• Title/Summary/Keyword: 독립시행

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Economic evaluation of manual therapy for musculoskeletal diseases: a systematic review and narrative synthesis of evidence (근골격계 질환의 수기요법에 관한 경제성 평가: 체계적 문헌 고찰 및 근거 합성 연구)

  • Kim, Chang-Gon;Lee, Jin-Hyun;Kim, Ka-Na;Shin, Byung-Cheul;Ko, Youn-Suk;Park, Tae-Yong;Ha, Won-Bae;Lee, Jung-Han
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.1-33
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    • 2020
  • 연구 목적 : 본 연구는 근골격계 질환에 대한 수기치료가 갖는 경제적 효과를 체계적으로 평가해 보기 위해 시행되었다. 연구 방법 : 2017년 2월 2일까지 국내외 관련 문헌을 체계적으로 검색 하였으며, 연관된 체계적 고찰 논문의 참고문헌을 조사하였다. 두 명의 연구자가 독립적으로 문헌을 선택하고, 비뚤림 위험 평가 및 경제성 평가 질 평가, 자료 추출을 시행하였다. 연구 결과 : 총 3,327개의 논문을 검토하여 최종적으로 18개의 무작위 대조 연구가 포함되었다. 경제성 평가는 수기요법과 다른 치료방법간의 유효성 비교를 통해 시행되었다. 요부 통증, 견관절 통증 및 외측 상과염 치료에 있어 침치료, 견인치료, 주사치료, 일반의 치료, 척추 안정화 기법 및 통증관리 치료보다 비용 효과적인 것으로 나타났다. 또한 또한, 수기치료는 경항통, 흉통, 고관절염 혹은 슬관절염, 경추신경병증 및 수부손상 치료에 있어 일반적 치료, 물리치료, 자가 치료 프로그램, 견인 치료에 비하여 효과적인 치료인 것으로 확인되었다. 결론 : 18개의 논문 중 10개의 논문에서 근골격계 질환 치료에 있어 수기치료가 경제적으로 효과가 있는 것으로 나타났다. 이러한 결과는 다른 치료방법에 비해 수기요법이 근골격계 질환에 있어서 경제적 가치가 있음을 시사하는 내용이다. 하지만, 근골격계 질환 수기치료의 경제성 평가에 대한 선행 연구는 전반적으로 부족한 실정으로, 보다 정확한 결과를 제시하고 정책결정을 위한 효과적인 제안을 위해서는 체계적인 추가 연구가 필요하다 사료되는 바이다.

Development of Gateway Review System for Supporting Collaborative Decision-Making through Project Life Cycle (사업 단계별 의사결정 지원 게이트웨이 리뷰 체계 구축)

  • Shin, Seung-Woo;Yi, June-Seong;Lee, Jee-Hee;Park, Kyung-Rog;Lim, Ji-Youn
    • Korean Journal of Construction Engineering and Management
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    • v.11 no.3
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    • pp.43-54
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    • 2010
  • As Urban Regeneration is being carried out, stakeholders are most likely to have disagreements on their interests. Besides, dispersion of numerous communication routes and obscure decision processes aggravate the situation. Eventually, fragmented decision-making processes and complex structure lead to inefficient outcome and delay of projects. This paper is a study on decision-making support not only helps the program manager have more efficient and optimum decision, but also provides alternatives for Urban Regeneration. This study is conducted as follows. Firstly, the project process and the decision-making structure among stakeholders in Urban Regeneration are analyzed, and then the current status of decision-making in Urban Regeneration project is classified. Secondly, with literature study on "Gateway Review", the decision-making gateway review process in Urban Regeneration is defined, and then the "Gateway Review Elements" are listed. Thirdly, to establish gateway review process, this paper presents a check points, namely gate which supports a program manager to monitor and to control the program management in Urban Regeneration. Each gate has several supporting tools such as diagram of critical decision points relation, scheme of stakeholder, checklist. Fourthly, the proposed concept is verified by experts who have been carefully selected to provide their respective reviews. Finally, decision-making support gateway review system is modified based on their critiques and suggestions.

