Kim, Keon-Yeop;Jeon, So-Youn;Jeon, Man-Joong;Lee, Kwon-Ho;Lee, Sok-Goo;Kim, Dong-Jin;Kang, Eun-Jeong;Bae, Sang-Geun;Kim, Jin-Hee
Journal of Preventive Medicine and Public Health
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v.45
no.4
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pp.267-275
/
2012
Objectives: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. Methods: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. Results: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. Conclusions: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.
Rapid developments in technology as part of the Fourth Industrial Revolution have created a demand for educational technology (EdTech) and a gradual transition from traditional teaching and learning to EdTech-assisted learning in medical education. EdTech is a portmanteau (blended word) combining the concepts of education and technology, and it refers to various attempts to solve education-related problems through information and communication technology. The aim of this study was to explore the use of key EdTech applications in medical education programs. A scoping review was conducted by searching three databases (PubMed, CINAHL, and Educational Sources) for articles published from 2000 to June 2021. Twenty-one studies were found that presented relevant descriptions of the effectiveness of EdTech in medical education programs. Studies on the application and effectiveness of EdTech were categorized as follows: (1) artificial intelligence with learner-adaptive evaluation and feedback, (2) augmented/virtual reality for improving learning participation and academic achievement through immersive learning, and (3) social media/social networking services with learner-directed knowledge generation, sharing, and dissemination in medical communities. Although this review reports the effectiveness of EdTech in various medical education programs, the number of studies and the validity of the identified research designs are insufficient to confirm the educational effects of EdTech. Future studies should utilize suitable research designs and examine the instructional objectives achievable by EdTech-based applications to strengthen the evidence base supporting the application of EdTech by medical educators and institutions.
Purpose: The purpose of this study was to analyze research trends and find whether Post-Traumatic Stress Disorder (PTSD) of refugees could affect structural or functional changes of brains of those under MRI, focusing on volumes, functional connectivities, and metabolites. Methods: A literature search was done using PubMed, Embase, RISS, and KMBase to identify studies that matched our research purpose. A total of eight studies were identified using Prisma flow diagram by two reviewers independently. Results: Eight studies were identified. Three studies were on North Korean defectors as subjects. The number of studies that observed structural changes, functional changes, and metabolite changes in brains was 2, 5, and 2, respectively. Although each study observed various parts of the brain, anterior cingulate cortex (ACC) was observed commonly in three studies. The PTSD group showed reduction of ACC volume and N-acetyl-aspartate (NAA) metabolite in ACC compared to the non- PTSD group. When exposed to negative stimuli, the PTSD group showed higher neural activity than the non-PTSD group, but not vice versa. Conclusion: ACC showed significant difference in volume, neural activity, and NAA metabolite between the PTSD and the non-PTSD group, resulting in significant differences in structural changes, functional changes, metabolite changes, respectively. This study showed the need for conducting more research using various biomarkers to clarify the relationship between PTSD of refugees and their brain changes.
Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic-pituitary-adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.
Ho, Jean-Pierre T.F.;van Riet, Tom C.T.;Afrian, Youssef;Chin Jen Sem, Kevin T.H.;Spijker, Rene;de Lange, Jan;Lindeboom, Jerome A.
Journal of Dental Anesthesia and Pain Medicine
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v.21
no.6
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pp.507-525
/
2021
Local anesthesia is indispensable in dentistry. Worldwide, millions of local anesthetic injections are administered annually, and are generally considered safe invasive procedures. However, adverse effects are possible, of which dentists should be aware of. This scoping review aimed to provide an extensive overview of the reported literature on the adverse effects of dental local anesthesia. The types of papers, what is reported, and how they are reported were reviewed. Additionally, the incidence and duration of adverse effects and factors influencing their occurrence were also reviewed. An electronic search for relevant articles was performed in PubMed and Embase databases from inception to January 2, 2020. The titles and abstracts were independently screened by two reviewers. The analysis was narrative, and no meta-analysis was performed. This study included 78 articles. Ocular and neurological adverse effects, allergies, hematomas, needle breakage, tissue necrosis, blanching, jaw ankylosis, osteomyelitis, and isolated atrial fibrillation have been described. Multiple adverse effects of dental local anesthesia have been reported in the literature. The results were heterogeneous, and detailed descriptions of the related procedures were lacking. Vital information concerning adverse effects, such as the dosage or type of anesthetic solution, or the type of needle used, was frequently missing. Therefore, high-quality research on this topic is needed. Finally, the adverse effects that are rarely encountered in real-world general practice are overrepresented in the literature.
The development projects subject to health impact assessment (HIA) in the current environmental impact assessment (EIA) system are limited to some projects under Article 12 of the Enforcement Decree of the Environmental Health Act (Additional Assessment Objects Subject to Health Impact Assessment Items), but health impact-related matters are being evaluated and reviewed during consultation. In particular, when a development site is planned around some pollutant sources in a residential development plan, it is evaluated and reviewed whether the site meets the risk criteria through a current concentration survey of major hazardous air pollutants. This study prepared a quantitative method to confirm the validity of the location of the residential area to be developed in the residential development plan and proposed a plan to expand the project subject to HIA within the EIA procedure. A detailed methodology was proposed by reviewing the screening and scoping procedures of the EIA system, and a case analysis of the urban development plan discussed in the past was conducted to verify the methodology.
