• Title/Summary/Keyword: medical manager

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The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.75-101
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    • 2021
  • Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

Herbal Medicine for the Treatment of Non-Erosive Reflux Disease: A Systematic Review and Meta-Analysis Protocol

  • Minjeong Kim;Chaehyun Park;Jae-Woo Park;Jinsung Kim;Seok-Jae Ko
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1176-1185
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    • 2023
  • Introduction: Non-erosive reflux disease (NERD) is the most common subtype of gastroesophageal reflux disease (GERD). This study aims to synthesize evidence on the efficacy and safety of various herbal medicines for the treatment of NERD. Methods and analysis: Ten electronic databases will be examined: MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, Embase, Allied and Complementary Medicine Database, China National Knowledge Infrastructure Database, Citation Information by Nii, Korean Medical Database, Korean Studies Information Service System, National Digital Science Library, and Oriental Medicine Advanced Searching Integrated System. All randomized controlled trials published from inception to May 2023 that meet the eligibility criteria will be selected. Two independent researchers will extract data, such as publication year, study design, intervention details, outcome measures, main results, and adverse events. The risk of bias and quality of evidence will be assessed, and subgroup analyses will be performed according to the type of control intervention and herbal medicine. The analysis process will be conducted using Review Manager 5.4 software. Discussion: This review will present a summary and rationale for herbal medicine's effectiveness in treating NERD. The findings of this review can help those who want to apply herbal medicine to the treatment of NERD.

The Task and Role of the Quality Improvement Facilitator (QI전담자의 주요 업무 및 역할 규명)

  • Kim, Moon-sook;Kim, Hyun-ah;Kim, Yoon-sook
    • Quality Improvement in Health Care
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    • v.21 no.2
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    • pp.40-56
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    • 2015
  • Objectives: To outline overall duties of quality improvement (QI) performers within a health care organization, thus describing their key tasks, including task element-related frequency, importance and difficulty in enough detail. Methods: A DACUM (Developing A CurriculUM) workshop took place to outline overall job activities of QI performers. To examine the scope of their duty and task, we performed a questionnaire survey of 338 QI performers from 111 hospitals. Results: The results of our survey showed that for the task assigned to each QI performer, there were 10 duties, 31 tasks and 119 task elements. Respondents cited a project planning as the most frequent/important duty, and a research was the highest level of difficulty in their duty. They also said that the most frequent task was index management, the most important task was a business plan, and the highest level of difficulty was a practical application of QI research. QI performers added that the most frequent task element was receipt of patient safety reporting in patient safety system, the most important task element was an analysis for patient safety and its improvement, and the highest level of difficulty was a regional influence analysis related to the patient safety and its improvement. Conclusion: To ensure that QI performers play a pivotal role as a manager to better improve patient safety and the quality of health care services, proper training program for them should be developed by reflecting the results of our study.

Short-course Versus Long-course Preoperative Radiotherapy plus Delayed Surgery in the Treatment of Rectal Cancer: a Meta-analysis

  • Liu, Shi-Xin;Zhou, Zhi-Rui;Chen, Ling-Xiao;Yang, Yong-Jing;Hu, Zhi-De;Zhang, Tian-Song
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5755-5762
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    • 2015
  • Background: Short-course preoperative radiation (SCRT) with delayed surgery was found to increase pathologic complete response (pCR) rates in several trials. However, there was no clear answer on whether SCRT or long-course chemo-radiotherapy (LCRT) is more effective. Therefore we conducted this meta-analysis to evaluate the safety and efficacy of SCRT versus LCRT, both with delayed surgery, for treatment of rectal cancer. Materials and Methods: The literature was searched from PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov up to November, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the level of evidence. Review Manager 5.3 was employed for statistical analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results: Three RCTs, with a total of 357 rectal cancer patients, were included in this systematic review. Metaanalysis results demonstrated there were no significantly differences in sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate. Compared with SCRT, LCRT was associated with significant increase in the pCR rate [RR=0.49, 95%CI (0.31, 0.78), P=0.003]. Conclusions: In terms of sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate, SCRT with delayed surgery is as effective as LCRT with delayed surgery for management of rectal cancer. LCRT significantly increased pCR rate compared with SCRT. Due to risk of bias and imprecision, further multi-center large sample RCTs were needed to confirm this conclusion.

