• 제목/요약/키워드: CARE guideline

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Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging (KOSCI) - Part 2: Interpretation of Cine, Flow, and Angiography Data

  • Lee, Jae Wook;Hur, Jee Hye;Yang, Dong Hyun;Lee, Bae Young;Im, Dong Jin;Hong, Su Jin;Kim, Eun Young;Park, Eun-Ah;Jo, Yeseul;Kim, Jeong Jae;Park, Chul Hwan;Yong, Hwan Seok
    • Investigative Magnetic Resonance Imaging
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    • 제23권4호
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    • pp.316-327
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    • 2019
  • Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.

대체교사 제도에 대한 국비지원과 도비지원 대체교사의 인식 (The Recognition of the Substitute Teacher System between Substitute Teachers by Public Funds Support and Substitute Teachers by Local Province Funds Support)

  • 백선정;김혜금
    • 한국보육지원학회지
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    • 제9권3호
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    • pp.209-228
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    • 2013
  • 본 연구는 경기도에서 활동 중인 국비지원 대체교사 49명과 도비지원 대체교사 53명 총 102명을 대상으로 대체교사 제도에 대한 인식이 어떠한지를 살펴보고 대체교사 제도의 활성화 방안을 모색해보고자 하였다. 본 연구결과는 다음과 같다. 첫째, 대체교사 지원사업에 참여하게 된 경로로 국비 대체교사는 인터넷 사이트, 도비 대체교사는 보육정보센터 홍보물이 높게 나타났다. 국비와 도비 대체교사 모두 '다른 활동과 병행하기 위해서'가 대체교사 지원사업 참여 동기로 나타났다. 둘째, 국비와 도비 대체교사 모두 '어린이집의 다양한 상황에 융통성 있게 대응하는 것'을 대체교사의 자질로 중요하게 보았다. 셋째, 국비 대체교사는 초과근무가 없고 보육교사에 비해 상대적으로 부담이 적다는 점을, 도비 대체교사는 다양한 어린이집 경험을 통한 전문성 향상과 초과근무가 없다는 점을 만족스러운 점으로 들었다.

교통사고 상해 증후군의 한의 임상진료 현황 조사: 2차 온라인 심층 설문 조사 (A Survey on Korean Medicine Treatment for Traffic Injuries: A Second On-line In-depth Survey)

  • 임경태;황의형;황만석;박인화;박선영;신병철
    • 한방재활의학과학회지
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    • 제28권4호
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    • pp.89-101
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    • 2018
  • Objectives To understand current status of clinical practice patterns on Korean Medicine treatment practice of traffic injury patients by 2nd on-line survey for developing Korean Medicine treatment clinical pratice guideline (CPG) for traffic injuries. Methods A revised questionnaire about current practice patterns of Korean Medicine treatments for traffic injuries was distributed by e-mail survey to 19,385 respondents of Korean Medicine doctors from May 21th in 2018 to June 21th in 2018. All data were statistically analysed. Results The response rate was 3.5%. Most of the respondents felt necessity of the development of Korean Medicine CPG for traffic injuries. The results showed the detailed usage and trend of current Korean Medicine treatment such as acupuncture, pharmacopuncture, moxibustion, Chuna manual therapy, cupping, Korean Medicine physiotherpy for traffic injury patients. Conclusions This survey helps to determine current Korea Medicine treatments' clinical practice patterns for traffic injury patients. All data from the survey will provide basic data for future clinical studies and adaptation for the revision of Korean Medicine CPG for traffic injuries.

How to Define the Content of a Job-Specific Worker's Health Surveillance for Hospital Physicians?

