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The Effects of Advance Care Planning on Decision Conflict and Psychological Distress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Yeun, Young-Ran
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.144-153
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    • 2021
  • Purpose: Advance care planning (ACP) is widely understood to improve end-of-life care. This systematic review and meta-analysis aimed to examine the effects of ACP interventions on decision conflict and psychological distress. Methods: A search of PubMed, CINAHL, CENTRAL, EMBASE, KISS, KoreaMed, and RISS was conducted in November 2020. The study included randomized controlled trials. Data were pooled using fixed- and random-effects models. Results: Fourteen studies were identified that cumulatively included 1,548 participants. ACP interventions were effective in alleviating decision conflict (d=-0.53; 95% CI: -0.83 to -0.23), depression (d=-1.22; 95% CI: -1.71 to -0.74) and anxiety (d=-0.76; 95% CI: -1.12 to -0.39). Conclusion: ACP interventions have significant positive effects on reducing decision conflict and psychological distress. A high level of bias was shown related to allocation concealment and blinding. The results of this study are expected to be useful for end-of-life care providers to improve the effectiveness of ACP interventions.

Ryodoraku Application for Diagnosis : a Review of Korean Literature (양도락의 진단적 활용에 대한 문헌 고찰 - 국내문헌을 중심으로 -)

  • Noh, Seung-Hee;Kim, Kun-Hyung;Yoon, Young-Jin;Yang, Gi-Young;Kim, Jae-Kyu;Lee, Byung-Ryul;Yim, Yun-Kyoung
    • Korean Journal of Acupuncture
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    • v.28 no.4
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    • pp.125-135
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    • 2011
  • Objectives : This study is aimed to evaluate the diagnostic value of Ryodoraku for traditional Korean medicine practice reported in the Korean literature. Methods : A search of seven Korean databases was performed up to May 2011 using the search term 'Ryodoraku(in Korean)'. All clinical studies on diagnostic Ryodoraku characteristics were included. Results : The search yielded 59 studies, of which 5 were considered suitable for this analysis. Four were observational studies. Only one was a controlled trial. Average Ryodoraku score(RS), mean values for each measure point, physiologic limit, number of Pyesaek and Gyeokcha, and pattern classification were used as references for the analysis. Correlations were observed between average RS and idiopathic Parkinson's disease, some sub-groups of respiratory disease, chronic low back pain, and menopause. Some mean values for measure points showed particularly high or low tendencies in patients with idiopathic Parkinson's disease, chronic low back pain, and menopause. Positive correlations were observed between the number of Pyesaek and H-Y stage in idiopathic Parkinson's disease and F2(肝) and the modified Kupperman's index with menopausal women. The four classes, organized based on Ryodoraku pattern, showed differences in various characteristics. Conclusions : Since only five studies met the experimental conditions, this evaluation of the diagnostic value of Ryodoraku in various situations is limited. Future studies should be conducted using various physiologic and pathologic situations.

Presenteeism in Clinical Nurses: An Integrative Literature Review (임상간호사의 프리젠티즘 연구에 관한 통합적 고찰)

  • Kwon, Minjung;Choi, Eunsuk
    • Korean Journal of Occupational Health Nursing
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    • v.26 no.3
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    • pp.160-171
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    • 2017
  • Purpose: This review aimed to integrate the results of studies related to presenteeism in clinical nurses and to suggest directions for future research. Methods: The search for relevant studies was conducted using six data bases according to predetermined index terms, "$nurs^*$" and "presenteeism." Thirteen studies that met the inclusion criteria were selected and analyzed. Results: This review found that the conceptual use and scope of presenteeism were not consistent among the studies. Most studies investigated the nurses' health-related variables as the most important factors and reported their positive association with presenteeism. Presenteeism was also found to be associated with job stress, job satisfaction, social support, and organizational culture and had a negative impact on nursing outcomes such as patient safety. Conclusion: The research on presenteeism can be used as a way to explain outcomes in the field of nursing where direct measurement of productivity is difficult. Presenteeism is a multidimensional problem, and a theoretical foundation is needed to explain the presenteeism of clinical nurses.