The Effect of Case Management Services for High-risk Medicaid Beneficiaries (고위험군 의료급여 수급권자에 대한 의료급여 사례관리 효과)

  • Ahn, Young Jin;Choi, Yun-Kyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.8
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    • pp.5430-5441
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    • 2015
  • The purpose of this study is to investigate the effect of Medicaid case management (CM) performed by Medicaid case managers on health management and to examine the overall health care utilization with high risk Medicaid beneficiaries. The subjects involved in this research were 113 Medicaid beneficiaries who were recipients CM in Y-gu between October 1st, 2012 and March 31th, 2013. The results show that there were significant differences in 'recognition of own disease', 'understanding of Medicaid policy', 'medication' and 'healthy lifestyle'. Also there were significant differences in 'appropriateness of health utilization', 'number of medical institutions', 'level of social isolation' and 'general health status'. In addition, significant differences were found in Medicaid days, outpatient days, medication days and Medicaid costs. It was found that the Medicaid CM had a positive effect on health care utilization. The study suggests the need of strengthening and diversifying Medicaid CM as well as supporting the management and monitoring after the termination of Medicaid CM.

Effects of a Program Using Video-Audio Media on Knowledge Level and Compliance of Sick Role for Patients Undergoing Coronary Angiography (동영상프로그램이 관상동맥조영술환자의 질병지식과 환자역할이행에 미치는 효과)

  • Kang, Myung-Kyung;Shon, Kyung-Hee;Lee, Gab-Nyea
    • The Journal of Korean Academic Society of Nursing Education
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    • v.17 no.1
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    • pp.100-109
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    • 2011
  • Purpose: This study was conducted to investigate how a program using video-audio media will affect the knowledge level and compliance of the sick role of patients admitted for coronary angiography. Method: A non-equivalent control group non-synchronized design was used. Subjects were selected from patients admitted to the internal ward of a hospital in B city for coronary angiography between July 1 and September 31, 2010. Twenty subjects were assigned to the control and experimental group, respectively. Video-audio media developed by the authors was used as the experimental tool. The effects of the program were analyzed using a knowledge assessment tool and questionnaire for compliance of the sick role. The SPSS/WIN 14.0 program was used for data analysis. Result: The first hypothesis that the "experimental group receiving the program using video-audio media will report a higher level of knowledge compared to the control group" was supported. The second hypothesis that the "experimental group that received the program using video-audio media will report a higher level of compliance of sick role" was supported. Conclusion: The program using video-audio media was effective in enhancing patients' knowledge about the disease and compliance of the sick role. Thus, it can be an effective nursing intervention for patients with coronary artery disease.

Efficacy of Herbal Medicines for the Treatment of Psoriasis : Systematic Review and Meta-analysis (건선의 한약치료 효과에 대한 체계적 문헌 고찰과 메타 분석)

  • Ryu, Deok-Hyun;Ryu, Deok-Seon;Roh, Seok-Sun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.1-19
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    • 2017
  • Objectives : This study aimed to validate the effect of herbal medicine intervention to relieve the symptoms of psoriasis using systematic review and meta-analysis and provide the newest reason of effectiveness of Korean medicine to psoriasis. Methods : Data were collected through electronic database including Pubmed, Cochrane CENTRAL, NDSL OASIS, Koreantk. Two experts assessed risk of bias of randomized controlled trials by Cochrane group's Risk of Bias tool after searching, reviewing and selecting papers. Data were analyzed using Review Manager(RevMan) 5.3 and Comprehensive Meta Analysis 2.0. Results : Total number of selected trials was 16 randomized controlled trials. This study evaluated the risk of bias and effectiveness of herbal medicine to psoriasis. There were high frequency uncertain in selection bias, performance bias and detection bias. In this meta-analysis, Korean medicine treatment was more effective than western medicine (ES:0.507, 95%CI:0.147-0.867) and placebo (ES:0.955, 95%CI:0.598-1.312). Conclusions : Herbal medicine intervention can be an effective for treatment in psoriasis. But enhancing levels of evidence, we must try to accumulate clinical researches of herbal medicine to psoriasis in Korea.

A Study on the Measurement of Bacterial Contamination of MRI Examination Equipment and Disinfection Conditions (자기공명영상검사장비의 세균오염도 측정 및 소독에 관한 연구)

  • Jeung, Seung-Woon;Lim, Chung-Hwan;You, In-Gyu
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.665-672
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    • 2013
  • In radiology department, where patients with a variety of diseases receive their tests, there is a large possibility of cross contamination of nosocomial infection. Magnetic resonance imaging (MRI) tests take particularly more time than other tests do, which increases the possibility of being exposed to cross contamination. Therefore, this research examines the status of MRI equipment sterilization and investigates the bacterial distribution on head coils, which have the most frequent contact with patients, patient fixation blocks, and bores, which are confined spaces. The status of MRI equipment disinfection was examined by a survey targeting 150 employees, and the distribution of bacteria was measured in ten medical facilities. The result of bacterial distribution tests on MRI equipment showed various bacteria, including Staphylococcus, Acinetobacter, Sphingomona, Pantoea agglomeranss, Micrococcus, Bacillus, Saprophyticus, Brevundimona, and Myroidesspecies. The result of examining the stat us of MRI room disinfection showed that the disinfections of the head coil, block, and bore were implemented well, and the largest proportion was carried out once a day in the morning. The time and implementation of disinfection by the disinfection manager showed that they were implemented well when the manager was the MRI room examiner. The disinfection after examining a patient using an appropriate disinfectant is mandatory to prevent cross contamination.

