• Title/Summary/Keyword: levels of evidence

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Evaluation of Changes in Serum Thyroid Hormone Levels in Patients with Hepatitis B Infection

  • Hyeokjun Yun;Bo Kyeung Jung;In Soo Rheem;Kap No Lee;Jae Kyung Kim
    • International Journal of Advanced Culture Technology
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    • v.11 no.2
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    • pp.276-283
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    • 2023
  • Purpose: We aimed to determine the differences in the levels of serum thyroid hormone (free T4 [FT4]) and thyroid stimulating hormone [TSH]) as biomarkers for hepatitis B virus (HBV) infection status, with respect to age and sex. Methods: We retrospectively analyzed serum samples from 200 patients who underwent HBV testing from August 2022 to September 2022. Serum samples were collected from patients suspected of having HBV infection who visited this hospital. Thyroid hormone levels were measured, and patients were grouped according to age and sex. Results: Differences in TSH and FT4 levels in the serum of patients in the HBV-positive and -negative groups were not significant. Among the HBV-positive patients in the younger age group (<60 years), TSH and FT4 levels were 1.78 ± 0.09 µIU/mL (normal: 0.4-5.0 µIU/mL) and 1.24 ± 0.02 ng/mL (normal: 0.8-1.9 ng/mL), respectively, whereas among the HBV-positive patients in the older age group (≥60 years), TSH and FT4 levels were 2.22 ± 0.17 µIU/mL and 1.24 ± 0.07 ng/mL, respectively. Conclusions: The presence of HBV did not markedly affect serum thyroid hormone levels. Our findings shed light on the conflicting evidence on the association between thyroid hormone levels and HBV infection. We, Hyeokjun Yun and Bo Kyeung Jung are co-first authors which made substantial contribution equally to the conception and designed of this work. Jae Kyung Kim, In soo Rheem and Kap No Lee made significant contributions to the acquisition and analysis of the data.

Environmental Isotope-Aided Studies on River Water and Ground Water Interaction in the Region of Seoul Part I: Isotope Hydrology of the Shallow Alluvial Aquifer Han R. Valley (동위원소를 이용한 서울 지역의 강수와 지하수와의 상호연관성에 관한 연구 제 1 보 : 동위원소를 이용한 한강류역 충적대수층 지하수의 수문학적 연구)

  • Jong Sung Ahn;Jae Sung Kim;You Sun Kim;Peter Airey;Bryan Payne
    • Nuclear Engineering and Technology
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    • v.13 no.2
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    • pp.85-96
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    • 1981
  • A preliminary study of the isotope hydrology of the Han River Valley is presented. This investigation is part of a project whose overall aim is to relate the levels of heavy metal ions to the dynamics of the groundwater movement in order to establish (i) whether there is any evidence for the deterioration in groundwater quality associated with the release of industrial effluents and (ii) if so, to determine the migration path-ways. Evidence is adduced that the recharge mechanism is principally determined by the degree of urbanisation. In the metropolitan area of Seoul, river recharge dominates probably due to the combined effects of reduced infiltration and increased pumpage. In the inter-urban region, the major source of recharge is local precipitation. During the spring sampling period when the river levels were low. evidence was obtained for appreciable groundwater infiltration in the vicinity of the upstream transect. No significant correlations were observed between the levels of heavy metals in the groundwater, and the recharge mechanism, the distance from the river or the electrical conductivity of the samples.

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A Systematic Review on the Effects of Group Art Therapy on the Older with Dementia (집단미술치료가 치매 노인에게 미치는 영향에 대한 체계적 고찰)

