• Title/Summary/Keyword: Evidence-based protocol

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The Current Status of the Warsaw Convention and Subsequent Protocols in Leading Asian Countries (아시아 주요국가(主要國家)들에 있어서의 바르샤바 체제(體制)의 적용실태(適用實態)와 전망(展望))

  • Lee, Tae-Hee
    • The Korean Journal of Air & Space Law and Policy
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    • v.1
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    • pp.147-162
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    • 1989
  • The current status of the application and interpretation of the Warsaw Convention and its subsequent Protocols in Asian countries is in its fredgling stages compared to the developed countries of Europe and North America, and there is thus little published information about the various Asian governments' treatment and courts' views of the Warsaw System. Due to that limitation, the accent of this paper will be on Korea and Japan. As one will be aware, the so-called 'Warsaw System' is made up of the Warsaw Convention of 1929, the Hague Protocol of 1955, the Guadalajara Convention of 1961, the Guatemala City Protocol of 1971 and the Montreal Additional Protocols Nos. 1,2,3 and 4 of 1975. Among these instruments, most of the countries in Asia are parties to both the Warsaw Convention and the Hague Protocol. However, the Republic of Korea and Mongolia are parties only to the Hague Protocol, while Burma, Indonesia and Sri Lanka are parties only to the Warsaw Convention. Thailand and Taiwan are not parties only to the convention or protocol. Among Asian states, Indonesia, the Phillipines and Pakistan are also parties to the Guadalajara Convention, but no country in Asia has signed the Guatemala City Protocol of 1971 or the Montreal Additional Protocols, which Protocols have not yet been put into force. The People's Republic of China has declared that the Warsaw Convention shall apply to the entire Chinese territory, including Taiwan. 'The application of the Warsaw Convention to one-way air carriage between a state which is a party only to the Warsaw Convention and a state which is a party only to the Hague Protocol' is of particular importance in Korea as it is a signatory only to the Hague Protocol, but it is involved in a great deal of air transportation to and from the united states, which in turn is a party only to the Warsaw Convention. The opinion of the Supreme Court of Korea appears to be, that parties to the Warsaw Convention were intended to be parties to the Hague Protocol, whether they actually signed it or not. The effect of this decision is that in Korea the United States and Korea will be considered by the courts to be in a treaty relationship, though neither State is a signatory to the same instrument as the other State. The first wrongful death claim in Korea related to international carriage by air under the Convention was made in Hyun-Mo Bang, et al v. Korean Air Lines Co., Ltd. case. In this case, the plaintiffs claimed for damages based upon breach of contract as well as upon tort under the Korean Civil Code. The issue in the case was whether the time limitation provisions of the Convention should be applicable to a claim based in tort as well as to a claim based in contract. The Appellate Court ruled on 29 August 1983 that 'however founded' in Article 24(1) of the Convention should be construed to mean that the Convention should be applicable to the claim regardless of whether the cause of action was based in tort or breach of contract, and that the plaintiffs' rights to damages had therefore extinguished because of the time limitation as set forth in Article 29(1) of the Convention. The difficult and often debated question of what exactly is meant by the words 'such default equivalent to wilful misconduct' in Article 25(1) of the Warsaw Convention, has also been litigated. The Supreme Court of Japan dealt with this issue in the Suzuki Shinjuten Co. v. Northwest Airlines Inc. case. The Supreme Court upheld the Appellate Court's ruling, and decided that 'such default equivalent to wilful misconduct' under Article 25(1) of the Convention was within the meaning of 'gross negligence' under the Japanese Commercial Code. The issue of the convention of the 'franc' into national currencies as provided in Article 22 of the Warsaw Convention as amended by the Hague Protocol has been raised in a court case in Korea, which is now before the District Court of Seoul. In this case, the plaintiff argues that the gold franc equivalent must be converted in Korean Won in accordance with the free market price of gold in Korea, as Korea has not enacted any law, order or regulation prescribing the proper method of calculating the equivalent in its national currency. while it is unclear if the court will accept this position, the last official price of gold of the United States as in the famous Franklin Mint case, Special Drawing Right(SDR) or the current French franc, Korean Air Lines has argued in favor of the last official price of gold of the United States by which the air lines converted such francs into us Dollars in their General Conditions of Carriage. It is my understanding that in India, an appellate court adopted the free market price valuation. There is a report as well saying that if a lawsuit concerning this issue were brought in Pakistan, the free market cost of gold would be applied there too. Speaking specifically about the future of the Warsaw System in Asia though I have been informed that Thailand is actively considering acceding to the Warsaw Convention, the attitudes of most Asian countries' governments towards the Warsaw System are still wnot ell known. There is little evidence that Asian countries are moving to deal concretely with the conversion of the franc into their own local currencies. So too it cannot be said that they are on the move to adhere to the Montreal Additional Protocols Nos. 3 & 4 which attempt to basically solve many of the current problems with the Warsaw System, by adopting the SDR as the unit of currency, by establishing the carrier's absolute liability and an unbreakable limit and by increasing the carrier's passenger limit of liability to SDR 100,000, as well as permiting the domestic introduction of supplemental compensation. To summarize my own sentiments regarding the future, I would say that given the fact that Asian air lines are now world leaders both in overall size and rate of growth, and the fact that both Asian individuals and governments are becoming more and more reliant on the global civil aviation networks as their economies become ever stronger, I am hopeful that Asian nations will henceforth play a bigger role in ensuring the orderly and hasty development of a workable unified system of rules governing international commercial air carriage.

