• Title/Summary/Keyword: Systemic reviews

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A Study on the Improvement Measures of Drowning Accident in South Korea (물놀이 안전사고 개선방안에 관한 연구)

  • Kim, Jung-Gon;Lim, Hojung;Kim, Tae-Hwan;Lee, Dae-Sung
    • Journal of the Society of Disaster Information
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    • v.15 no.1
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    • pp.153-164
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    • 2019
  • Purpose: This paper aims to derive improvement measures, in terms of legal and technical aspects, which can reduce effectively the casualties caused by drowing accidents. Method: Firstly, we checked the status of drowing accident management and carried out the interview of field private safety guards. field private safety guards. In addition, surveys were conducted on safety personnel and managers. Based on survey results, we are lastly analyzed the specific problems and reviews the improvement measures from technical and legal aspects. Result: As an analytical result, it was considered that supplementary supporting tools such as CCTV, monitoring devices using IoT and artificial intelligence technologies were necessary to prevent drowning accident, and qualification with limited authority should be added to the private safety guard because of the lack of regulation. Conclusion: In order to manage water safety effectively, a comprehensive water safety management system should be established that integrates people and equipment through systemic education of security personnel, authorization of enforcement, and introduction of surveillance equipment.

Meta-analysis of Intravitreal Injection of Anti-vascular Endothelial Growth Factors for Diabetic Macular Edema (당뇨황반부종에서 항혈관성장인자의 유효성과 안전성: 네트워크 메타분석)

  • Tchoe, Hajin;Shin, Sang Jin;Suh, Jae Kyung;Cho, Songhee;Yang, Jangmi;Kang, Min Joo;Jee, Donghyun
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.2
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    • pp.144-151
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    • 2019
  • Purpose: Intravitreal aflibercept, ranibizumab, bevacizumab, and dexamethasone are the most widely used drugs in the treatment of diabetic macular edema (DME). The aim of this study was to compare the efficacy and safety of anti-vascular endothelial growth factors and dexamethasone for the treatment of DME. Methods: There were nine previous systematic reviews on this topic; we updated these high-quality reviews. Seven studies were added to two studies following a literature search. Efficacy outcomes were 1) average improvement in visual acuity, 2) proportion of patients who experienced an improvement in vision (an increase in best-corrected visual acuity (BCVA) of ${\geq}15$ in the Early Treatment Diabetic Retinopathy Study [ETDRS]), and 3) proportion of patients who experienced worsening vision (a decrease in BCVA of ${\geq}15$ in the ETDRS). Safety outcomes included systemic adverse events and ocular-related adverse events. Results: The mean difference in the BCVA for ranibizumab versus bevacizumab treatment was 0.16 (95% confidence interval [CI]: -0.02, 0.34), and that for ranibizumab versus aflibercept was -0.08 (95% CI: -0.26, 0.10). The mean difference in the change of BCVA for aflibercept versus ranibizumab was -0.20 (95% CI: -0.40, -0.01), and that for aflibercept versus bevacizumab was -0.34 (95% CI: -0.53, -0.14). Other efficacy outcomes showed similar trends, and there was no significant difference between treatments. There was also no significant difference in both systemic and ocular adverse events rates between the treatments. Conclusions: In DME patients, the efficacy of aflibercept was found to be higher with respect to BCVA changes compared with ranibizumab or bevacizumab. However, there were no significant difference in terms of visual acuity improvement or visual acuity of more than 15 letters, nor in terms of anti-vascular endothelial growth factors (as a safety outcome).

Current Trends and Recent Advances in Diagnosis, Therapy, and Prevention of Hepatocellular Carcinoma

