• 대한간호학회지
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• 제28권4호
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• pp.941-957
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• 1998

The purpose of this study was to use meta-analysis to analyze result of 17 studies which investigated the effects of integrated programs, and 11 studies which examined the effects of exercise programs on pain, depression, and disability. The 28 studies analyzed in this work were selected from the following sources. MEDLINE Search, bibliographies of related studies, main academic journals of nursing in Korea, and journals on arthritis issues. For the analysis of the data, homogeniety of effect sizes which were calculated based on data in the 28 studies was tested and its average effect size was computed by using meta analysis software package which was developed by Song(1992, 1998). The results can be summarized as follows : 1) Homogeneity tests were conducted on integrated programs on pain. In the prelimiary homogeneity tests on effect size of all 17 studies, no homogeneity was found. When homogeneity tests on the effect size of the remaining 15 studies were performed, excluding two studies which had extremely larger effect size compared to other studies, the 15 studies were found to be homogeneous(Q=16.38, p=.23). The obtained average effect size, D(Mean Standardized Difference Between Means), was .25. When homogeneity tests on effect size on pain was conducted for the excercise programs, effect size for all nine studies were found to be homogeneous (Q=7.42, p=.49) and the average effect size D=.30. Therefore, Hypothesis 1 was rejected from the results, that an average effect size of the integrated programs on pain was not significantely different from that of the exercise programs on pain. 2) Since only two studies investigated the effect of exercise programs on depression, comparison between the average effect size of integrated programs and that of exercise programs on depression could not be conducted, and hypothesis 2 could not be tested. Thereby, only the average effect size of integrated programs on depression was obtained. Eight studies were tested to be positive on the homogeneity of effect sizes(Q=18.31, p=.02) at $\alpha$<.01 and its average effect size was D=.11. 3) For the analysis of integrated program on disability, 13 studies, except for four which had an extremely large effect size compared to the others were found to be homogeneous at $\alpha$<.01 (Q=22.30, p=.04) and the average effect size on disability was D=.16. For analysis of the exercize programs on disability, eight studies, except for one which had an extremely large effect size compared to others, were found to be homo geneous(Q=7.87, p=.34) and the average effect size on disability was D=.60. Therefore, Hypothesis 3 was accepted from the results that an average effect size of exercise programs on disability was significantly larger than that of integrated programs on disability.

• Clinics in Shoulder and Elbow
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• 제4권2호
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• pp.173-180
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• 2001

Aim: To evaluate validity and responsiveness of four shoulder scoring systems. Material and Method: Twenty-five cases of shoulder instability(22 traumatic, 3 non-traumatic) and twenty-three cases of rotator cuff tear(12 small or medium, 10 large or massive) treated surgically were evaluated with the Shoulder Function Score of the University of Pennsylvania(Penn FS), Constant Score, UCLA Shoulder Rating Scale and Simple Shouler Test(SST), preoperatively and at final follow-up. The average follow-up was 16.0 months in instability group and 17.5 months in rotator cuff tear group. Using the SPSS program, Pearson linear correlation coefficiency(PLCC) between the scores were calculated. And to assess the construct validity, PLCC between patients' satisfaction and the scores were also calculated. Responsiveness was measured by the standardized response mean(SRM). Result: In instability group, correlation between the scoring systems was low preoperatively except between Constant and SST, but high after operation. Patients' satisfaction with the scores showed low PLCC preoperativley, but high PLCC postoperatively. SRM was high in PENN and UCLA, but when the satisfaction segment of the score was eliminated from UCLA, the SRM was the lowest. In rotator cuff tear group, there was high correlation between the scores not only preoperatively but postoperatively. And the patients' satisfaction matched well with the scores. SRM was particularly high in UCLA and SST. Even when satisfaction segment was eliminated from UCLA, the SRM was still the highest. Conclusion : Evaluation by the 4 scoring systems investigated in the study showed less consistency in instability than rotator cuff tear in terms of correlation and validity. Responsiveness was generally higher in rotator cuff tear group than in instability group except for Pennsylvania Shoulder Function Score. Therefore it is construed that use of any among the four scoring systems doesn't make difference in evaluation of rotator cuff lesions. However in instability group, care is needed because different result may be obtained according to the selection of a scoring system.

