Specialist Program (재활 전문간호사 교육과정안 개발연구)

  • Kang, Hyun-Sook;Suh, Yeon-Ok;Lee, Myung-Hwa;Kim, Jeong-Hwa;Lim, Nan-Young;Suh, Moon-Ja;Lee, Jeong-Ja;Park, In-Joo;Cho, Bok-Hee;Kim, In-Ja;So, Hee-Young;Song, Chung-Sook;Lee, Sung-Sook;Hwang, Ok-Nam;Park, Sang-Yeun;Yoo, Yang-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.179-186
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    • 2001
  • The purpose of this study is to develop a systematic and efficient curriculum for the rehabilitation nurse specialist program. This research was carried out as a group work of 15 experts in order to share various opinions about the curriculum, and also through literature review. Articles, curriculums of other Clinical Nurse Specialist Programs, medical laws guidelines, as well as Clinical Nurse Specialist Program from the Korean Nurses Association were reviewed, and the issue was discussed throughly via group meetings. The developed curriculum is as follows: 1. Educational philosophy lies in the fact that the rehabilitation nurses support the patients to maximize their potential and functional level, so that they could maintain healthy state and re-adapt to changed environment. Furthermore the rehabilitation nurses are disposed of arbitrary decision power under their own responsibility, thus they take charge of welfare and healthy environment of the local society through the patients(subjects) and local resources. 2. Educational goals are to train rehabilitation nurse specialist, who correspond to the social needs, so to say, those who have the knowledge and skills for nursing practice, education and research. 3. The curriculum consists of 37 credits, of which 24 credits are based on lectures and 13 credits based on clinical practice. General courses are 3 subjects (5 credits) ; nursing theory, nursing research, and laws/ethics. Mandatry courses are 8 subjects with 19 credits; advanced physical assessment, pharmacology, pathophysiology, issues in rehabilitation nursing, advanced rehabilitation nursing intervention I, advanced rehabilitation nursing intervention II, sports physiology, special rehabilitation nursing intervention. As for the clinical practice courses, assessment and evaluation for rehabilitation(64 hours), community and home based rehabilitation nursing(128 hours), hospital based rehabilitation nursing(128 hours), institution based rehabilitation nursing(96 hours) would be treated. 4. Contents of the curses were developed to correspond with the courses' objectives and specific items. 5. Evaluation would be carried out both in the lecture and in the clinical practice. The knowledge and skills of the students would be measured to ensure full validity and credibility. However this developed curriculum should be continuously modified and updated in more desirable direction.

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Parkinson's Disease among Firefighters : A Focused Review on the Potential Effects of Exposure to Toxic Chemicals at the Fire Scene (리뷰 : 화재현장에서 노출될 수 있는 화학적 유해물질과 파킨슨병 간의 관련성)

  • Ye, Shinhee;Kim, Hyunjoo;Jeong-Choi, Kyunghee;Kim, Jieun E.;Park, Shinwon;Lee, Yumin;Ha, Eun-Hee
    • Korean Journal of Biological Psychiatry
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    • v.24 no.1
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    • pp.19-25
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    • 2017
  • Previous studies have found that firefighters have a tenfold higher prevalence of Parkinson's disease (PD) compare to the general population. Firefighters are constantly exposed to various occupational hazards including toxic chemicals of fire residue and the toxic chemicals can effects development and progression of PD. Nevertheless, there were no studies about the association between exposure to chemical byproducts of combustion and the development of PD among firefighters. Thus the aim of this study is to look into existing researches regarding the effect of chemical byproducts of combustion on the development of PD. An extensive literature search was conducted to identify harmful chemical components of smoke and fire residue, using the PubMed database during November of 2016. We searched for relevant articles by combining several keywords that contained "Parkinson's disease" and each of the different toxic chemicals, yielding a total of 1401 articles. After applying the selection criteria, 12 articles were chosen. Chemical substances reported to have a harmful effect on PD, in at least one article, were carbon monoxide, toluene, manganese and lead. Carbon monoxide and metal substances including manganese and lead were found to be associated with an increased PD risk in more than two articles. There was a heightened risk of PD in firefighters due to exposure of chemical byproducts of combustion including carbon monoxide, toluene, manganese and lead. However, to the best of our knowledge, to support this result we need more systematic epidemiological studies about these risk factors of PD among firefighters. In addition, further studies for the effects of prolonged exposure to toxic fire residue on the development and progression of PD in firefighters are needed.