  • Kim, Do-Yoen;Lee, Hye-Mi;Bae, Ji-Woo;Jung, Nam-Hae
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.4
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    • pp.71-81
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    • 2022
  • Purpose : This study aimed to present evidence by analyzing the characteristics and effectiveness of group art therapy interventions through an examination of domestic studies on group art therapy for older people with dementia. Methods : The database used DBpia, Riss, and Google Scholar, and the research period was from 2016 to November 2021. For the selected studies, the level of evidence was analyzed, bias evaluation was performed, and patient, intervention, comparison, and outcome were analyzed. For the evaluation of bias, the risk of bias assessment tool for non-randomized study (RoBANS) and Cochrane's risk of bias (RoB) were used. Results : As for the level of evidence of the included studies, level I consisted of five studies, and levels II and III each had one article. As a result of the bias evaluation of five studies through RoB, a "low risk of bias" was found for incomplete result data, selective result reporting, and others, except for four unclear evaluation areas. The "low risk of bias" ratio was 0~25 % in the evaluation of bias in two studies through RoBANS. For the evaluation tool, cognitive evaluation tool was used the most while mini-mental state examination-Korea was used the most frequently. For the intervention method, the most frequently used was group art therapy that employed recall in three studies, while collage, Korean painting, use of paper media, and procedural memory were used in each of the other studies. Each intervention was found to be significantly effective overall. Conclusion : This study provided clinical evidence by systematically reporting research on group art therapy for older people with dementia. In the future, it is necessary to check the effect of group art therapy on various areas other than cognition for older people with dementia. Moreover, the study should be conducted with the risk of bias sufficiently taken into consideration.

Clinical Practice Guideline for acupuncture in Post-stroke urinary retention (뇌졸중후 요저류에 대한 침치료 임상진료지침)

  • Lee, Ji-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Cho, Chung-Sik;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.37 no.1
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    • pp.1-9
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    • 2016
  • Objectives: Objectives : This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with Post-stroke Urinary Retention; PSUR. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUR compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: 4 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUR. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as SP6, CV3, CV6, CV4, SP9, BL28, BL23, BL22, KI3 or BL67, for 15-30 minutes. 20-140Hz frequency and 10-20 minutes of treatment is suggested if electro-acupuncture treatment is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for PSUR.

Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors (근거기반실무(Evidence-based Practice) 자기효능감, 교과목 요구도, 장애요인 및 촉진요인 탐색을 위한 혼합연구: 교수 및 임상실습 프리셉터를 중심으로)

  • Oh, Eui Geum;Yang, You Lee;Yoo, Jae Yong;Lim, Ji Yun;Sung, Ji Hyun
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.501-513
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    • 2016
  • Purpose: The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. Methods: For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. Results: Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. Conclusion: The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients (체외막산소화장치 적용 중환자를 위한 근거기반 간호 프로토콜 개발 및 효과 평가)

  • Kim, Soomi;Kim, Chul-Gyu
    • Journal of Korean Academy of Nursing
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    • v.53 no.3
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    • pp.275-294
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    • 2023
  • Purpose: This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol. Methods: The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol's effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses' outcome variables were evaluated using a questionnaire. Results: First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001). Conclusion: This protocol may help prevent infections and pressure injuries in patients, and improve nurses' satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

Development of evidence-based protocol to maintain high humidity of incubator in Extremely Low Birth Weight Infant (초극소 저출생체중아의 고농도 가습환경 유지를 위한 근거중심 프로토콜 개발)

  • Yu, Mi;Choi, Yun-Jin;Han, Li-La;Yun, Young-Mi;Bae, Geun-Ha;Lee, Ji-Eun;Park, Ji-Seon;Park, Ui
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.5-17
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    • 2009
  • Purpose: The purpose of this study was to investigate the current humidification state of incubator, the factors disturbing high humidification and to establish the evidence-based nursing protocol to maintain it. Methods: The subjects were 15 infants who were born with extremely low birth weight (ELBW) from May to October, 2007, and data were collected during the first 3 days and analyzed with SPSS WIN program. Results: The goal of humidity level in incubator was 95%, but mean humidity levels were 89.7%(1st day), 91.9%(2nd day), and 91.8%(3rd day)(p<0.001). The disturbing factors were opening frequency and duration of incubator door and window by caregivers. The handling of infants by nurses and doctors happened more frequently during the first day. Especially, nurses handled them more often than others, but the duration of opening during the invasive procedures by doctors was longer than others. The opening frequency had negative correlation with duration(r=-.779, p<.01). Conclusion: So the evidence-based protocol for maintaining high humidity in incubator for ELBW infants during the first 3 days and next 2 days was made. Furthermore we need to educate NICU nurses and doctors about minimal handling.