  • Wang, Chun-Hsiang;Wey, Keh-Cherng;Mo, Lein-Ray;Chang, Kuo-Kwan;Lin, Ruey-Chang;Kuo, Jen-Juan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.3595-3604
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    • 2015
  • Hepatocellular carcinoma (HCC) has been one of the most fatal malignant tumors worldwide and its associated morbidity and mortality remain of significant concern. Based on in-depth reviews of serological diagnosis of HCC, in addition to AFP, there are other biomarkers: Lens culinaris agglutinin-reactive AFP (AFP-L3), descarboxyprothrombin (DCP), tyrosine kinase with Ig and eprdermal growth factor (EGF) homology domains 2 (TIE2)-espressing monocytes (TEMs), glypican-3 (GPC3), Golgi protein 73 (GP73), interleukin-6 (IL-6), and squamous cell carcinoma antigen (SCCA) have been proposed as biomarkers for the early detection of HCC. The diagnosis of HCC is primarily based on noninvasive standard imaging methods, such as ultrasound (US), dynamic multiphasic multidetector-row CT (MDCT) and magnetic resonance imaging (MRI). Some experts advocate gadolinium diethyl-enetriamine pentaacetic acid (Gd-EOB-DTPA) MRI and contrast-enhanced US as the promising imaging madalities of choice. With regard to recent advancements in tissue markers, many cuting-edge technologies using genome-wide DNA microarrays, qRT-PCR, and proteomic and inmunostaining studies have been implemented in an attempt to identify markers for early diagnosis of HCC. Only less than half of HCC patients at initial diagnosis are at an early stage treatable with curative options: local ablation, surgical resection, or liver transplant. Transarterial chemoembolization (TACE) is considered the standard of care with palliation for intermediate stage HCC. Recent innovative procedures using drug-eluting-beads and radioembolization using Yttrium-90 may exhibit beneficial effects in HCC treatment. During the past few years, several molecular targeted agents have been evaluated in clinical trials in advanced HCC. Sorafenib is currently the only approved systemic treatment for HCC. It has been approved for the therapy of asymptomatic HCC patients with well-preserved liver function who are not candidates for potentially curative treatments, such as surgical resection or liver transplantation. In the USA, Europe and particularly Japan, hepatitis C virus (HCV) related HCC accounts for most liver cancer, as compared with Asia-Pacific regions, where hepatitis B virus (HBV) may play a more important role in HCC development. HBV vaccination, while a vaccine is not yet available against HCV, has been recognized as a best primary prevention method for HBV-related HCC, although in patients already infected with HBV or HCV, secondary prevention with antiviral therapy is still a reasonable strategy. In addition to HBV and HCV, attention should be paid to other relevant HCC risk factors, including nonalcoholic fatty liver disease due to obesity and diabetes, heavy alcohol consumption, and prolonged aflatoxin exposure. Interestingly, coffee and vitamin K2 have been proven to provide protective effects against HCC. Regarding tertiary prevention of HCC recurrence after surgical resection, addition of antiviral treatment has proven to be a rational strategy.

Pressure Ulcer Risk Factors and Preventive Intervention in Long-Term Care Facilities : A Mixed method study (노인요양기관의 욕창발생 위험요인과 욕창예방 관리: 혼합연구)

  • Yun, Haesun;Park, Jeeyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.3
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    • pp.147-155
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    • 2020
  • The purpose of this study was to compare the risk factors of pressure sores and preventive intervention strategies and to provide basic data for the management of pressure sores prevention for long-term care facilities. It was a mixed method study using a systematic literature review and focus group interviews for analysis. A PRISMA flow diagram was prepared in accordance with the research selection process for the systemic literature review. The studies were retrieved from domestic and international studies from 2010 to June, 2019. A total of 8 studies were selected according to the selection criteria. The studies were searched electronically using a search engine with the key words of 'pressure ulcers', 'bedsore', 'decubitus ulcers', 'intervention', 'prevention', 'elderly', and 'long term'. Focus group interviews were conducted through a semi-structured questionnaire for nurses who had worked for more than three years in long-care facilities. The study results suggest that position change and pressure reduction device reduced the incidence of pressure sores and were important for prevention. The use of standardized care protocols is necessary. Multidisciplinary cooperation was an important issue.

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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Clinical Application of Radial Head Prosthesis (요골두 치환술의 임상적 적용)

  • Moon, Jun-Gyu
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.140-145
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    • 2011
  • Purpose: Installing a radial head prosthesis has developed into a reliable procedure to replace the native radial head for treating unreconstructible radial head fracture when this is associated with an unstable elbow or forearm. A variety of implants have been developed and these are now commercially available. This article reviews the literature related to the indications, the available implants and the surgical techniques of radial head replacement arthroplasty. Materials and Methods: The main indication for a metallic radial head prosthesis is a comminuted fracture that is not amenable to reconstruction, and particularly if it is associated with complex elbow injuries. Excision of the radial head should be avoided in the presence of combined injured ligaments or interosseous membrane injury. Three different implants are available in Korea, including the bipolar, press fit monopolar and loose fit monopolar radial head prostheses. A primary technical goal of radial head arthroplasty is the insertion of an implant that closely replicates the native radial head. The major pitfall when using a metallic radial head prosthesis is the insertion of a longer implant, which results in overstuffing of the radiocapitellar joint. Results and Conclusion: Satisfactory clinical results can be anticipated when a radial head prosthesis is used for the correct indications and when a systemic approach is undertaken to ensure proper sizing. For the future studies, we need data regarding the long term outcomes and comparison of the various types of prostheses.

