• Title/Summary/Keyword: Consensus of Information

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Sharing Experiences in Selecting Clinical Outcome and Approving Validated Questionnaires : Insights from an Elderly Registry Study (노인등록연구 사례를 통한 임상평가지표 선정 과정 및 검증된 설문도구 승인 경험의 공유)

  • Nahyun Cho;Hyungsun Jun;Won-Bae Ha;Junghan Lee;Mi Mi Ko;Young-Eun Kim;Jeeyoun Jung;Jungtae Leem
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.17-43
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    • 2024
  • Objectives: Underpinned by the context of a Korean traditional medicine cohort study on healthy aging, this research primarily aims to guide the selection of Clinical Outcome Assessments (COAs) for elderly healthy aging patient registry research, offering insights into the selection process; and secondly, to streamline the resource-intensive process of obtaining permissions for validated COAs, benefiting future traditional Korean medicine clinical researchers. Methods : In this study, we identified outcomes through a review of previous studies, followed by a process involving expert consultations to select the final outcomes. Subsequently, for the selected outcomes that were Clinical Outcome Assessments (COAs) developed tools, we searched in commercial databases to confirm the availability of Korean versions and the necessity of obtaining permissions. Finally, we obtained permissions for their utilization and, when needed, acquired the original instrument questionnaire through payment. Results: Through a literature review of existing observational studies, a total of 57 outcomes were selected, with 19 of them identified as COA instruments. Upon verifying usage permissions for these 19 instruments, it was found that 17 required author-specific permissions, and among these, 2 needed a purchase as they were commercially available. Conclusion: This study provides a detailed overview of outcome selection and permission acquisition for elderly patient registry research. It underscores the importance of Clinical Outcome Assessment (COA) tools and the rigorous approval process, aiming to enhance research reliability. Continuous verification of COA information is essential, and future research should explore Core Outcome Set (COS) development through consensus-building approaches like Delphi studies.

Current Trends in the Treatment of Ankle Arthritis: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 관절염 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Gwak, Heui-Chul;Kim, Hak Jun;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.111-116
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    • 2021
  • Purpose: Variations in the preferred conservative and operative treatment methods for ankle arthritis may be observed in the practice of orthopedic surgeons. This study is based on the Korean Foot and Ankle Society (KFAS) member survey and aims to report the current trend and changes in the management of ankle arthritis over the last few decades. Materials and Methods: A web-based questionnaire containing 24 questions was sent to all KFAS members in July 2021. The questions were mainly related to the preferred techniques and clinical experience in osteotomy, arthrodesis, and total ankle arthroplasty (TAA) for patients with ankle arthritis. Results: Sixty-three out of 550 surgeons (11.5%) responded to the survey. The responses to 6 out of the total of 24 questions (25.0%) achieved the levels needed to reflect a tendency. Answers that showed a tendency were related to the following: a surgical approach for arthrodesis (anterior approach), use of auto-bone graft for arthrodesis (iliac bone), a nonunion rate of more than 10% following arthrodesis, main reason related to unsatisfactory results after arthrodesis (nonunion or delayed union), the main reason to change total ankle prosthesis (unstable supply of prosthesis), the unusualness of revision TAA and conversion of fusion to TAA. Diversity was found in several aspects of treatment (degree of experience and satisfaction in supramalleolar osteotomy, fixation method for arthrodesis, preferred TAA prosthesis and longevity, degree of experinece, annual number of TAA operation. Conclusion: This study proposes updated information with regard to the current trends in the management of ankle arthritis in Korea. Both consensus and variations in the approach to patients with ankle arthritis were identified through this survey. With an increasing preference for TAA, the need for the development of a prosthesis optimized for Koreans and a stable supply of prostheses were the suggestions made by the study.

Reproductive Physiology of Pineal Hormone Melatonin (송과선 호르몬 멜타토닌의 생식 생리학)

  • 최돈찬
    • The Korean Journal of Zoology
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    • v.39 no.4
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    • pp.337-351
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    • 1996
  • Melatonin Is a multifunctional hormone secreted from the pineal gland in the middle of cerebrum and cerebellum. Its synthesis and release reflect photopedod;Photopedod is a yearly predictable ambient factor that most animals utilize as an environmental cue for maximum survival. Hamsters maintaln reproductive activity in summer during which day length exceeds night time. Upon the advent of autumnal equinox they undergo gonadal regression. The photoperiodic effects are prevented by removal of the pineal gland and restored by the timed repiacument of melatonin. The results suggest that melatonin constitutes part of control mechanism whereby environmental information is transduced to neuroendocrine signal responsIble for the functional integrity of the reproductive system. From the studies for the action site of melatonin following the treatment of photopedod or melatonin in the lesion of a spedflc portion of hypothalamus, suprachiasmatic nuclei and pars tuberalis are shown to be a consensus site for melatonIn. The action of melatonin. In the regulation of reproduction is largely unknown. It is mainly due to the lack of acute effect of melatonin on gonadotropin secretion. However, reduction of the gonadotropln release and augmentation of the hypothalamic gonadotropin-releasing hormone (GnRH) content by long-term treatment of melatonln Indicate that constant presence of melatonln may partidpate in the regulation of sexual activity via the GnRH neuronal system. The action mechanism by which melatonin exerts Its effect on GnRH neuron needs to be eluddated. The inability of opiold analogues to affect the reproductive hormones in sexually regressed animals by inhibftory photopedod and melatonin suggests that the opioldergic neuron may be a prime intervening mediator. Recent cloning of melatonin receptor will contribute to investigate its anatomical Identification and the action mechanism of melatonin on target tissues at the molecular level.