A Study on Homogeneity Analysis of the Guipi Decoction for Treatment of Insomnia Disorder -Focusing on Randomized Controlled Clinical Trials in CNKI (불면장애에 사용된 귀비탕의 동질성 연구 -CNKI에서 검색한 무작위배정 임상연구를 중심으로-)

  • Kim, Dong-Hee;Sakong, Jong-Won;Kang, Chang-Wan;Lee, Sang-Hyup;Ha, Ji-Won;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.3
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    • pp.145-163
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    • 2018
  • Objectives: The study was designed to provide clinical evidence of homogeneity in analysis of the herbal medicine, Guipi decoction in treating insomnia, using a t-test of randomized controlled trials (RCTs). Methods: This study included RCTs that verified homogeneity of Guipi decoction in treating insomnia. Literature studies of CNKI (Chinese National Knowledge Infrastructure Database) were performed. The basic components group was made to the Guipi decoction of the Yixuerumen?s text. The excluded group was created with the number of herbs excluded from the basic components group. T-test performed that the effective rate in the basic components group and excluded groups. Results: The basic components of Guipi decoction contain Atractylodis Rhizoma Alba, Poria Sclerotium (Poria Sclerotium Cum Pini Radix), Polygalae Radix, Astragali Radix, Zizyphi Semen, Angelicae Gigantis Radix, Aucklandiae Radix, Glycyrrhiza uralensis Fischer, Ginseng Radix (Codonopsis Pilosulae Radix), Longanae Arillus. Herbs excluded from the basic components group were Longanae Arillus, Ginseng Radix (Codonopsis Pilosulae Radix), Glycyrrhiza uralensis Fischer and herbs added to the basic components group were Polygonum multiflorum Thunberg, Schisandrae Fructus, Salviae Militiorrhizae Radix, Paeoniae Radix Alba (in order from the most used to the least). T-test revealed the effective rate in the basic components group was not statistically significant compared to the excluded groups (p=0.161/p=0.162/p=0.103). Conclusions: Effectiveness in treatment of basic components of Guipi decoction and excluded groups were revealed to be homogeneous in treating insomnia. As the number of herbs in the basic components group decreased, mean value in effectiveness of treatment also decreased consequentially. However, there were no statistical significances.

Complications and Carcinogenic Effects of Mustard Gas - a Systematic Review and Meta-Analysis in Iran

  • Panahi, Yunes;Gholami, Nasrin;Ghojazadeh, Morteza;Moslemi, Farnaz;Naghavi-Behzad, Mohammad;Azami-Aghdash, Saber;Ghaffari, Alireza;Piri, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7567-7573
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    • 2015
  • Background: Catastrophic effects of mustard gas as a chemical warfare agent have always been a major problem for those exposed to this agent. In this meta-analysis it was tried to evaluate carcinogenesis, ocular, cutaneous and respiratory complications of mustard gas exposure among Iranians who had been exposed to this agent during the Iran-Iraq war. Materials and Methods: In this meta-analysis, the required data were collected using keywords "mustard gas", "sulfur mustard", "cancer", "neoplasm", "respiratory complications", "ocular complications", "lung disease", "chronic complication", "eye", "skin", "cutaneous complication", "carcinogenesis" and their combination with keywords "Iran", "Iranian", "prevalence", "mortality" and their Farsi equivalent terms from the databases of SID, Iranmedex, Magiran, Pubmed, Science Direct, Google Search engine, Gray Literature and Reference of References. To determine the prevalence of each complication and perform meta-analysis, CMA: 2 (Comprehensive Meta-Analysis) software with a randomized model was used. Results: Of the 542 articles found, 7 national articles, consistent with the aims of this study were selected. Meta-analysis of seven papers revealed that cancer risk, especially cancer of the respiratory system was elevated, so that the relative risk (RR) of cancer role of mustard gas was inconsistent from 2/1 to 4 in this survey. Also prevalence of delayed skin disorders due to sulfur mustard was 94.6%, pulmonary complications 94.5% and ocular complications 89.9%. The incidence of various cancers in victims exposed to mustard gas was 1.7% worldwide where the rate was 2.2% in Iranian victims of the Iraq-Iran war. Conclusions: Based on present study the prevalence of delayed mustard gas related cutaneous, pulmonary and ocular complications is above 90% and risk of carcinogenesis is higher in comparison to worldwide statistics. This may suggest need for long-term and persistent follow-up and rehabilitation procedures for populations exposed to this agent.