• Restorative Dentistry and Endodontics
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• 제23권2호
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• pp.618-629
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• 1998

CAD/CAM-fabricated ceramic restorations nowadays are used as alternatives of amlagam and posterior composite resin restorations, especially in the cases of inlay restorations. But the reported results on marginal and internal fit of CAD/CAM-fabricated ceramic inlay have showed considerable difference. In this study, to evaluate the marginal and internal fit of CEREC2-fabricated ceramic inlay restoration and to compare with the fit of gold inlay and amalgam restoration, standardized Class II MO cavities were prepared in forty extracted caries-free human premolars. The teeth with prepared cavities were divided into 4 groups of ten teeth each. In group 1, CEREC2-fabricated ceramic inlays were treated with Scotchbond Multi-Purpose Plus(SMP plus) and cemented with Scotchbond Resin Cement. In group 2, casted gold inlays were cemented in the same method as in group 1. In group 3, casted gold inlays were cemented with zinc-phosphate cement. And in group 4, the prepared cavities were restored with amalgam. Restored teeth were thermocycled, stored in 1% methylene blue for 24 hours, and sectioned faciolingually and mesiodistally using EXAKT. Sectioned surfaces were observed with stereomicroscope and the gaps were measured at 9 points of mesiodistally sectioned surface and 7 points of faciolingually sectioned surface. The measured data were treated by Kruskal-Wallis one way ANOVA and Student-Newman-Keuls test. 1. The differences among measured gaps at each points were statistically significant for 4 experimental groups (P<0.05). 2. There were statistically significant differences in the measured gaps at each points between group 1 and group 2, group 1 and group 3, group 1 and group 4, group 2 and group 4, and group 3 and group 4 (P<0.05). 3. There were not statistically significant differences in the measured gaps at each points between group 2 and group 3 (P>0.05). 4. In the cases of inlay restorations(group 1, group 2, group 3), the gaps at internal line angle(distopulpal, axiogingival, faciopulpal, linguopulpal line angle) had a tendency to increase. In the cases of amalgam restorations(group 4), the gaps at occlusal margin, gingival margin and axiogingival line angle were greater than those at the other parts of cavities. 5. In CEREC2-fabricated ceramic inlays which were treated with Scotchbond Multi-Purpose Plus and cemented with Scotchbond Resin Cement, the mean gaps were $111{\mu}m$ at cavity margins, $168{\mu}m$ at vertical walls of cavities, $225{\mu}m$ at internal line angles and $123{\mu}m$ at cavity floors.

• 말소리와 음성과학
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• 제6권2호
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• pp.73-79
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• 2014

Alveolar fricative sounds /s/ and /s'/ are learned last for normal children in the speech development process for Koreans. These are especially difficult to articulate for hearing-impaired children often causing articulation errors. The acoustic phonetic evaluation uses testing tools to provide indirect and object information. These objective resources can be compared with standardized resources on speech when interpreting the results of a test. However, most previous studies in Korea did not consider acoustic studies that used the spectrum moment values of hearing-impaired children. Therefore, this study was conducted to compare the characteristics of hearing-impaired children's pronunciation of fricative sounds using spectrum moment values. For this purpose, the study selected a total of 10 hearing-impaired children (5 boys and 5 girls) currently in 3rd or 5th grade and attending one of the elementary schools in Seoul or Gyeonggi-do. For the selection process, their age, type of hearing aid, implantation of hearing aid (CI) before two years of age, hearing capacity (dB) before and after wearing the hearing aid, duration of speech rehabilitation, and time of learning alveolar fricative sounds were all considered. Also, 10 normal children (5 boys and 5 girls) were selected among 3rd or 5th grade students attending one of the elementary schools in Seoul or Gyeonggi-do. The subjects were asked to read the carrier sentence, "I say _______," including a list of 12 meaningless syllables composed of CV and VCV syllables, including alveolar fricative sounds /s/ and /s'/ and vowels /a/, /i/, and /u/. The recorded resources were processed through the Time-frequency Analysis Software Program to measure M1 (mean), M2 (variance), M3 (skewness), and M4 (kurtosis) of the fricative noise. No significant differences were found when comparing spectrum threshold values in the acoustic phonetic characteristics of hearing-impaired children and normal children in alveolar fricative sound pronunciation according to vowels /a/, /i/, and /u/, alveolar fricative sounds /s/ and /s'/, and syllable structure (CV, VCV) other than, for M3 in the comparison of groups according to disability. In the comparison of syllable structures, there were statistically significant differences in M1, M2, M3, and M4 with clinical significance. However, there was no significant difference in results when comparing the alveolar fricative sounds according to the vowels.