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Clinical Efficacy of Coptidis Rhizoma for Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis (비알콜성 지방간 환자에 대한 베르베린 투여 치료의 임상적 효능 연구: 체계적 문헌 고찰과 메타분석)

  • SongWon Park;MinJee Kim;Seong-Woo Lim
    • Journal of Korean Medicine for Obesity Research
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    • v.22 no.2
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    • pp.158-166
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    • 2022
  • Objectives: The purpose of this meta-analysis was to evaluate the effects of berberine on non-alcoholic fatty liver disease (NAFLD) through a systematic review and meta-analysis. Methods: We searched seven electronic databases for studies through October 2022. All randomized controlled trials (RTCs) of berberine were included. Data extraction and risk of bias assessments were performed by two independent reviewers. The RevMan 5.4.1 program was used for meta-analysis. Results: A total of 279 relevant studies were identified, and 6 eligible RCTs were included to study the efficacy berberine on NAFLD. The six selected trials are studies on the effect between berberine and conventional treatment combined treatment versus conventional treatment. Liver function tests, blood lipid levels, and blood glucose levels were assessed. Combination treatment with berberine, ursodeoxycholate acid, metformin, and monascus purpureus showed statistically significant improvements in liver function levels, blood lipid levels, and blood glucose levels compared to conventional treatment alone. However, there was no significant efficacy of berberine combination dietary, exercise than control group on NAFLD. The meta-analysis results of examining 4 RCTs comparing the therapeutic efficacy of berberine showed statistically significant improvement in the liver function test, blood lipids levels, blood glucose levels. Conclusions: This study suggests that berberine has positive efficacy on blood lipids, blood glucose liver function, fatty liver condition of NAFLD. However, the level of evidence is low because of small effect size,so further investigation is needed.

An Analysis of the Levels of Prospective Teachers' Comments on Elementary Mathematics Instruction (예비교사의 초등 수학 수업에 대한 비평 수준 분석)

  • Pang, Jeongsuk;Sunwoo, Jin
    • Journal of Elementary Mathematics Education in Korea
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    • v.19 no.4
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    • pp.625-647
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    • 2015
  • How a pre-service teacher understands and comments on mathematics instruction can serve as the foundation of her teaching expertise. Given that prospective teachers observe demonstrative mathematics teaching implemented by an in-service teacher and make a comment on it during their practicum period, this paper specified the levels of their ability in commenting on mathematics instruction and explored the characteristics of such levels. It is significant that this paper provides a systematic and comprehensive analysis of such levels in terms of topic, agent, stance, evidence, and alternative perspective. The results of this study showed that the commenting levels may be classified by Level 1 (fragmentary), Level 2 (inspective), and Level 3 (analytical), and that the most frequent level of this study was at Level 2. Multiple regression analysis demonstrated that stance is the most influential in determining the levels of comments among their analytic components. An analysis of the participants' anecdotes showed that the experience of observing demonstrative teaching during the practicum may have impact on the belief of mathematics instruction and self-image as a teacher. Building on these results, this paper provides implications of teacher preparation programs to enhance prospective teachers' ability to analyze elementary mathematics lessons.

Peroxiredoxins in Regulation of MAPK Signalling Pathways; Sensors and Barriers to Signal Transduction

  • Latimer, Heather R.;Veal, Elizabeth A.
    • Molecules and Cells
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    • v.39 no.1
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    • pp.40-45
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    • 2016
  • Peroxiredoxins are highly conserved and abundant peroxidases. Although the thioredoxin peroxidase activity of peroxiredoxin (Prx) is important to maintain low levels of endogenous hydrogen peroxide, Prx have also been shown to promote hydrogen peroxide-mediated signalling. Mitogen activated protein kinase (MAPK) signalling pathways mediate cellular responses to a variety of stimuli, including reactive oxygen species (ROS). Here we review the evidence that Prx can act as both sensors and barriers to the activation of MAPK and discuss the underlying mechanisms involved, focusing in particular on the relationship with thioredoxin.