A Characteristics of the Vulnerable Area for Emergency Medical Service in Daejeon by Analysis of Geographic Information System (지리정보시스템(GIS)으로 분석한 대전광역시 응급의료서비스 취약지 특성)

  • Hwang, Ji-Hye;Na, Baeg-Ju;Lee, Dong-Woo;Hong, Jee-Young;Lee, Moo-Sik
    • Proceedings of the KAIS Fall Conference
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    • 2010.05b
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    • pp.859-862
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    • 2010
  • 본 연구는 대전광역시의 응급의료서비스 취약지를 도출하고 취약지역의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성을 분석하여 응급의료 관련 정책의 의사결정에 유용한 기초자료로 제공하기 위한 연구이다. 응급의료서비스 취약지 도출은 Arc GIS의 공간분석 방법 중 가중분석(Cost Weighted distance) 방법으로 응급의료센터로부터의 접근성 분석을 하였으며, 응급의료서비스 취약지의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성은 SPSS 17.0을 이용하여 비모수 t-검정 및 다중회귀분석을 시행하였다. 본 연구의 주요 결과는 다음과 같다. 연구지역의 응급의료기관 분포는 동구와 유성구, 대덕구는 지정된 응급의료센터가 없으나 서구와 중구는 응급의료센터가 2개소 이상 위치하고 있어 응급의료기관 분포가 편중되어 있으며, GIS를 활용하여 응급의료센터와의 접근성 분석을 수행한 결과, 대전광역시 자치구별 전체 면적 대비 응급의료서비스 취약지의 비율이 높은 자치구는 동구가 41.2%로 가장 높았다. GIS를 활용하여 행정동별 응급의료서비스 취약지를 분석한 결과, 대덕구 신탄진동, 동구 대청동과 산내동, 유성구 구즉동과 노은2동, 서구 기성동, 중구 산성동으로 나타났으며, 응급의료서비스 취약지 중 기성동, 대청동이 노인 인구밀도가 높게 나타났다. 응급의료서비스 취약여부에 따른 보건학적 특성별 차이를 분석한 결과, 국민기초생활수급권자, 장애인등록자, 농업인구 비율의 평균은 취약지가 비취약지에 비해 높았으며 통계적으로 유의한 차이를 보였다(p<0.01). 응급의료서비스 취약여부를 종속변수로 하고 지역별 보건학적 특성을 독립변수로 하여 로지스틱 회귀분석을 시행한 결과, 농업인구 비율과 국민기초생활수급권자 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부를 설명할 수 있는 변수인 것으로 나타났다(p<0.01, p<0.05). 이상의 결과를 종합하면 대전광역시 5개 자치구의 행정동 중 응급의료서비스 접근 불평등지역이 도출되었고 이러한 지역은 보건학적 특성 중 농업인구 비율과 국민기초생활수급권자의 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부와 관련성이 있는 것으로 나타났다. 향후 효율적인 응급의료 자원 분배를 위해서는 GIS를 활용한 의사결정이 필요하며, 응급의료서비스 이용의 형평성을 증진시키기 위해서 응급의료서비스의 사각지대에 놓여있는 지역의 보건학적 특성을 고려한 정책이 시행되어야 할 것으로 사료된다.