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Current Trends in the Treatment of Acute Achilles Tendon Rupture: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (급성 아킬레스건 파열의 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Jaeho;Cho, Byung-Ki;Chung, Hyung-Jin;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.88-94
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    • 2022
  • Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the epidemiology, diagnosis, and management of acute Achilles tendon rupture (AATR) over the past few decades. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in October 2021. The questions were mainly related to the clinical experience and preferred management of patients with AATR. Answers with a prevalence ≥50% of the respondents were considered a tendency. Results: Seventy-one (12.9%) of the 550 members responded to the survey. The male sex ratio in AATR was answered mean 78%, and the most common age groups were 30~40 years (n=49; 69.0%), and 40~50 years (n=37; 52.1%), in that order. The most common seasons for the occurrence of AATR were spring (37 cases; 52.1%) and autumn (27 cases; 38.0%). Also, sports-related rupture had an average occurrence of 76.2%. The most important clinical factor to determine the type of treatment was the history of previous injuries, and 75.9% of respondents started conservative treatment in the 2010s. The most preferred protocol of conservative treatment was an orthosis capable of ankle range of motion after casting (68.5%), and 53.7% 'satisfied' and 1.9% 'very satisfied' with conservative treatment. The most preferred surgical method was open repair (80.3%), and the Krackow method (60.6%), and 49.3% of treated patients responded 'satisfied' and 45.1% 'very satisfied' with this treatment. Conclusion: This study gives updated information concerning the current trend of epidemiology, diagnosis, and treatment of AATR in Korea. Both consensus and variation in the approach to AATR were identified using this survey study. This study may raise the awareness of various possible approaches toward AATR and should be used to further establish a standard protocol for the management of this injury.

Possible Continuity and Change of North Korea Though Analysis of, Kim Jong-un's New Year's Message (북한 신년사 분석을 통한 김정은 시대 지속과 변화)

  • Lee, Sung Choon
    • Convergence Security Journal
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    • v.14 no.6_1
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    • pp.75-87
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    • 2014
  • It may be meaningful that analysis of possible continuity and change of North Korea's Kim Jong-un's ruling in its third year. For this analysis, for the application more rational and statistical analysis methods, this study takes advantage of the new years' messages of Kim Il Sung, Kim Jong Il, and Kim Jong-un. In North Korea, the new years' messages are rare enough to give influence to every field of the North Korea's community and the New Year's message performs tutorial role throughout the whole year. The said messages of Il Sung, Kim Jong Il, and Kim Jong-un regimes have been researched and comprehensively summarized. The summarized New Year's Message by Kim Il Sung, Kim Jong Il, and Kim Jong Un are separated, compared and analyzed by the regime by presentation method, configured information, and others followed by New Year message's characteristics and implications of each North Korean regime that have been investigated. Based on the results of this analysis of Kim Jong-un era, possibility of its continuation and change is forecasted. Above all, for possible continuation of the ruling, sticking to the governing socialist way and military-first politics are presented. For possible causes of change, such the four factors as partial opening to overcome economic problems, the North Korean nuclear issue, influx of the nature of capitalism, and Kim Jung-un's control weakness have been presented. Such the factors of possible change and continuation of the North Korea Kim Jung-un ruling are expected to work as a combination of factors. The issue of continuation and change of North Korea Kim Jong-un's control is a key point for us to solve the issues between North and South Koreas. In the situation that the whole people of South Korea have a national consensus in the effort of gathering the public opinion, it is a high time that we needed to have much flexibility to actively cope with the North Korean issues.

