Journal of The Korean Society of Integrative Medicine
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v.12
no.3
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pp.237-247
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2024
Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.
Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.
Eun Ju Ha;Sae Rom Chung;Dong Gyu Na;Hye Shin Ahn;Jin Chung;Ji Ye Lee;Jeong Seon Park;Roh-Eul Yoo;Jung Hwan Baek;Sun Mi Baek;Seong Whi Cho;Yoon Jung Choi;Soo Yeon Hahn;So Lyung Jung;Ji-hoon Kim;Seul Kee Kim;Soo Jin Kim;Chang Yoon Lee;Ho Kyu Lee;Jeong Hyun Lee;Young Hen Lee;Hyun Kyung Lim;Jung Hee Shin;Jung Suk Sim;Jin Young Sung;Jung Hyun Yoon;Miyoung Choi
Korean Journal of Radiology
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v.22
no.12
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pp.2094-2123
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2021
Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.
This case study shows constructing the knowledge-based system using a rule-based approach for detecting illegal transactions regarding money laundering in the Korea Financial Intelligence Unit (KoFIU). To better manage the explosive increment of low risk suspicious transactions reporting from financial institutions, the adoption of a knowledge-based system in the KoFIU is essential. Also since different types of information from various organizations are converged into the KoFIU, constructing a knowledge-based system for practical use and data management regarding money laundering is definitely required. The success of the financial information system largely depends on how well we can build the knowledge-base for the context. Therefore we designed and constructed the knowledge-based system for anti-money laundering by committing domain experts of each specific financial industry co-worked with a knowledge engineer. The outcome of the knowledge base implementation, measured by the empirical ratio of Suspicious Transaction Reports (STRs) reported to law enforcements, shows that the knowledge-based system is filtering STRs in the primary analysis step efficiently, and so has made great contribution to improve efficiency and effectiveness of the analysis process. It can be said that establishing the foundation of the knowledge base under the entire framework of the knowledge-based system for consideration of knowledge creation and management is indeed valuable.
Park, Jeong Hwan;Mun, Sujeong;Kim, Sungha;Bae, Eun Kyung;Lee, Sanghun
The Journal of the Korea Contents Association
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v.15
no.1
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pp.357-365
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2015
Folk medicine is traditionally passed down to cure disease, and adverse events (AEs) of folk medicine are any unfavorable and unintended discomforts temporally associated with the use of folk medicine. The aim of this study was to analyze AEs types and risks of folk medicine through the internet news articles. Included in this analysis are all articles on the topic of folk medicine and AE reported in the top 3 online news websites (NAVER, DAUM and NATE) determined by InternetTrend$^{TM}$(www.internettrend.co.kr). It was searched in the last five years (between 1 January 2009 and 28 February 2014). In total, 18 AEs articles of 973 news articles met our inclusion criteria. A total of 27 people were experienced AEs associated with use of folk medicine. Age was from 4 months to 76 years old, and it was occurred in both men and women. Folk medicine that caused AEs in twice or more was therapy that patient taking the dictamnus or aconitum of toxic herbal medicines, vinegar therapy of external use to topical skin, and cupping or bee sting therapy by practitioners. Death as a kind of serious AEs was 11 people, and 10 people were died after treatment by unqualified practitioner. Folk medicine that is popular and widely used in Korea is actively interacted with information on the internet, so it apt to misuse and abuse without guidance of health professionals. Aspects of health care system, we point out that the need for government and medical society establish not only correct health information plan and promotion of risk but also system as reporting and monitoring of AEs by folk medicine.
Kim, Jeong-Hoon;Kim, Min-Hee;Do, Kee-Chul;Lee, Yu-Sun
Journal of the Korea Convergence Society
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v.13
no.5
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pp.219-228
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2022
In order to improve audit quality, it is essential to understand the occurrence of disagreement between auditors and managers, and this study aims to analyze the impact of Business Strategies on audit risk and accounting audit delay. To this end, we conducted an empirical analysis using sample 2,910 firm-year data from 2018 to 2020 of KOSPI-listed and KOSDAQ-listed companies. The results of the empirical analysis of this study are as follows. First, compared to the companies of defender type, prospectors can expand audit procedures for new products, R&D costs, and intangible assets, and increase audit delays due to disagreement between managers and auditors. Second, compared to KOSPI-listed companies, the prospectors in KOSDAQ are more likely to have lower financial reporting quality, which further increases audit delays. The results of this study analyzed whether a company's Business Strategy affects the possibility of disagreement between an auditor and a company, and verified whether there is a difference in the audit report lag by stock market. The results of this study show that auditors' strong duty of care is needed for the companies of prospector type with high audit risk, and it is meaningful to present reinforced audit systems and specific guidelines for the companies of prospector type through the definition of prospector type. It also enables the expansion of research to identify the relationship between non-financial factors and audit risks that make up the companies of prospector type.
The Comprehensive Assessment of Psychopathic Personality(CAPP) is an emerging comprehensive approach that makes use of 99 items in 33 symptoms to well-represented psychopathic personality disorder, but cross-cultural generalizability of this potential model have not endured extensive validation to date. The current study sought to validate the recently published CAPP-Self-Report form(CAPP-SR). 311 participants were derived from eleven prisons by the systematic sampling. They were administered the CAPP-SR, Triarchic Psychopathy Measure(TriPM), Levenson's SRP(LSRP), Short Dark Tetrad(SD-4), and Korean Offender Risk Assessment-General(KORAS-G designed for predicting Korean offenders'recidivism. The results showed that the CAPP-SR total, domain, and symptom scores were generally associated with TriPM, LSRP, SD-4, and KORAS-G scores in a manner consistent with conceptual expectations. Also. the findings cross-culturally provide support for construct validity and incremental validity of the CAPP-SR in Korea as well as have clinical implications for the CAPP model more broadly, which are discussed.