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Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit (소아심장외과 중환자실에서의 실무의사소통 프로토콜이 수술 후 성과에 미치는 영향)

  • Uhm, Ju-Yeon;Lee, Worlsook
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.3
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    • pp.243-253
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    • 2015
  • Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

Impact of Dual-Hemisphere Transcranial Direct Current Stimulation Combined with Modified Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Single Blinded Randomized Controlled Trial (수정된 강제 유도 운동치료와 결합된 이중 반구 경두개 직류 자극이 만성 뇌졸중의 팔 기능에 미치는 영향 : 단일 맹검 무작위 통제 시험)

  • Kim, Sunho
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.2
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    • pp.11-20
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    • 2020
  • Purpose : The purpose of this study was to research the effects of dual-hemisphere transcranial direct current stimulation (dual tDCS) and modified constraint-induced movement therapy (mCIMT) to improve upper extremity motor function after stroke. Methods : The study period was from August 2019 to November 2019, and included 24 patients who met the selection criteria. Participants were divided into 2 groups: dual tDCS and mCIMT, and sham dual tDCS and mCIMT group. Dual tDCS and mCIMT group performed mCIMT immediately after applying dual tDCS for 20 minutes, and sham dual tDCS and mCIMT group performed mCIMT immediately after applying sham tDCS for 20 minutes without turning on the power source. Total interventions were conducted 5 times per week for 4 weeks, and mCIMT was conducted for 30 minutes per session for both experimental and control groups. Fugl-Meyer assessment (FMA) and Motor Activity Log scale (MAL) were analyzed before and after 4 weeks of intervention. Results : Both experimental and control groups showed significant changes in FMA, Amount of Use (AOU), and Quality of Movement (QOM) of MAL. When the differences between groups was compared using ANCOVA, the experimental group showed a greater improvement in FMA and AOU of MAL than the control group. Conclusion : In order to enhance the effect of improving upper limb function of stroke patients, dual tDCS could be applied to provide more effective treatment in the clinical setting. Further studies will be needed in larger groups of stroke patients, including long-term follow-up, and multi-group comparisons through the establishment of anodal tDCS and mCIMT, cathodal tDCS, and mCIMT groups to clarify the effects of dual tDCS. In addition, research is needed to establish a protocol for tDCS, and this evidence-based intervention protocol is expected to be used in the clinical setting as an interventional method for various purposes.