Determinants Influencing Labor Union Commitment of General Hospital Employees' by the Characteristics of Unions (종합병원 직원의 노동조합성격에 따른 노조몰입 결정요인)

  • Kim, Wook-Soo;Ha, Ho Wook;Sohn, Tae Yong
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.56-83
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    • 2008
  • The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of general hospital organization management. The subject of this study were 686 employees in 12 General Hospitals in Metro Capital including Seoul. Materials were collected from administrators, nurses and medical technicians in target hospitals from March 20 to May 10, 2005 through survey questionnaires. The main results of this study were as follows: 1. the commitment level of the subjects according to their characteristics was higher in older employees than the younger ones, large family to support than small family to support and those who had higher positions in labor union. 2. The commitment level of the subjects according to the job and role related variables were higher those who had higher satisfaction level to their job and manager, role conflict in all hospitals. 3. The commitment level of the subjects according to union related variables, variables jointly controlled by union and employer was satistically significant positive correlation. In other words, the commitment level of the subjects according to the subjects' labor union involvement was higher in those who had higher satisfaction in labor union and perceived their colleagues' attitudes more positively in all hospitals. Regarding the atmosphere of the relationship between union and employer and the level of commitment in labor union, the better the atmosphere of the relationship between union and employer was, the higher the level of commitment in labor union was in all hospitals. 4. The results of multiple regression analysis shows that formal and informal socialization, union participation to the union management cooperation program, job satisfaction, satisfaction with the labor union's were all found as important antecedents of labor union commitment. 5. Job and role-related variables, union-related variables, variables jointly controlled by union and employer, and labor union commitment level were all found significantly different in accordance with the characteristics of unions concerned. To summarize study results, the level of commitment in labor union depends on job satisfaction, manager's attitudes, satisfaction to their jobs, union satisfaction, their colleagues attitudes toward union and the atmosphere of employer-employee relationship. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as formal and informal socialization, union participation to the union-management cooperation program is important determinant in union commitment, hospital managers should have countermeasures to enhance the colleague attitude and job satisfaction level of hospital employees. Since this study deals with psychological nature of workers not a few drawbacks and shortcomings may be detected in the finding. Nevertheless, the finding of this study, to become a momentum that will stimulate further research to detect all the cues of labor union commitment and to provide valuable reference in forming logical union commitment and labor union-management cooperation.

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Design and Implementation of Bio-data Monitering System Based on ISO/IEEE 11073 DIM/REST for IoT Healthcare Service (IoT 헬스케어 서비스를 위한 ISO/IEEE 11073 DIM/REST 기반 생체정보 모니터링 시스템 설계 및 구현)

  • Choi, Ju-Hyun;Chun, Seung-Man;Jang, Dong-Hyun;Park, Jong-Tae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.52 no.3
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    • pp.3-12
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    • 2015
  • Recently, various studies have been attempted to provide a biological information monitoring service through integrating with the web service. The medical information transmission standard ISO/IEEE 11073 PHD defines the optimized exchange protocol ISO/IEEE 11073-20601 based on the No-IP to exchange the biometric information between the ISO/IEEE 11073 agent and the manager. It's system structure based on the No-IP using ISO/IEEE 11073-20601 is not suitable for providing a remote biological information monitoring services. That is because it is difficult to provide to control and manage the biological information measurement devices, which have installed IP protocol stack at the remote. Furthermore, ACSE and CMDISE in ISO/IEEE 11073-20601 are not suitable to provide U-healthcare services based on IoT because they are complicated and difficult to implement it caused by the structural complexity. In order to solve the problems, in this paper, we propose the biological information monitoring architecture based on ISO/IEEE 11073 DIM/REST of IoT environment to provide the biological information monitoring service based on IoT. To do this, we designed biological information monitoring system architecture based on IoT and the message exchange protocol of ISO/IEEE 11073 DIM/REST between the ISO/IEEE 11073 agent and the ISO/IEEE 11073 manager. In order to verify the realistic possibility of the proposed system architecture, we developed the service prototype.