Occupational Therapy Intervention for Improving Play of Children : A Systematic Review (아동의 놀이 향상을 위한 작업치료 중재에 관한 체계적 고찰)

  • Lee, Sun-Hee;Park, Hae Yean
    • The Journal of Korean Academy of Sensory Integration
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    • v.15 no.2
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    • pp.93-106
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    • 2017
  • Objective : The purpose of this study is to provide an evidence for clinical practice by systemic analysis on occupational therapy interventions for improvement of children's play. Methods : Articles used in this study were collected from database of Pubmed, ProQuest, EBSCOhost, Scopus, RISS, KISS, and National Library of Korea. The key words used in the search were "Play AND Occupational Therapy AND (Intervention OR Treatment)" and the publication period was limited from January 2007 to April 2017. 11 articles in total were selected for the systematic review analysis. Results : The results revealed that the majority of studies was one-group non-randomized study and the majority of intervention used was play-based intervention in case of that play itself was the intervention goal. The most frequently used environment for the intervention was parallel setting of home and treatment room. The majority of studies was for children with ADHD and the most commonly used assessment tool was Test of Playfulness (ToP). Dependent variables measured along with play were language skills, social interactive skills, communication and pragmatic skills, problem-solving skills, caregiver responsiveness, and parent-child interaction. Conclusion : This study help to understand the current state of occupational therapy intervention for improvement of children's play. Starting with the understanding, it is expected that various studies on play of children will be done in the future.

A Systematic Review of Cognitive Orientation to Daily Occupational Performance for Children with Developmental Coordination Disorder (발달성협응장애 아동의 인지기반 작업수행(Cognitive Orientation to daily Occupational Performance; CO-OP) 중재에 대한 체계적 고찰 )

  • Choi, Yeon-Woo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.3
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    • pp.72-85
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    • 2022
  • Objective : This study was conducted to examine self-selected goals and the outcome measures used in the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for Developmental Coordination Disorder. Methods : Studies published from January 2012 to October 2022 in the PubMed, Embase, ScienceDirect, Cochrance Library databases were searched. Keywords used for search were ('developmental coordination disorder' OR 'DCD') AND ('Cognitive Orientation to daily Occupational Performance' OR 'Cognitive Orientation to Occupational Performance' OR 'CO-OP'). Among 211 searched studies, 7 selected studies that match the thesis of this study were analyzed. Results : The selected studies showed a relatively high level of evidence overall, including two randomized experimental studies, one non-random two-group study, three non-random one-group studies, one single-subject study. The self-selected goals preference of the children was high in the order of play, education, and daily life activities. Most of applicable sessions were conducted 10 times during a 1-h period, and intervention effects showed positive outcomes on the occupation performance motor domain. To measure the effectiveness of CO-OP, the improvement of occupational performance was evaluated using Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS), and the improvement of motor skills was evaluated using Movement Assessment Battery for Children (M-ABC). Conclusion : This study is expected to be used as basic clinical data when applying the CO-OP approach to Developmental Coordination Disorder.

An Overview of the Rationale of Monetary and Banking Intervention: The Role of the Central Bank in Money and Banking Revisited (화폐(貨幣)·금융개입(金融介入)의 이론적(理論的) 근거(根據)에 대한 고찰(考察) : 중앙은행(中央銀行)의 존립근거(存立根據)에 대한 개관(槪觀))