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A COMPARATIVE STUDY OF THE CANAL CONFIGURATION AFTER SHAPING BY PROTAPER ROTARY AND HAND FILES IN RESIN SIMULATED CANALS (레진모형근관에서 엔진구동형 및 수동형 ProTaper 파일로 근관성형 후 근관형태 변화에 대한 비교연구)

  • Yang, In-Seok;Kang, In-Chol;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.30 no.5
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    • pp.393-401
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    • 2005
  • The purpose of this study was to compare the canal configuration after shaping by ProTaper rotary files and ProTaper hand files in resin simulated canals. Forty resin simulated canals with a curvature of J-shape and S-shape were divided into four groups by 10 blocks each Simulated root canals in resin block were prepared by ProTaper rotary files and ProTaper hand files using a crown-down pressureless technique All simulated canals were prepared up to size $\#25$ file at end-point of preparation. Pre- and post-instrumentation images were recorded with color scanner. Assessment of canal shape was completed with an image analysis program. Measurements were made at 0, 1, 2, 3, 4, 5, 6 and 7 mm from the apex. At each level, outer canal width, inner canal width, total canal width, and amount of transportation from original axis were recorded. Instrumentation time was recorded. The data were analyzed statistically using independent t-test. The result was that ProTaper hand files cause significantly less canal transportation from original axis of canal body and maintain original canal configuration better than ProTaper rotary files, however ProTaper hand files take more shaping time.

The Effects of Guided Imagery Activities Using Music on Mood States, and Physiological Responses of Psychiatric Inpatients (음악을 사용한 지시적 심상이 입원 정신질환자의 기분상태 및 생리적 변화에 미치는 영향)

  • Cho, Hyun-joo;Moon, Ji-young
    • 재활복지
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    • v.20 no.1
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    • pp.113-130
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    • 2016
  • The purpose of this study is to determine the effects of guided imagery activities using music on both mood states and physiological responses of psychiatric inpatients. The experimental group was consisted of 27 psychiatric patients participating in the guided imagery activities using music for 11 minutes. Also, the control group was formed with 27 psychiatric patients with non-musical intervention. Mood states, blood pressure, pulse and skin temperature were checked before and after session. We could see the significant difference in the score of five areas-tension, depression, anger, vigor, fatigue-showed most differences in score. Also, the score of skin temperature of both experimental group and between two groups showed significant differences, too. Therefore, we can conclude that these results were showing that guided imagery activities using music was an effective nursing intervention method for altering mood state of psychiatric patients. Besides, it seemed to have physiological impact to make patients relax tension backed up by change of skin temperature.

Periimplant bone change after alveolar ridge preservation: radiographic retrospective study (발치와 치조제 보존술 후 식립한 임플란트 주위 골 변화: 후향적 방사선학적 분석)

  • Shim, Da-Eun;Pang, Eun-Kyoung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.281-290
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    • 2021
  • Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

Comparative Insect Biodiversity Analyses on the Agricultural Ecosystems of Goesan District of Korea (괴산군 지역 농업 생태계의 곤충 다양성 비교 분석)

  • Kim, Hoon;Sun, Yan;Lee, Seung-Min;Ku, Bon-Jin;Ku, Yun-Mo;Kim, Tae-Yeon;Moon, Myung-Jin
    • Korean Journal of Organic Agriculture
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    • v.29 no.4
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    • pp.539-559
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    • 2021
  • Agricultural ecosystem biodiversity monitoring and community variation analysis of insects were conducted from 2016 to 2018 in selected conventional and organic farming fields in Goesan district, Chungcheongbuk-do, South Korea. The total number of 1,125 species in 16 orders and 207 families were identified. The numbers of species collected in the locations practicing organic farming were greater than the conventional farming both in the paddy fields (564 vs. 383 species) and the upland fields (471 vs. 365 species). Among them, Hemiptera had the most abundant of species, followed by Diptera, Hymenoptera, Coleoptera and Araneae. We calculated various index values of biodiversity (diversity index H', richness index R, evenness index J', dominance index D, and similarity index QS) based on quantitative measurements of species and individuals collected over three years of field monitoring. Variations in biodiversity index values in different agricultural systems show that the positive effect of organic farming is to produce more biodiversity than conventional farming systems. When compared to other index results reported in Korea, Japan and China, the richness index was higher and other index values were at similar levels.