The effectiveness of Sensory Integration : Systematic Review (감각통합 중재 효과에 대한 체계적 고찰)

  • Park, Eom-Ji;Shin, Joong-Il
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.144-153
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    • 2016
  • This study examined the recent study trends through a systematic review of the effect of sensory integration intervention and the objective reason to show the areas where sensory integration intervention is effective. The databases, Medline and EMBASE, were searched for "Occupational therapy", "Sensory integration therapy", "Sensory processing", "Weighted vest", and "Wilbarger protocol". For the analysis studies, 14 studies on the effects of sensory integration intervention from 2010 to 2015 were analyzed and organized according to the principle of PICO. According to the result, there were 4 studies each of evidence levels I and e V, which was the largest number of studies (28.6%). The result from frequency analysis of the measurement used for measuring the effects of intervention showed that GAS and VABS-II were used in the 4 studies (11.8%). 71.4% of children with autism spectrum were the major subject group in the analysis studies and sensory integration intervention had an effect on the motor performance, sensory processing, behavior, learning-related education, and occupation performance area. This study result will be useful for establishing sensory integration as an interventional program in occupational therapy practice. In further studies, it will be important to verify the intervention effect of sensory integration in another rehabilitation area.

An Analysis on the Stability of the Electric Vehicles Connected Power System According to Charging Cost with Price Elasticity (가격탄력성을 이용한 전기자동차 충전요금제에 따른 연계계통의 안정성 분석)

  • Kim, Junhyeok;Kim, Joorak;Kim, Chulhwan
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.65 no.9
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    • pp.1577-1582
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    • 2016
  • Now we are facing severe environmental issues such as global warming. Due to these, the concerns about eco-friendly energy have been increased. Kyoto protocol and Copenhagen climate change conference are circumstantial evidence of it. With these trends, the interests for the Electric Vehicles(EVs) which do not emit any harmful gases have gradually been raised. Unfortunately, however, massive connection of EVs to the power system could cause negative impacts such as voltage variations, frequency variations and increase of demand power. To prevent the mentioned issues, KEPCO adopts Time-of-Use(ToU) price for EVs charging. Nevertheless, it is important to verify the propriety of the charging system. In this paper, therefore, we used pre-introduced price elasticity concept to predict possible Demand Response(DR) on charging of EVs. And analyzed possible demand power increase according to various price elasticities. Simulation results show that given ToU based charging system would not enough to control the increase of demand power by EVs on the power system. It is concluded, therefore, additional methods and/or algorithms are required.

Strategies to approach the customized health management service to prevent chronic diseases (만성질환 예방을 위한 맞춤형 건강관리 서비스의 접근전략과 발전방향)

  • Kim, Young-Bok
    • Korean Journal of Health Education and Promotion
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    • v.33 no.4
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    • pp.89-100
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    • 2016
  • Objectives: Life style modification leads to decrease health risk and change of health status for person at health risk. This study aimed to suggest essential components and effective strategies for customized health management service to provide individual and risk group in public and private health care organizations. Methods: To systematic review the essential component of health management service, I performed to collect political legislation, research papers, reports, publication and public release for heath management service from 2008 to 2016. Essential components of heath management service were service scope, service design, organizations and applied technology. Results: Service cope was composed of health risk factors, such as smoking, drinking, nutrition, physical activity and weight control. Main strategies were customized health management services, personalized behavior modification programs, evidence-based service protocol, utilization of information and communications technology (ICT), multi-dimension and multi-level approach, and public and private organizations partnership through health policies and health care system. Conclusions: To make the most of the limited resources, it should require a systematic approach that focuses on continuous monitoring and partnership of health management service.

The Early Detection of Recurrence of Malignant Peripheral Nerve Sheath Tumor by Frequent Magnetic Resonance Imaging

  • Lee, Chang-Sub;Huh, Ji-Soon;Chang, Jee-Won;Park, Ji-Kang
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.51-54
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    • 2010
  • Surgery has a key role in the treatment of malignant peripheral nerve sheath tumors (MPNSTs), but the resectability of paraspinal MPNSTs is only 20%. Therefore, spinal MPNSTs show frequent recurrence and poor prognosis. Local recurrence is much more common than metastasis for MPNSTs, and surgery still has a key role in the treatment of local recurrence. Therefore, it is important that recurrence must be detected before resectability is lost. However, no evidence-based follow-up protocol has been established for MPNST. The authors performed gross total resection in a 34-year-old woman presented with thoracic MPNST. Adjuvant radiotherapy and chemotherapy were not administered since these adjuvant therapies generally do not improve survival in MPNST and may cause additional neurovascular damage. Instead, the authors monitored the primary site every 3 months using magnetic resonance imaging to detect local recurrence at the earliest opportunity. The tumor recurred locally on two occasions without overt symptoms at 21 and 24 months postoperatively. These recurrences were treated successfully by gross total removal.