Systematic Review on Herbal Treatment for Obesity in Adults (성인비만의 한약치료 임상연구에 대한 체계적 고찰)

  • Han, Kyungsun;Lee, Myeong-Jong;Kim, Hojun
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.4
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    • pp.23-35
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    • 2016
  • Objectives This systematic review is to support the effectiveness of herbal medicine for the treatment of simple obesity in adults. Methods A total of 8 electronic databases were searched in English, Chinese and Korean. Standard methodologies for the systematic review were used to search, analyze and synthesize data based on NECA's guideline for undertaking systematic review and meta-analyses for intervention. Results After screening 1781 potential articles, we identified 13 randomized controlled trials (RCTs). We conducted a meta-analysis for the study using Bangpungtongsung-san and Taeeumjowi-tang to evaluate the effectiveness of herbal medicines on weight loss compared to placebo control. Both herbs showed positive effect in weight, body mass index and waist circumference. In an analysis comparing herbal effects considering constitutions showed that proper treatment can lower adverse events. Conclusions Our results provide evidence that herbal medicine can be an effective treatment for the obesity compare to placebo or to conventional medicine without serious adverse events. Further study is needed to evaluate effectiveness of herbal medicines considering personalized treatment and its safety.

Chinese Medicine including Chuna Manual Therapy for Osteoarthritis : A Systematic Review (골관절염에 대한 추나요법을 포함한 중의학치료의 효과 : 체계적 문헌 고찰)

  • Kim, Han-Kyul;Gwon, Tae-U;Kim, Byung-Jun
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.1
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    • pp.11-21
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    • 2018
  • Objectives: To evaluate the evidence supporting the effectiveness and safety of Chinese medicine, including Chuna manual therapy, for the treatment ofosteoarthritis. Methods: We conducted a search of 8 electronic databases(Pubmed, Web of Science, EMBASE, Cochrane Library, CAJ, KISTI, NDSL, and RISS) to find all randomized controlled clinical trials that discuss Chuna manual therapy forosteoarthritis till May 2018. Results: Our inclusion criteria selected 7eligible RCTs involving 633 participants. The meta-analysis of 6 studies showed positive results for the useof Chinese medicine, including Chuna manual therapy, for treating knee osteoarthritis. There was no evidence of worsening symptoms or any adverse events. Conclusions: Our systematic review found favorable evidence regardingthe effectiveness of Chinese medicine, including Chuna manual therapy, for treating knee osteoarthritis. However, our systematic review had several limitations owingto the low quality of original articles andadditionalclinical trials would be necessary for stronger evidence.

Comparison of Extracorporeal Shock Wave Therapy Versus Injection Therapy for Shoulder Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Dajeong Kim;Hyunjoong Kim
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.48-55
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    • 2023
  • Objective: The purpose of this study is to compare the effects of extracorporeal shock wave therapy (ESWT) and injection therapy through qualitative and quantitative analysis by synthesizing randomized controlled trials (RCTs) conducted on patients with various shoulder diseases. Design: A systematic review and meta-analysis of randomized controlled trials Methods: This review conducted a literature search through international electronic databases in January 2023 to compare the effects of ESWT and injection therapy. Qualitative analysis was performed as a risk of bias tool, and quantitative analysis was synthesized with a random effect model to show the effect size as a standardized mean difference (SMD). Results: Five RCTs involving 298 individuals with shoulder disorders were included in this systematic review and meta-analysis. ESWT showed a moderate effect on pain (SMD=-0.44; 95% CI, -0.95 to 0.06) and a large effect on shoulder function (SMD =-0.81; 95% CI, -1.70 to 0.07) than injection therapy. A significant difference was found in the shoulder range of motion, showing a large effect size (SMD=1.50; 95% CI, 0.58 to 2.43). Conclusions: When considering treatment options for the management of patients complaining of shoulder disorders, it is appropriate to recommend ESWT first rather than injection therapy to increase the range of motion of the joint. In addition, ESWT is safe for pain control and shoulder function improvement, and a positive prognosis could be expected.

Soy Supplementation Does Not Affect Serum Adiponectin Levels in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Jahangir Karimian;Parivash Shekarchizadeh-Esfahani
    • Clinical Nutrition Research
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    • v.13 no.2
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    • pp.130-138
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    • 2024
  • Numerous studies have indicated that low levels of serum adiponectin are linked with the development of various chronic diseases. While some recent research has suggested that soy has a positive impact on serum adiponectin levels, the results are inconsistent. Therefore, we aim to conduct a thorough systematic review and meta-analysis of randomized controlled trials (RCTs) that investigate the effects of soy on serum adiponectin levels in adults. The search was conducted until March 2024 on PubMed, Scopus, Web of Science, and Cochrane Library databases to identify RCTs that studied the effects of soy supplementation on serum adiponectin levels. A random-effects model was used to pool the weighted mean differences (WMDs). Ten and nine RCTs were selected for the systematic review and meta-analysis, respectively. After analyzing data from 9 eligible RCTs, it was found that soy supplementation did not significantly impact the concentrations of adiponectin (WMD = -0.24㎍/mL; 95% confidence interval, -1.56 to 1.09; p = 0.72). However, there was significant heterogeneity between the studies (I2 = 89.8%, p < 0.001). Sensitivity analysis showed that overall estimates were not affected by the elimination of any study. We did not observe any evidence regarding publication bias. In conclusion, soy supplementation did not have a significant effect on adiponectin levels in adults. However, further RCTs are needed with longer intervention duration, higher doses, and studies conducted in different countries.