• 한국가족관계학회지
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• 제22권4호
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• pp.181-204
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• 2018

Objectives: The aim of this study is to integrate the results of the previous studies from 1900 to 2016 according to the types of dependent variables individually and statistically to obtain the results of the overall level of the marital education program I need to figure it out. In other words, the general and valid study on the overall effectiveness of the marriage education program will lead to more concluded conclusions and draw up an integrated and holistic conclusion about the effectiveness of the marriage education program. Method: The purpose of this study was to investigate the effect of married couples' education program on married couples' education program. The results of this study are as follows. First, Comprehensive Meta-Analysis. In other words, funnel plot, forest plot, and trim & fill were used to analyze all the variables related to the education of the couple, and homogeneity test After choosing an analytical model for the analysis, we calculated the 'standardized mean difference' effect size (d) that can compare different individual studies through the analytical model. The results of this study are as follows. Results: The purpose of this study was to investigate the overall effect size of domestic couples education programs after 1990, and to investigate the effect sizes of dependent variable types and program - related variables. First, the total effect size of the domestic marriage education program was close to the level of the large effect size and had a substantial and preventive effect. Self-esteem, communication, marital adjustment, emotion, and self control have a substantial and prophylactically significant change depending on the type of subordinate variables related to the marital education program But there was no change in origin family and life satisfaction. Third, as a result of the categorization of the dependent variable categorization of the Korean couple education program, it was found that the marital relations of the participant in the individual inner and the marital relations The effect was significant enough to change. Fourth, Korean couple education program was most effective when mixed age couples were participated in various family life cycle. Conclusions: Based on the results of this study, it is necessary to study more deeply about marital education program effect of marriage education for various special groups such as married couples who are in a crisis of divorce, . It also means that the results of the research for the last 30 years from 1900 to 2016 were comprehensively and systematically summarized through meta - analysis. The results of this study provide information on how to provide the most effective couples education programs for practitioners in the field. The result of this study will be the data of judgment about how to organize the marital education program for people of any ages and characteristics in the future.

• Journal of Nutrition and Health
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• 제54권5호
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• pp.515-533
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• 2021

본 연구는 유아를 대상으로 한 영양교육의 중재효과를 평가하고, 과일·채소의 선호도 및 영양지식 향상에 효과적인 영양교육 유형을 분석하기 위해 체계적 문헌고찰과 메타분석을 수행하였다. 메타분석의 효과크기 결과에 따르면 유아 대상 영양교육은 과일·채소 선호도 및 영양지식을 유의적으로 향상시켰으며, 일반영양교육 보다는 과일·채소 중심 영양교육이 유아의 과일·채소 선호도 및 영양지식 향상에 더 효과적이었다. 또한 유아의 과일·채소 선호도 및 영양지식 향상을 위해서는 원예활동, 요리활동 및 오감활동 등의 직접 노출 활동을 포함하는 영양교육이 더욱 효과적이라는 것을 확인할 수 있었다. 본 연구는 유아대상 영양교육의 효과를 입증했을 뿐만 아니라, 유아의 과일·채소 선호도 및 영양지식 향상에 가장 효과적인 영양교육의 형태를 도출했다는 점에서 의의가 있다.

• 한방비만학회지
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• 제20권2호
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• pp.178-192
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• 2020

