• 대한한의학회지
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• 제38권3호
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• pp.73-85
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• 2017

Objectives: The purpose of this study was to investigate the status of Korean medicine treatment, and to analyze problems and demands to provide basic data on Korean medicine in military medical services. Methods: This survey was completed by 30 volunteer Korean medicine military doctors on service via a web-based questionnaire system. The questionnaire was developed through in-depth interviews with Korean medicine military doctors and consisted of general information on the subject, overall characteristics of the medical environment, current status of Korean medicine care in each workplace, problems and needs, and related clinical evidence and education. Results: Korean medicine military doctors administered acupuncture treatment most frequently in clinical practice. The most common complaints were related to musculoskeletal diseases, which accounted for 86.5% of all diseases, including those of the respiratory, digestive, and nervous systems. Most of the problems in Korean medicine care were pointed out as being due to a lack of awareness of Korean medicine in the military. Many doctors were aware that it is necessary to establish clinical evidence for Korean medicine in the military, and were also positive about the possibility of performing clinical research in the military, but the experience of actual participation in clinical research or related education was uncommon. Conclusions: Korean medicine military treatment differs from private medical care due to the specificity of each workplace and the military medical system. In the future, it will be necessary to establish an appropriate Korean medicine treatment model in the military suitable for these characteristics and strategic plans for clinical evidence.

• Parasites, Hosts and Diseases
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• 제55권4호
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• pp.425-428
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• 2017

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.

• 대한임상검사과학회지
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• 제54권4호
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• pp.285-292
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• 2022

국제표준직업분류나 일본·미국의 법률시스템, 양성시스템를 통해서 본 안과검사인력은 안과전문의, 검안사, 시능훈련사, 검안기사, 안과기사가 포함된다. 국가통계포털 자료에 의하면 2022년 안과에 근무하는 안경사의 수는 의료기관 종별에 따라 파악이 가능하지만, 임상병리사의 수는 파악이 불가능하다. 다만, 본 연구를 통해서 상급종합병원의 경우 임상병리사가 안경사보다 많이 근무하는 것으로 조사되었다. 우리나라 안과검사실 인력의 경우 국제표준직업분류, 국제표준교육분류, 의료법, 의료기사 등에 관한 법률 및 고등교육법에 비추어 봤을 때, 미국의 검안사는 비교 대상이 아니며 안과전문의나 검안사의 지도를 받아 업무수행하는 검안기사가 부합되는 직업일 것이다. 민간자격으로 대한안과학회 및 대한검안학회에서 안과검사실에 종사하는 임상병리사 및 안경사에게 '임상검안사'라는 호칭을 부여하여 새로이 자격관리를 정립한다면 국민 안(眼)보건 향상에 더욱 도움이 되리라 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2643-2647
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• 2013

Background: Despite anti-smoking campaigns, smoking prevalence among Thai males aged 30 or older is high, at around 50%. The purpose of this study was to determine the relationship between smoking and mortality in a rural Thai community. Materials and Methods: Subjects enrolled into the Khon Kaen cohort study between 1990 and 2001 were followed up for their vital status until $16^{th}$ March 2012. The death resource was from the Bureau of Policy and Strategy, Ministry of Interior, Thailand. A Cox proportional hazards model was used to analyse the association between smoking and death, controlling for age, education level and alcohol drinking, and confidence intervals were calculated using the floating risk method. Results: The study recruited 5,962 male subjects, of whom 1,396 died during a median 13.5 years of follow-up. Current smokers were more likely to die than never smokers after controlling for age, education level and alcohol drinking (HR, 95%CI: 1.41, 1.32-1.51), and the excess mortality was greatest for lung cancer (HR, 95%CI: 3.51, 2.65-4.66). However, there was no increased risk with increasing dose of tobacco, and no difference in risk between smokers of yamuan (hand-rolled cigarettes) and manufactured tobacco. Conclusion: Mortality from cancer, particularly lung cancer, and from all causes combined is dependent on smoking status among men in rural Thailand, but the relative risks are lower than have been reported from studies in high income countries, where the tobacco epidemic is more established.

• 한국임상약학회지
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• 제24권4호
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• pp.255-264
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• 2014

Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

• 한국응급구조학회지
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• 제26권3호
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• pp.47-60
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• 2022

Purpose: This study aimed to identify the level of communication ability between paramedic students and patients in clinical practice. In addition, it was performed to produce essential data contributing to the qualitative improvement of communication ability. Methods: Data were collected from paramedic students with clinical experience after they provided online consent. Data collection was performed from June 3 to July 12, 2022. One hundred forty-seven questionnaires with 92 items were analyzed using SPSS statistics 28.0. Results: 57.1% of students took communication as a subject despite 92.5% of respondents saying that communication education is necessary for them. The average level of participant communication ability was 4.60 (±1.05) points (measured on a 7-point Likert scale). Among the subdivided communication ability levels, the highest level was demonstrated in the physical examination-related interview (5.36±0.96), and the lowest was shown in the completion part (3.93±1.51). Furthermore, a statistically significant difference was found in communication ability level according to school grade (F=4.709, p=.000). The highest correlation (r=.972, p<.001) was obtained between total communication ability and understanding the patient's point of view. Conclusion: Paramedic students should improve their communication skills to serve patients more effectively. Finally, more educational content should be developed on field-based situations in communication courses.

• 한국임상약학회지
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• 제21권4호
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• pp.319-331
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• 2011

Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

• 대한영양사협회학술지
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• 제20권3호
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• pp.199-211
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• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• 보건의료산업학회지
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• 제10권3호
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• pp.27-37
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• 2016

Objectives : This study was conducted to test the influence of job stress and calling on the organizational commitment of clinical nurses. Methods : 220 clinical nurses at two university hospitals in Busan were recruited. They were asked to complete a questionnaire, and 192 data sets were included in the statistical analysis. Results : The mean score of the clinical nurses' organizational commitment was 4.0. All subdomains of job stress and calling were found to have correlations with organizational commitment. The organizational system (t=-6.099, p<.001), lack of reward (t=-3.990, p<.001), purpose/meaningfulness (t=3.624, p<.001), and occupational climate (t=-3.581, p<.001) were revealed to have influences on the organizational commitment. The model was statistically significant, explaining 52.2% of the variance (F=47.808, p<.001). Conclusions : To help clinical nurses become committed to their organizations, administrators need to build fair and rational organizational systems, strengthen various types of rewards, and help nurses reconcile nursing and the meaning of their lives. In addition, every nurse should endeavor to change the nursing organizational climate which is based on vertical collectivism, to a rational climate.

• 보건의료산업학회지
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• 제6권1호
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• pp.163-172
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• 2012

The purpose of the study were to investigate the effect of laughter program on the stress of nursing college students in clinical practice. The research design is one group pretest-posttest survey. Thirty-eight nursing college students took part in the study. Laughter program was carried out for 1hour 6weeks. Laughter program showed significant change on the state anxiety, mood-emotion, laughter index, subjective stress and self esteem. The acquired data were analyzed with SPSS/win 15.0 using descriptive methods paired t-test, Pearson correlation coefficient. The research producted following results: Laughter program can be effective to decrease the clinical practice stress; anxiety, mood-emotion and subjective stress index. Laughter program can be effective to increase laughter index and self esteem of nursing college students. Based on the study, It is necessary to repeat studies and considering to develop proper methods of clinical practice stress of nursing college students. This study recommends that laughter program coupled with cognitive approaches could affect ways of nursing college students coping with stress and contribute to the improvement from increasing their satisfaction.