The Development of Travel Demand Nowcasting Model Based on Travelers' Attention: Focusing on Web Search Traffic Information (여행자 관심 기반 스마트 여행 수요 예측 모형 개발: 웹검색 트래픽 정보를 중심으로)

  • Park, Do-Hyung
    • The Journal of Information Systems
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    • v.26 no.3
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    • pp.171-185
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    • 2017
  • Purpose Recently, there has been an increase in attempts to analyze social phenomena, consumption trends, and consumption behavior through a vast amount of customer data such as web search traffic information and social buzz information in various fields such as flu prediction and real estate price prediction. Internet portal service providers such as google and naver are disclosing web search traffic information of online users as services such as google trends and naver trends. Academic and industry are paying attention to research on information search behavior and utilization of online users based on the web search traffic information. Although there are many studies predicting social phenomena, consumption trends, political polls, etc. based on web search traffic information, it is hard to find the research to explain and predict tourism demand and establish tourism policy using it. In this study, we try to use web search traffic information to explain the tourism demand for major cities in Gangwon-do, the representative tourist area in Korea, and to develop a nowcasting model for the demand. Design/methodology/approach In the first step, the literature review on travel demand and web search traffic was conducted in parallel in two directions. In the second stage, we conducted a qualitative research to confirm the information retrieval behavior of the traveler. In the next step, we extracted the representative tourist cities of Gangwon-do and confirmed which keywords were used for the search. In the fourth step, we collected tourist demand data to be used as a dependent variable and collected web search traffic information of each keyword to be used as an independent variable. In the fifth step, we set up a time series benchmark model, and added the web search traffic information to this model to confirm whether the prediction model improved. In the last stage, we analyze the prediction models that are finally selected as optimal and confirm whether the influence of the keywords on the prediction of travel demand. Findings This study has developed a tourism demand forecasting model of Gangwon-do, a representative tourist destination in Korea, by expanding and applying web search traffic information to tourism demand forecasting. We compared the existing time series model with the benchmarking model and confirmed the superiority of the proposed model. In addition, this study also confirms that web search traffic information has a positive correlation with travel demand and precedes it by one or two months, thereby asserting its suitability as a prediction model. Furthermore, by deriving search keywords that have a significant effect on tourism demand forecast for each city, representative characteristics of each region can be selected.

New treatment method for pain and reduction of local anesthesia use in deep caries

  • Yun, Jihye;Shim, Youn-Soo;Park, So-Young;An, So-Youn
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.5
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    • pp.277-285
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    • 2018
  • Chemo-mechanical caries removal methods are known to be more effective compared with conventional methods in pain reduction. $Carie-care^{TM}$, a chemo-mechanical caries removal agent, was introduced in 2010 but a systematic review of its efficacy has not yet been performed. The purpose of this study was to investigate the effectiveness of $Carie-care^{TM}$ on the outcomes of treatment of caries in children and adolescents. The primary outcome was pain while the secondary outcomes included complete caries removal (CCR), time, need for local anesthesia and behavioral response changes. A Comprehensive literature search was performed in PubMed, EMBASE, and the Cochrane Library up to 30 September 2018. The following keywords were used in the search: 'chemo-mechanical caries removal agent', 'dental caries', 'Carie-care', 'chemo-mechanical caries removal', 'chemo-mechanical caries excavation', other related keywords, and their combinations. From 942 studies identified, 16 were analyzed. Finally, 4 studies met the eligibility criteria and 260 teeth in 120 children and adolescents were included in this review. This review showed that $Carie-care^{TM}$ reduces pain during caries treatment but requires a longer time for effective treatment than conventional methods. Local anesthesia was not required in the Chemo-mechanical caries removal (CMCR) group. In addition, dental anxiety decreased compared to the control group, and co-operation was more positive. Therefore, it may be a useful alternative to conventional methods in children and adolescents, but further verification through additional studies is needed.

Evaluation of the Effect of Clinical Practice Guideline using Systematic Review (체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가)

  • Lee, Sun-Hee;Ha, Gwi-Yeom;Kim, Ju-Hye;Seo, Ju-Hyun;Kim, Hyun-Mi
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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