  • Jwa, Sung-hee
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.71-94
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    • 1990
  • This paper reviews the rationale of monetary and banking intervention by an outside authority, either the government or the central bank, and seeks to delineate clearly the optimal limits to the monetary and banking deregulation currently underway in Korea as well as on a global scale. Furthermore, this paper seeks to establish an objective and balanced view on the role of the central bank, especially in light of the current discussion on the restructuring of Korea's central bank, which has been severely contaminated by interest-group politics. The discussion begins with the recognition that the modern free banking school and the new monetary economics are becoming formidable challenges to the traditional role of the government or the central bank in the monetary and banking sector. The paper reviews six arguments that have traditionally been presented to support intervention: (1) the possibility of an over-issue of bank notes under free banking instead of central banking; (2) externalities in and the public good nature of the use of money; (3) economies of scale and natural monopoly in producing money; (4) the need for macro stabilization policy due to the instability of the real sector; (5) the external effects of bank failure due to the inherent instability of the existing banking system; and (6) protection for small banknote users and depositors. Based on an analysis of the above arguments, the paper speculates on the optimal role of the government or central bank in the monetary and banking system and the optimal degree of monetary and banking deregulation. By contrast to the arguments for free banking or laissez-faire monetary systems, which become fashionable in recent years, monopoly and intervention by the government or central bank in the outside money system can be both necessary and optimal. In this case, of course, an over-issue of fiat money may be possible due to political considerations, but this issue is beyond the scope of this paper. On the other hand, the issue of inside monies based on outside money could indeed be provided for optimally under market competition by private institutions. A competitive system in issuing inside monies would help realize, to the maxim urn extent possible, external economies generated by using a single outside money. According to this reasoning, free banking activities will prevail in the inside money system, while a government monopoly will prevail in the outside money system. This speculation, then, also implies that the monetary and banking deregulation currently underway should and most likely will be limited to the inside money system, which could be liberalized to the fullest degree. It is also implied that it will be impractical to deregulate the outside money system and to allow market competition to provide outside money, in accordance with the arguments of the free banking school and the new monetary economics. Furthermore, the role of the government or central bank in this new environment will not be significantly different from their current roles. As far as the supply of fiat money continues to be monopolized by the government, the control of the supply of base money and such related responsibilities as monetary policy (argument(4)) and the lender of the last resort (argument (5)) will naturally be assigned to the outside money supplier. However, a mechanism for controlling an over-issue of fiat money by a monopolistic supplier will definitely be called for (argument(1)). A monetary policy based on a certain policy rule could be one possibility. More importantly, the deregulation of the inside money system would further increase the systemic risk inherent in the current fractional banking system, while enhancing the efficiency of the system (argument (5)). In this context, the role of the lender of the last resort would again become an instrument of paramount importance in alleviating liquidity crises in the early stages, thereby disallowing the possibility of a widespread bank run. Similarly, prudential banking supervision would also help maintain the safety and soundness of the fully deregulated banking system. These functions would also help protect depositors from losses due to bank failures (argument (6)). Finally, these speculations suggest that government or central bank authorities have probably been too conservative on the issue of the deregulation of the financial system, beyond the caution necessary to preserve system safety. Rather, only the fullest deregulation of the inside money system seems to guarantee the maximum enjoyment of external economies in the single outside money system.

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The Content Analysis of the Textbooks of Dental Clinical Course (치과임상교과목 교재에 대한 내용분석)

  • Lee, Sun-Mi;Yoo, Jung-Sook;Ahn, Se-Youn;Lim, Mi-Hee;Han, Ji-Youn;Jun, Mi-Kyoung;Lee, Hyun-Ok;Won, Young-Soon
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.272-279
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    • 2015
  • This study was conducted to provide baseline data which could suggest a direction of role based efficient integrated clinical education by avoiding duplicate of contents through analyzing clinical courses. Among the 7 clinical courses, orthodontics and periodontology were the most published subjects which were published in 5 kinds of books and dental materials was the least published subject which was published in 2 kinds of books on investigation of overlapping contents based on titles that appeared on chapters and verses of all textbooks for clinical courses. Dental implant was covered in 4 subjects such as oral maxillofacial surgery, prosthodontics, periodontology and dental materials which was the most number. Other overlapping contents were restoration treatment, occlusion and malocclusion, temporomandibular joint diseases, anesthesia sedation, tooth trauma, systemic disease and dental treatment, dental casting, isolation techniques, tooth bleaching, pulp protection, gingivitis periodontitis, tooth development, etc. Reviews of textbooks of clinical courses should be conducted in a detailed manner by systematic, various studies in order to improve quality of the textbooks.