Effect of Oral Motor Facilitation Technique on Oral Motor Function in Stroke Patients (구강운동촉진기술(Oral Motor Facilitation Technique)이 뇌졸중 환자의 구강운동기능에 미치는 효과)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.135-151
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    • 2023
  • Objective : This study was conducted to confirm the effect of the oral motor facilitation technique (OMFT) on oral motor function in stroke patients. Methods : This study was conducted on 72 stroke patients with dysphagia were included. Thirty-six patients were randomly assigned to the experimental and control groups were randomly classified into 36 patients each using a random table, and a two-group pre-post test was designed. The experimental group underwent OMFT, and the control group underwent traditional dysphagia therapy for 30 min, once a day, 5 times a week for 4 weeks, for a total of 20 sessions. The Comprehensive Orofacial Function Scale (COFFS) was used to evaluate oral motor function. Repeated-measures analysis of variance (ANOVA) was performed to confirm the effect of the period, and an independent t-test was performed to analyze the difference in change between the two groups. Results : Total COFFS scores improved in both groups. The experimental group showed significant changes in mandibular and lip movements, cheek blows, and tongue movements. In addition, there were significant differences depending on the intervention period in terms of masticatory distribution, food spillage, swallowing of solid and liquid foods, and voice changes. There were significant differences in the mandibular opening and closing categories between the two groups. Conclusion : OMFT is effective in improving oral motor function in stroke patients with dysphagia and can be used as basic evidence in clinical practice.

Antithrombin-III as an early prognostic factor in children with acute lung injury (급성 폐손상 소아 환자에서 조기 예후 인자로서의 antithrombin-III)

  • Lee, Young Seung;Kim, Seonguk;Kang, Eun Kyeong;Park, June Dong
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.443-448
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    • 2007
  • Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

Psychosocial Factors Predicting Delayed Diagnosis of Breast Cancer : The Role of Marital Relationship Functioning (지연된 유방암 진단을 예측하는 정신사회적 요인 : 부부관계기능의 역할)

  • Kim, Ji Young;Woo, Jungmin;Lee, Sang Shin;Kim, Hea Won;Khang, Dongwoo;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.13-22
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    • 2014
  • Objectives : Breast cancer has been the most prevalent female cancer in South Korea since 2001. Early detection of this disease is the most effective strategy for reducing mortality. The objective of this study was to identify factors which could predict advanced stage at diagnosis of breast cancer. Methods : Participants who were initially diagnosed with breast cancer and referred to the Stress Clinic of the Breast Cancer Center at Kyungpook National University Hospital were included. Through a semi-structured interview, the authors investigated psychosocial variables such as the extent of marital and family functioning and emotional-economic family burden as well as sociodemographic and health behavior-, health characteristic- and cancer-related variables. Results : Data were collected from 219 participants. One hundred and twenty(54.8%) subjects were diagnosed with advanced-stage breast cancer. Variables that were significantly different between the advanced-stage and early-stage groups included : monthly breast self examination(p<0.000), annual mammographic screening(p<0.000), mode of tumor detection(p<0.000), nature of the first symptoms(p<0.000), time to treatment after diagnosis(p<0.000), overloaded economic and family burden(p=0.018), marital functioning(p<0.000) and family functioning(p<0.00). Logistic regression analysis indicated that irregular annual mammography screening(OR=7.431 ; 95% CI 2.407-22.944) or a lack of screening(OR=25.299 ; 95% CI 7.855-81.482) and a dysfunctional marital relationship(OR=4.772 ; 95% CI 2.244-10.145) were significantly associated with advanced stage at diagnosis of breast cancer. Conclusions : We reconfirmed screening behavior to be a risk factor for delayed diagnosis of breast cancer. Our findings also emphasized the importance of psychosocial factors such as marital functioning in early detection of breast cancer. Psychiatric consultation in the area of martial functioning could be beneficial for increasing early detection in breast cancer.

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