Quantitative Analyses of Esophageal Cancer Research in Pakistan

  • Qureshi, Muhammad Asif;Khan, Saeed;Ujjan, Ikram Din;Iqbal, Asif;Khan, Ramsha;Khan, Bilal Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3117-3122
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    • 2016
  • Background: Health-care research is a neglected discipline in Pakistan and research related to esophageal cancer (ranks 9th in Pakistani males and 5th in females) is no exception in this regard. Particularly, there are no data available to delineate the overall status of esophageal cancer epidemiological studies in Pakistan. This study describes the first ever effort to make a systematic quantification, in an attempt to provide a road-map to all stakeholders for designing appropriate epidemiological, diagnostic and therapeutic strategies. Materials and Methods: International (PubMed, ISI Web of Knowledge) and local (PakMedinet) scientific databases as well as Google search engine were searched using specified keywords to extract relevant publication. Well-defined inclusion criteria were implemented to select publications for final analyses. All data were recorded by at least 3 authors and consensus data were entered into and analyzed for descriptive statistics (such as frequencies, percentages and annual growth rates) using Microsoft Excel and SPSS software. Results: A total of 79 publications fulfilled the inclusion criteria including 20 publications for which full texts were not available. Of the 79 publications, 59 (74.6%) were original/research publications, 5 (6.3%) were case reports, 4 (5.1%) were research communications, 2 (2.5%) were review articles, 1 was (1.2%) correspondence and 8 (10.1%) were undefined categories. Only 13 (<20%) cities of Pakistan contributed towards the 79 publications. On average, only 1.9 relevant publications/year were published from 1976 (year of first publication) to the present. Alarmingly, a decline in the annual growth at -4.1% was recorded in the last six years. Conclusions: Esophageal cancer research is largely unfathomed in Pakistan. Urgent/dramatic steps are required by all concerned to address this common (and under reported) cancer of Pakistan.

A Study of Collection Development Policies of the University Libraries in Korea (한국의 종합대학도서관 장서개발정책에 관한 연구)

  • 손정표
    • Journal of Korean Library and Information Science Society
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    • v.11
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    • pp.101-142
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    • 1984
  • This study is a survey of collection development policies in the 40 university libraries among 42 in Korea as of 1984. The survey used a questionnaire with 36 questions concerning the basic elements of the collection development policy. The survey results revealed many problems demanding correction. The measures to correct the problems in the university libraries are as follows. 1. It is desirable that the libraries should have a collection development policy statement written and adopted for the systematic collection building. 2. It is advisable that the libraries should include a function of the materials selection among other various functions of the Library Committee for the purpose of informing administrators of the goals of the libraries and the validity of the budgetary allocation. 3. It is desirable that each library should organize the Collection Development Committee for minimizing the possibility of personal bias on the part of the individual selectors. 4. It is advisable that the primary responsibility for materials selection should be delegated as follows: for the materials for faculty research, to the faculty members; for the other collections, to the professional staff of each department; for the final review of whether or not to purchase, to the Collection Development Committee. 5. It is desirable for the purchase priority of materials to be set up in accordance with the order of 6 levels of collection development. 6. It is advisable that the libraries should, as top priority, purchase materials in direct su n.0, pport of the undergraduate and graduate academic programs, and in subject matter areas other than languages and literature, Korean materials should have not only the higher priority than the foreign language materials, but also maintain the comprehensive collection level. 7. It is desirable that the special collections should be purchased by special funds from the authority, and the special collections librarian should have the responsibility of the materials selection under the advice of the faculty members relating to the subject area. 8. It is advisable that duplicate copies should be bought only for high use items, but for reserve books, by the program enrollment, and textbooks should not be bought in general, except as su n.0, pplemental materials for course work in which they are necessary and heavily used. 9. It is reasonable that the material budget should be distributed as follows: by the ratio for distributing funds, about 60-70% for the library and 30-40% for departments; by the type of materials, about 50% for books, 40% for periodicals and 10% for other materials, or when not bought other materials, about 50-60% for books and 40-50% for periodicals. In addition, it is desirable that undergraduate class enrollment, graduate class enrollment, undergraduate majors, graduate majors, average book cost in the discipline, number of faculty, and use rate by subject should be considered as the factors for the allocation of funds by department, and special consideration should be given to newly-founded departments so the library holdings can be adequate to su n.0, pport them.

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