  • Ruitenburg, Martijn M.;Frings-Dresen, Monique H.W.;Sluiter, Judith K.
    • Safety and Health at Work
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    • 제7권1호
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    • pp.18-31
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    • 2016
  • Background: A job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps should be taken to determine the content of a job-specific WHS for hospital physicians and outlines that content. Methods: Based on four questions, decision trees were developed for physical and psychological job demands and for biological, chemical, and physical exposures to decide whether or not to include work-related health effects related to occupational exposures or aspects of health reflecting insufficient job requirements. Information was gathered locally through self-reporting and systematic observations at the workplace and from evidence in international publications. Results: Information from the decision trees on the prevalence and impact of the health- or work-functioning effect led to inclusion of occupational exposures (e.g., biological agents, emotionally demanding situations), job requirements (e.g., sufficient vision, judging ability), or health effects (e.g., depressive symptoms, neck complaints). Additionally, following the Dutch guideline for occupational physicians and based on specific job demands, screening for cardiovascular diseases, work ability, drug use, and alcohol consumption was included. Targeted interventions were selected when a health or work functioning problem existed and were chosen based on evidence for effectiveness. Conclusion: The process of developing a job-specific WHS for hospital physicians was described and the content presented, which might serve as an example for other jobs. Before implementation, it must first be tested for feasibility and acceptability.

Risk Factors of Red Blood Cell Transfusion in Isolate off Pump Coronary Artery Bypass Surgery

  • Chung, Eui Suk;Park, Kay-Hyun;Lim, Cheong;Choi, Jinho
    • Journal of Chest Surgery
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    • 제45권5호
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    • pp.301-307
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    • 2012
  • Background: Perioperative transfusion of red blood cell (RBC) may cause adverse effects. Bloodless-cardiac surgery has been spotlighted to avoid those problems. Off pump coronary artery bypass (OPCAB) surgery can decrease the transfusion. However, the risk factors of transfusions in OPCAB have not been investigated properly. Materials and Methods: One hundred and thirteen patients (male:female=35:78, mean age=$66.7{\pm}9.9$ years) who received isolated OPCAB were retrospectively analyzed from March 2006 to September 2007. The threshold of RBC transfusion was 28.0% of hematocrit. Bilateral internal thoracic arteries graft were used for 99 patients (87.6%). One hundred and three (91.1%) and 35 patients (31.5%) took aspirin and clopidogrel just before surgery. Results: Sixty-five patients (47.5%) received the RBC transfusion (mean $2.2{\pm}3.2$ units). Mortality and major complications were not different between transfusion and no-transfusion group. But, ventilator support time, intensive care unit stay and hospitalization period had been reduced in no-transfusion group (p<0.05). In multivariate analysis, patients risk factors for RBC transfusion were preoperative low hematocrit (<37.5%) and clopidogrel medication. Surgical risk factors were longer graft harvesting time (<75 minutes) and total operation time (<5.5 hours, p <0.05). Conclusion: We performed the transfusion according to transfusion guideline; over 40% cases could conduct the OPCAB without transfusion. There were no differences in major clinical results between transfusion and non-transfusion group. In addition, when used together with accurate understanding of transfusion risk factors, it is expected to increase the proportion of patients that do not undergo transfusions.

Update on infantile hemangioma

  • Jung, Hye Lim
    • Clinical and Experimental Pediatrics
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    • 제64권11호
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    • pp.559-572
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    • 2021
  • The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

성장장애 한의표준임상진료지침 개발을 위한 한의사 인식조사 (A Survey on Korean Medicine Doctors' Recognition for Developing Korean Medicine Clinical Practice Guideline for Growth Disorders)

  • 안혜리;심수보;이혜림
    • 대한한방소아과학회지
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    • 제35권4호
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    • pp.1-15
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    • 2021
  • Objectives The purpose of this study is to provide data for development of the korean medicine (KM) clinical practice guidelines (CPG) for growth disorder (GD) by identifying the awareness and knowledge needs of KM doctors (KMD) through online survey. Methods Survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed 18 questions regarding the current status of clinical care for GD, clinician's knowledge level about GD, and other details that clinicians use during practice. The survey was conducted from January 2021 to March 2021. An online survey was conducted on 101 KMDs from the association of pediatrics of KM. Results According to the survey, 96 respondents (40.3%) said the causation of GD without growth hormone deficiency needs to be included in CPG. 96 (23.5%) of the respondents wishes to utilize percentile in diagnosis and evaluation of the growth assessment. 24.7% of the clinicians were using the herbal medicine treatment. Currently, when treating with KM for GD, herbal medicine (100%) is the most widely used, followed by acupuncture (77.6%), and moxibustion (36.7%). In terms of a complex treatment, growth therapy efficacy (26.8%) is shown to be the most important factor to consider and needed to be included in CPG for the complex treatment, and diet (22.3%) is also considered to be important in GD. Conclusions In this study, we were able to understand the clinical KMDs' perception of GD, knowledge level, and the requirements in the CPG. The results of this study will provide the basic data for development of CPG for GD.