Algorithmic approach to the lymphatic leak after vascular reconstruction: a systematic review

  • Nicksic, Peter John;Condit, Kevin Michael;Nayar, Harry Siva;Michelotti, Brett Foster
    • Archives of Plastic Surgery
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    • v.48 no.4
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    • pp.404-409
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    • 2021
  • Background To date, there are no consensus guidelines for management of lymphatic leak in groin vascular reconstruction patients. The goal of this study is to review the relevant literature to determine alternatives for treatment and to design an evidence-based algorithm to minimize cost and morbidity and maximize efficacy. Methods A systematic review of the literature was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Two independent reviewers applied agreed-upon inclusion and exclusion criteria to eligible records. Studies that included patients who underwent groin dissection for oncologic diagnoses and level 5 data were excluded. Interventions were then categorized by efficacy using predetermined criteria. Results Our search yielded 333 records, of which eight studies were included. In four studies, the success of lymphatic ligation ranged from 75% to 100%, with average days to resolution ranging from 0 to 9. Conservative management in the form of elevation, compression, and bedrest may prolong time to resolution of lymphatic leak (14-24 days) and therefore cost. Conclusions The majority of patients should be offered early operative intervention in the form of lymphatic ligation with or without a primary muscle flap. If the patient is not an operative candidate, a trial of conservative management should be attempted before other nonsurgical interventions.

The Let's Eat Healthy and Move at School program for adolescents in South Korea: Program design, implementation, and evaluation plan using intervention mapping

  • Park, Jiyoung;Hoor, Gill A. Ten;Baek, Seolhyang;Chung, Sochung;Kim, Yang-Hyun;Hwang, Gahui
    • Child Health Nursing Research
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    • v.27 no.3
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    • pp.225-242
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    • 2021
  • Purpose: This study aimed to systematically develop an obesity prevention program for adolescents to promote healthy eating and physical activity in schools. Methods: The development of the Let's Eat Healthy and Move at School program for adolescents followed the six steps of intervention mapping (IM). IM is a widely used protocol for developing systematic and effective interventions based on theories and evidence. Results: To better understand the problem and identify the needs of adolescents, interviews were conducted with teachers, school nurses, and students (step 1). In step 2, the desired behaviors and their determinants were established and combined into a matrix comprising 16 change objectives. In step 3, theoretical methods such as persuasive communication and consciousness-raising were chosen. The program was segmented into three educational activity sessions in step 4. In step 5, an implementation manual was developed for program instructors to ensure effective and accurate implementation. Finally, practices for evaluating the program's effectiveness and procedures were designed in step 6. Conclusion: The Let's Eat Healthy and Move at School program will provide adolescents with guidelines to promote healthy living and prevent obesity in everyday life using strategies for sustainable adolescent obesity prevention and management.

Occupational Therapy for Community Mobility in Stroke Patients : Systematic review (뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰)

  • Jo, Eun-Ju;Kam, Kyung-Yoon;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.77-89
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    • 2018
  • Objective : The purpose of this study was to analyze occupational therapy intervention on the community mobility for stroke patients, and to provide evidence of intervention in the clinical fields. Methods : A systematic review was executed according to the PRISMA checklist. The accessed database was PubMed, EMBASE, Cochrane Library (CENTRAL), ProQuest Dissertations & thesis (PQDT), RISS, and KoreaMed. We included the articles published from 2005 to September 2018. RoBANS checklist was used to evaluate the quality of the articles. Included articles, totally eight, were categorized according to the type of intervention. Results : The study design of the literature was varied from two-group randomized trial, quasi-experimental study, case-control trial, one group pre-post comparison study, and cross-sectional study. In the evidence level, 6 articles were included in level II (75%). The percentage of low risk of bias in each article ranged from 52.5%~87.5%. Four studies (50%) provided intervention based on virtual reality or virtual environment. The three (37.5%) provided intervention based on the protocol, and the other (12.5%) did wheelchair training. All studies reported significant effects of the intervention. Conclusion : This systematic review provided evidences to use proper intervention in the clinical fields. Various type of studies should be conducted to prove the effect of occupational therapy intervention for community mobility.