Yun Hwa Roh;Sae Rom Chung;Jung Hwan Baek;Young Jun Choi;Tae-Yon Sung;Dong Eun Song;Tae Yong Kim;Jeong Hyun Lee
Korean Journal of Radiology
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v.24
no.10
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pp.1028-1037
/
2023
Objective: To evaluate the computed tomography (CT) features for diagnosing metastatic cervical lymph nodes (LNs) in patients with differentiated thyroid cancer (DTC) and validate the CT-based risk stratification system suggested by the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) guidelines. Materials and Methods: A total of 463 LNs from 399 patients with DTC who underwent preoperative CT staging and ultrasound-guided fine-needle aspiration were included. The following CT features for each LN were evaluated: absence of hilum, cystic changes, calcification, strong enhancement, and heterogeneous enhancement. Multivariable logistic regression analysis was performed to identify independent CT features associated with metastatic LNs, and their diagnostic performances were evaluated. LNs were classified into probably benign, indeterminate, and suspicious categories according to the K-TIRADS and the modified LN classification proposed in our study. The diagnostic performance of both classification systems was compared using the exact McNemar and Kosinski tests. Results: The absence of hilum (odds ratio [OR], 4.859; 95% confidence interval [CI], 1.593-14.823; P = 0.005), strong enhancement (OR, 28.755; 95% CI, 12.719-65.007; P < 0.001), and cystic changes (OR, 46.157; 95% CI, 5.07-420.234; P = 0.001) were independently associated with metastatic LNs. All LNs showing calcification were diagnosed as metastases. Heterogeneous enhancement did not show a significant independent association with metastatic LNs. Strong enhancement, calcification, and cystic changes showed moderate to high specificity (70.1%-100%) and positive predictive value (PPV) (91.8%-100%). The absence of the hilum showed high sensitivity (97.8%) but low specificity (34.0%). The modified LN classification, which excluded heterogeneous enhancement from the K-TIRADS, demonstrated higher specificity (70.1% vs. 62.9%, P = 0.016) and PPV (92.5% vs. 90.9%, P = 0.011) than the K-TIRADS. Conclusion: Excluding heterogeneous enhancement as a suspicious feature resulted in a higher specificity and PPV for diagnosing metastatic LNs than the K-TIRADS. Our research results may provide a basis for revising the LN classification in future guidelines.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.34
no.3
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pp.27-54
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2021
Objectives : This review was conducted to validate the effectiveness and safety of herbal medicine combined with conventional therapy for rosacea. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on rosacea were searched through eight electronic databases from 2016 to March 17, 2020. This study collection and data extraction were performed by two independent reviews. The Cochrane risk-of-bias tool was used for the evaluation of the risk of bias in all included RCTs. Mean differences(MD) and Risk ratio(RR) of 95% Confidence intervals(Cls) were calculated and data synthesis was conducted using Review Manager(RevMan, ver.5.4) Results : Eighteen RCTs were included and all trials compared the combined therapy of herbal medicine with conventional western therapy to conventional therapy alone. The effective rate of the combination of herbal medicine with western medicine(RR 1.20, 95% CI : 1.13-1.28, p<0.00001, I2=0%), the effective rate of the combination of herbal medicine with laser-based therapy(RR 1.12, 95% CI : 1.04-1.21, p=0.004, I2=18%) and the effective rate of the combination treatment group using herbal medicine, western medicine and external drugs were all statistically higher that of the control group(RR 1.19, 95% CI : 1.11-1.28, p<0.00001, I2=0%). The score of non transient erythema(MD -0.36, 95% CI : -1.01 0.29, p=0.27, I2=93%), flushing(MD -0.69, 95% CI : -0.97, 0.41, p<0.00001, I2=32%), papules or pustules(MD 0.10, 95% CI : -0.15, 0.35 p=0.44, I2=0%) were also seen in the herbal medicine and western medicine combination group. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the safety and effectiveness of the combined therapy of herbal medicine with conventional western therapy for rosacea.
The purpose of this study is to examine the timing and the risk factors associated with the adoption of legally-free foster children. The sample of the study was drawn from foster care files of Adoption and Foster Care Analysis and Reporting System(AFCARS) in 32 states between October 1998 (FY 1999) and September 2002(FY 2002). The timing post-TPR to adoption was examined by plotting the Kaplan-Meier cumulative hazard function for adoption and by plotting the KM hazard functions stratified by child's race and child's age at TPR. Cox proportional-hazards regression analysis was used to identify risk factors for adoption of legally-free foster children after TPR. The hazard of adoption was very low immediately after TPR but increased steadily starting at 3 months and then declined after 20 months. The cumulative hazard functions for White non-Hispanic children and Black non-Hispanic children crossed over at 13 months after TPR. Racial minority status, older age, and disability were negatively associated with the hazard of adoption. Physical abuse, sexual abuse had the lower hazard for adoption compared by neglect. Caretaker's inability to cope had the slightly lower hazard for adoption whereas inadequate housing showed the slightly greater hazard for adoption. Characteristics of foster care services turned into be powerful predictors of adoption. Specifically, legally-free children placed in pre-adoptive homes, those who shared the same racial/ethnic background with their foster caretakers, and those who were placed in two-parent families have a greater likelihood of adoption. The findings highlight the importance of foster care service provisions after TPR to facilitate adoption of legally-free foster children. Furthermore, a more substantial resources and targeted support for foster children who experience physical abuse and sexual abuse in need of adoption should be provided for moving the foster children into permanency.
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