한국 군 인트라넷 사용이 신세대 장병들의 군복무만족도에 미치는 영향 (Using the Korean troops intranet impacts on satisfaction of new generation soldiers)

  • 소명섭;임재욱;이종구
    • 국제지역연구
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    • 제16권3호
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    • pp.367-390
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    • 2012
  • 본 논문은 20대 병영생활을 하는 인적자원들이 2년의 복무기간동안 보다 효율적인 시간관리와 정신적 육체적 건강관리를 통해 사회에 환원될 수 있도록 군복무에 대한 만족도에 군 인트라넷이 어떤 영향을 미치는 지에 대한 실상을 분석하는데 목적이 있다. 이는 개인적으로나 국가적인 차원에 있어 군복무의 효율적인 운영이라는 차원에서 시사하는 바가 매우 클 뿐만 아니라 향후 신세대 예비 군복무자들에게 있어 자기관리에 필요한 유용한 정보를 제공할 수 있는 지침이 되기 때문이다. 본 연구는 인터넷 세대로 이루어진 20대 초반의 신세대 장병들에게 군 인트라넷이 군복무 만족에 어떤 영향을 미치는지 그 요인을 분석하는 동시에 아울러 이것을 군조직 차원에서 효율적인 활용을 위해 정보를 제시하는데 그 의의를 두고자 한다. 결론적으로 인트라넷은 복무만족에 효과적으로 영향을 미치는 중요한 요인이자, 수단이라는 것이 입증되었으며 나아가 군조직에서 적용되고 있는 인트라넷 망을 단순업무나 전파수단이 아닌 조직의 전략과 목표달성을 위해 보다 한 차원 높은 군 인트라넷 활용으로 발전시켜야 한다는 시사점이 도출되었다.

국내 학술지에 게재된 증례 연구 분석을 통한 산후풍의 한의학적 치료에 대한 고찰 (A Review on Sanhupung Treatment in Korean Medicine by Analyzing Case Studies Published in Korean Journal)

  • 황수인;이희윤;윤영진;박장경
    • 대한한방부인과학회지
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    • 제34권4호
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    • pp.131-150
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    • 2021
  • Objectives: The purpose of this study is to analyze the domestic study trends on Korean medicine treatment of Sanhupung. Methods: Case studies applying Korean medicine treatment on Sanhupung were searched through 5 domestic journal databases. General characteristics, interventions, outcomes, and results of the selected studies were analyzed. Also, the quality of the case studies was reviewed based on the CAse REport (CARE) guideline and Joanna Briggs Institute (JBI) critical appraisal checklist. Results: 11 studies (16 cases) were found to be analyzed according to their general characteristics, symptoms, interventions, treatment period, outcome, and results. The most common complaint of Sanhupung patients was pain, and the most applied intervention for Sanhupung was herbal medicine and acupuncture. The duration of treatment ranged from 9 days to 4 months. All case studies reported that the Korean medicine treatment was effective in treating Sanhupung. According to the quality assessment, 'Timeline of case', 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', and 'Informed consent' were showed low reporting rates. Conclusions: Further clinical studies are needed to establish the evidence for Korean medicine treatment for Sanhupung.

International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow's Milk Protein Allergy and Lactose Intolerance in Infants and Children

  • Madrazo, J Armando;Alrefaee, Fawaz;Chakrabarty, Anjan;de Leon, Julia C.;Geng, Lanlan;Gong, Sitang;Heine, Ralf G.;Jarvi, Anette;Ngamphaiboon, Jarungchit;Ong, Christina;Rogacion, Jossie M.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권3호
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    • pp.263-275
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    • 2022
  • Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.