Kim, Je-Beom;Lee, Dong-Yoon;Ha, Da-Jung;Kwon, Chan-Young
The Journal of Korean Medicine
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v.42
no.3
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pp.99-118
/
2021
Objectives: The aim of this study is to review and analyze the trends in prospective clinical research (PCR), project, clinical study protocol of Korean medicine (KM) for dementia. Methods: We searched PCRs of KM on dementia in six electronical databases, up to January 28, 2021. Moreover, the clinical research protocol and projects of KM for dementia were searched. Results: Total eight PCRs, nine projects, and three clinical study protocols were included. In the PCRs, there were one randomized controlled trial, five before and after study, and two comparative group before-after studies. Four of them used herbal medicine, two used acupuncture, one study used both herbal medicine and acupuncture, and the other one used moxibustion. Jowiseungchung-tang was the most frequently used herbal medicine. BL62, KI6 were used in electro-acupuncture, auricular-Shenmen in auricular acupuncture, and GV20 in moxibustion. The most frequent outcome was Korean-Dementia Rating Scale (K-DRS). One reported significant increase in K-DRS score, one reported 60% improvement, and the other studies mostly reported no significant difference. In the projects including 20 clinical studies of dementia, herbal medicine, integrative medicine and acupuncture were mainly used. In the protocols, herbal medicine, complex KM intervention, and integrative medicine were used. Conclusions: Currently, the number of PCRs of KM for dementia is very scarce. Therefore, the researcher's interest in this field and national research support should be made more, and the quality of clinical research in the future can be further improved by supplementing the limitations of previously published clinical research.
Thyroid uptake measurements can be subject to measurement errors due to the scoping and positioning of the thyroid gland. To compensate for these limitations, the clinical utility of the thyroid simultaneous counting method as an alternative to thyroid uptake measurement was analyzed and evaluated experimentally through quantitative analysis of images acquired after thyroid scanning. Experimental data were obtained using a Gamma camera (GE infinia), a thyroid uptake system (KOROID 1), and a thyroid neck phantom. Based on the thyroid uptake rate of 1-5% according to the protocol of thyroid scan test (99mTcO4 - , 370 MBq) in normal results, 99mTcO4 - was set in the range of 3.7-18.5 MBq (Matrix: 256×256, Scan time: 1 min, collimator: pin hole, phantom-collimator distances: 7 cm). The acquired images were corrected for the attenuation of isotopes due to the set-up time and half-life by applying the Auto Region of interest (ROI) drawing system, and the significance of the experimental results was evaluated by Multiple linear regression analysis (SPSS, ver. 22, IBM). The thyroid uptake rate showed a significant correlation between the dose and the measured counts when using the thyroid uptake system equipment. Meanwhile, the quantitative analysis counts of phantom images using Gamma camera also showed a significant correlation. Thus confirmed that the correlation between these two experiments was statistically significant (P<0.05). The simultaneous counting protocol, which indirectly measures thyroid uptake from thyroid scans, is likely to be clinically relevant if complemented by additional studies with different variables in patients with thyroid disease.
Purpose MR neurography (MRN) is an imaging technique optimized to visualize the peripheral nerves. This review aimed to discover an optimized protocol for MRN of the lumbosacral plexus (LSP) and identify evidence for the clinical benefit of lumbosacral plexopathies. Materials and Methods We performed a systematic search of the two medical databases until September 2021. 'Magnetic resonance imaging', 'lumbosacral plexus', 'neurologic disease', or equivalent terms were used to search the literature. We extracted information on indications, MRN protocols for LSP, and clinical efficacy from 55 studies among those searched. Results MRN of the LSP is useful for displaying the distribution of peripheral nerve disease, guiding perineural injections, and assessing extraspinal causes of sciatica. Three-dimensional short-tau inversion recovery turbo spin-echo combined with vascular suppression is the mainstay of MRN. Conclusion Future work on the MRN of LSP should be directed to technical maturation and clinical validation of efficacy.
Seungwon Jung;Seungkwan Choi;Jungho Jo;Yunhee Han;Hyeonjun Woo;Byeonghyeon Jeon;Wonbae Ha;Junghan Lee
Journal of Korean Medicine Rehabilitation
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v.34
no.1
/
pp.23-38
/
2024
Objectives This study examined recent domestic and international clinical research trends in Gua sha therapy to suggest future direction for research. Methods We used six domestic and international databases (Research Information Sharing Service, Korean studies Information Service System, Oriental Medicine Advanced Searching Integrated System, PubMed, Embase, Cochrane Library) to select clinical studies with an original text in English or Korean published after 2018. Results Finally, 55 studies were selected. Randomized controlled trials accounted for the largest amount with 42 studies. Instrument assisted soft tissue mobilization was the most frequent term referring to Gua sha. Muscle shortening, limited range of motion, and plantar fasciitis were the most common symptoms, with six cases each. Additionally, there were two studies targeting symptoms other than the musculoskeletal system. Conclusions Additional research is needed on the effects of Gua sha therapy on the back of the lower extremities and hip joints, and research is needed on the possibility of their clinical use for diseases or symptoms other than those of the musculoskeletal system. And standards for the terminology of Gua sha and the types and methods of applied interventions are needed.
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