• 제목/요약/키워드: Clinical training guideline

검색결과 25건 처리시간 0.019초

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.

심박변이도 및 SCL-90-R 측정을 통한 자율훈련법과 과일 명상의 효과 비교 분석 (An Analysis of Comparison between Autogenes Training and Imaginary Meditation by Heart Rate Variability and SCL-90-R)

  • 서진우;김종우;정선용;김지영;황은영
    • 동의신경정신과학회지
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    • 제19권3호
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    • pp.35-44
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    • 2008
  • Objective: There are many meditation methods used in clinical field. But the effect of meditation may be different to people's mind, and meditation itself. Now we investigate this subject with two different meditation methods which has been analyzed by heart rate variability. Method: We tried to check people's heart rate who educated meditation, before educated and during the meditation. The meditation was educated differently for each group. One is the auto genes traning, and the other is the imaginary meditation by thinking about eating and smelling favorite fruits. All of them are used to oriental psychiatry clinic patients. And we simultaneously conduct people's emotional state by SCL-90-R. Result: The result in Autogene traning group has significant difference in total power and HRV-index score between before and during the training but in imaginary meditation group has no significance: Autogene traning group has a significance in low frequency score and has increased tendency with increasing tendency of Heart rate index and Total power. Through the SCL-90-R score, the higher depression t-score, the anxiety t-score, and the hostility score is, the HRV scores such as total power, low frequency, and HRV-index much increase. and so on. Conclusion: We can guess that the Autogenes training has more significant effect than the imaginary meditation. And we can also guess that as the emotional problem is getting more severe, the effect of meditation would be much better. And we finally suggest that we should make a standard guideline of imaginary meditation, cause the imaginary meditation has so many variation.

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20년간(1987년~2007년) 한의원 경영수지의 경향 연구 (Trend analysis of financial balance of Korean medicine clinics during 20years(1987~2007))

  • 김대훈;임병묵
    • 대한예방한의학회지
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    • 제16권2호
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    • pp.41-52
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    • 2012
  • Objectives : This study aimed to analyze the trend of financial balance of Korean medicine clinics during 20 years, and to provide basic information for adjusting the fee schedule of Korean medicine procedures in national health insurance(NHI). Methods : We collected 6 financial analysis reports for Korean medicine clinics from the Association of Korean Oriental Medicine(AKOM). The data on incomes, costs and EBIT(earning before interests and taxes) of subject clinics were abstracted, and their long-term trends were evaluated. Results : The proportion of insurance income in total income increased from 23% to 56% during 20 years. Among 5 treatment groups, 'non-insurance medication' took up 65~67% of total incomes in 1997, but its proportion decreased to 42.4% in 2007. 'medical procedure, physical therapy and others' increased from 12.4% in 1987 to 29.2% in 2007. The labor cost was major part of total cost and its proportion maintained from 52% to 54%. Cost of 'non-insurance medication' was on the decline from 41% in 1996 to 31.6% in 2007. EBIT were -17.4 million won in 1996, and 18.4 million won in 2007. Conclusions : Financial balance of Korean medicine clinics improved until early 2000, but it became worse in 2007. Though deficits from NHI procedures has been covered up by profit from 'non-insurance medication', health insurance became a major source of income during last two decades.

Collaboration through the Asia Pacific MPS Network (APMN), Asia Pacific MPS Registry (APMR), and Association for Research of MPS & Rare Diseases (ARMRD)

  • Cho, Sung Yoon
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제1권1호
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    • pp.2-4
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    • 2015
  • Though the rate of incidence of each rare disease, including mucopolysaccharidosis (MPS), is low, this is not the case if they are taken as a whole. Rare diseases often have genetic causes and vary in type. However, the signs and symptoms vary greatly by disease, making it difficult to make accurate diagnoses and conduct necessary research, which is why we believe it is a field that deserves more attention and research. It is important to establish an infrastructure of experts in each country and promote cooperation within the Asia-Pacific region in order to improve specialist training and communication. Given the need for a system of cooperation, the Asia Pacific MPS Network (APMN) was established by several MPS experts in South Korea, Japan, and Taiwan in January 2013. Thereafter, the Asia Pacific MPS Registry (APMR), an electronic remote data system, was established by the APMN. Then, the Association for Research of MPS & Rare Diseases (ARMRD), an academic society that supports research on MPS and other rare diseases, was established by President Dong-Kyu Jin in April in 2015. The main task of the ARMRD is to support APMN-related work. The ARMRD published a uniform guideline that reflects the characteristics and circumstances of local patients through the Korean MPS Expert Council. Now, the APMN, APMR, and the annual Korean MPS Symposium are supported by ARMRD. Organizations like the APMN and APMR are necessary because international cooperation and collaboration are needed to conduct clinical trials on those diseases. ARMRD members hope to encourage the interest of experts and researchers of MPS & rare diseases as well as active participation in the research and treatment of patients suffering from rare diseases, including MPS, to ultimately improve the quality of life of the patients as well as their families.

국내중독현황 (Statistics of Poison Exposure in Korea)

  • 황정연;고재욱
    • 대한임상독성학회지
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    • 제1권1호
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    • pp.59-64
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    • 2003
  • Objective: This study was conducted for the nationwide statistical survey of poison exposure to provide the rationale for establishing and developing the poison control center (PCC) in Korea. Design: Study group for Korea PCC in National Medical Center reviewed the medical literature on poison exposure of Korea from death reports of National Statistical Office (NSO), the toxic exposure statistics from the report of National Health Insurance Corporation (NHIC), and poison related data from 119 ambulance services (FD) for the purpose of obtaining the poison and its related data. We also conducted questionnaire from the expert who work in emergency medicine department at the designated 320 emergency medical centers in Korea for the preparedness and acknowledgement about necessity of PCC and their need for that. Results: We reviewed the reliable data from the death report of NSO, poison exposure data from NHIC, and running report from FD. Poisoning death occured at home ($36.7\%$) and hospital ($46.3\%$). Poisoning are more common in rural area than the city area. Patients were seen more frequently in the local clinics than in any hospital. The drugs ($45.7\%$) and pesticide ($18.1\%$) are common poison. Common place to poison exposure were residential area ($39.9\%$), industry ($9\%$). mass residential area ($7\%$). and farm ($6\%$). The education level were primary school ($33.2\%$), high school ($23.7\%$), and middle schol ($21.3\%$) in order. We have to provide the poison guideline for lay public to understand easily, and for medical experts. The medical facilities need to be invested and have more interest for toxicology. All medical staff who work in the designated emergency medical center want PCC to establish. They want to have poison information from hospital ($91.3\%$), regional poison information center ($45.0\%$), regional poison control center ($52.5\%$), nationwide poison information center ($48.8\%$), nationwide poison control center ($46.25\%$), as a role of poison control center. They also want that pcc have poison epidemiologic study and statstics, training program for the experts, registration of rare case of posion on website, reflection of policies to activities for antidote production etc., speedy consultation system for poison analysis, public education, establishment of both regional and national pee, etc. Conclusion: Poison center must be established to provide poison information for all the public and medical experitise, focusing rural area and private clinic, to detoxify, to reduce the cost, time, morbity, and mortality through the whole country.

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