Objectives: The present study aimed to compare the impacts of cognitive behavioral therapy (CBT) and behavioral treatment (BT) on weight loss and psychological outcomes among patients with three different subtypes of obesity: simple obesity, obesity with binge eating disorder, and obesity with depression. Methods: Embase, PubMed, the Cochrane Central Register of Controlled Trials, Research Information Sharing Service, and Korean Studies Information Service System were systematically searched for randomized controlled trials conducted on or before May 2020, that used CBT to treat obesity. Methodological quality was assessed using Cochrane's risk of bias tool 2 and publication bias was evaluated through the funnel plot using the trim and fill method, Egger's test, and Begg and Mazumdar rank correlation test. A meta-analysis was conducted using a random-effects model and the standardized mean difference with 95% confidence interval (CI) was used to determine effect size. Results: Twenty-one randomized controlled trials with a total of 22 intervention arms and 2,590 patients were included. Our study results revealed that the effects of CBT, compared with BT, on weight loss distinctly differed across all patient subgroups. In the simple obesity group, CBT was more effective than BT (Hedges' g=0.138, CI=0.012~0.264); however, in the obesity with binge eating disorder group, BT was more effective than CBT (Hedges' g=-0.228, CI=-0.418~-0.038); in the obesity with depression group, the effect of CBT was not statistically different from that of BT (Hedges' g=0.276, CI=-0.307~0.859). Further studies with larger sample sizes are required to confirm the outcomes observed in this study. Conclusions: Our results indicated that the effects of CBT on obesity treatment vary based on patient subtype. Therefore, our findings suggest that CBT or BT should be selectively recommended as a treatment strategy for different obesity subtypes.

• Tuberculosis and Respiratory Diseases
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• 제84권1호
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• 한국산학기술학회논문지
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• 제22권1호
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• pp.520-530
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• 2021

목표: 본 연구는 음악요법이 치매 노인의 인지기능, 초조행동, 불안, 우울에 미치는 영향을 규명하는 것을 목적으로 한다. 방법: 2010년부터 2019년까지 PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar, PsycINFO에서 종합적인 문헌검색을 하였고 메타분석에서는 RevMan 5.4 프로그램을 사용하여 표준화된 평균 차이(Hedge's g)와 95% 신뢰 구간은 요약 측정으로 산출하고 랜덤 효과 모델과 역분산 방법을 적용하였다. 총 13개의 연구가 포함되었으며, 모두 오류 위험 평가를 위한 코크란 평가도구를 근거로 질 평가를 하였다. 결과: 효과 크기(Hedge's g)는 1차 결과 변수인 인지기능 0.31[95% CI:-0.02, 0.65], 초조행동 -0.03[95% CI: -0.17, 0.11], 2차 결과 변수인 불안 -0.61[95% CI: -1.17, -0.05], 우울 -0.44[95% CI: -0.88, 0.00]이었다. 음악중재 유형별 하위그룹 분석 결과 복합음악요법이 치매 환자의 인지기능(g=0.45[95% CI: 0.03, 0.87])에 유의한 증가 효과가 있는 것으로 나타났다. 결론: 음악요법은 불안과 우울을 감소시키는 데 유의한 효과를 보였으며, 복합음악치료는 치매 환자의 인지기능 개선 효과를 보였다.

• 한국컴퓨터정보학회논문지
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• 제27권7호
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• pp.145-152
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• 2022

뇌졸중은 균형 장애와 보행능력에도 직접적인 영향을 미친다. 본 연구는 고유수용성신경근촉진법이 뇌졸중 환자의 균형 및 보행에 미치는 영향 연구를 목적으로 한다. 따라서 뇌졸중 환자에게 고유수용성 신경근촉진법을 적용하여 균형과 보행 능력을 평가하는 모든 무작위 배정 연구를 포함하였다. 본 연구는 메타분석에서 있어서 꼭 필요한 프리즈마 가이드 라인을 준수하였다. Cochrane library, CINAHL, Pubmed에서 2021년 11월까지 발행된 연구를 포함하였고, 그 연구들은 고유수용성신경근촉진법을 적용한 무작위 배정 연구들이다. 데이터베이스에서 검색된 1091개의 논문 중 18개의 연구를 메타분석을 시행하였고, 메타분석은 R 프로젝트 4.0.2를 사용하여 시행하였다. 본 연구의 전체 효과 크기는 0.56으로 중간 정도로, 균형과 보행에 관한 척도에 대한 효과 크기도 중간정도 산출되었다. 무작위 배정 정도를 나타내는 페드로 점수는 18점 만점에서 6.63으로 비뚤림 위험이 낮은 것으로 나타났다. 이러한 결과는 PNF가 뇌졸중 환자의 균형 및 보행을 향상시키는 효과적인 중재 방법임을 알 수 있다.