Direction of Elderly Education in the Age of Science and Technology (과학기술 시대 노인교육의 방향)

  • Yoon Ok Han
    • The Journal of the Convergence on Culture Technology
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    • v.10 no.2
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    • pp.1-10
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    • 2024
  • The purpose of this study is to explore the direction of elderly education in the age of science and technology. The research contents to achieve the research purpose are, first, to examine the current status of elderly education, and second, to suggest the direction of elderly education in the age of science and technology. Due to the current status of education for the elderly, education for the elderly continues to change and develop, and various programs and activities are provided to help the elderly enjoy a richer retirement life. According to the survey report on the elderly, 11.9% of all elderly people participate in learning activities. Senior welfare centers accounted for the largest number of institutions conducting learning activities for elderly education learning activities participants at 35.5%. First, in the direction of elderly education in the age of science and technology, education on the use of digital technology and information is necessary in the composition of elderly education contents. Second, in the case of elderly education methods, customized elderly education methods are needed. Third, in the case of operating elderly education institutions, specialized education centers for elderly education must be further strengthened and supported. The international community is already forming a consensus that the establishment of new social systems and financial investment due to the increase in the elderly population should be considered a new growth engine rather than a social crisis. Although there is a burden on the social security sector due to the increase in the elderly population, there is a shift in the direction of recognizing the potential capabilities and experiences of the elderly and returning them to social resources. Elderly education in the age of science and technology needs to change to a direction that can build a healthy and progressive society in the future.

The Bethedsa System 2001 Workshop Report (The Bethesda System 2001의 최신지견)

  • Hong, Eun-Kyung;Nam, Jong-Hee;Park, Moon-Hyang
    • The Korean Journal of Cytopathology
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    • v.12 no.1
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    • pp.1-15
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    • 2001
  • The Bethesda System (TBS) was first developed in 1988 for the need to enhance the communication of the cytopathologic findings to the referring physician in unambiguous diagnostic terms. The terminology used in this reporting system should reflect current understanding of the pathogenesis of cervical/vaginal disease so the framework of the reporting system should be flexible enough to accommodate advances in medicine including virology, molecular biology, and pathology. Three years after the Introduction of TBS, the second Bethesda workshop was held to set or amend diagnostic criteria for each categories of TBS. TBS 1991 is now widely used. The third Bethesda workshop, The Bethesda System 2001 Workshop, was held in National Cancer institute Bethesda, Maryland from April 30 to May 2, 2001. Again, the goals of this workshop were to promote effective communication and to clarify in reporting cervical cytopathology results to clinicians and to provide with the information to make appropriate decisions about diagnosis and treatment. Nine forum groups were made and there were Web-based bulletin board discussions between October, 2000 and the first week of April, 2001. On the basis of bulletin board comments and discussions, the forum moderators recommended revised terminologies in the Workshop. Hot discussions were followed after the presentation by forum moderators during the workshop. Terminologies confusing clinicians and providing no additional informations regarding patient management were deleted in the workshop to clarify the cervicovaginal cytology results. Any informations related to the patient management were encouraged to add. So 'Satisfactory for evaluation but limited by...' of 'Specimen Adequacy' catergory was deleted. Terminology of 'Unsatisfactory' was further specified as 'Specimen rejected' and 'Specimen processed and examined, but unsatisfactory'. Terminologies of 'Benign Cellular Change' and 'Within Normal Limits' were combined and terminology was changed to 'Negative for intraepithelial lesion or malignancy'. In General categorization, category 'Other' was newly inserted and the presence of 'Endometrial cells' in women over 40 years old can be checked. Although the category 'Benign Cellular Change' was deleted, the organisms or reactive changes of this category can be listed in the descriptive diagnoses. Terminologies of ASCUS and AGUS were changed to atypical squamous cell and atypical glandular cell, respectively. Diagnostic term of 'Adenocarcinoma in situ', which is highly reproducible with reliable diagnostic criteria, was newly Inserted. The category of hormonal evaluation was deleted. Criteria for liquid-based specimen were discussed. Reporting by computer-assisted cytology was discussed and terminology for automated review was newly inserted. This is not the final edition of Bethesda 2001. The final document can be prepared before the ASCCP meeting in which Consensus Guidelines for the Management on Cytology Abnormalities and Cervical Precursors will develop in September 2001.

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Current Trends in the Treatment of Osteochondral Lesion of the Talus: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (거골 골연골병변 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Young, Ki Won;Lee, Dong Yeon;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.4
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    • pp.149-156
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    • 2021
  • Purpose: Given the lack of definite evidence-based guidelines in clinical practice, there may be a wide variation in treatment protocols for osteochondral lesions of the talus (OLT). Based on the Korean Foot and Ankle Society (KFAS) member survey, this study aimed to report the current trends in the management of OLT. Materials and Methods: A web-based questionnaire containing 30 questions was sent to all KFAS members in September 2021. The questions were mainly related to clinical experience and preferences in diagnosis, conservative, and surgical treatments for patients with OLT. Answers with a prevalence of ≥50% of respondents were considered a tendency. Results: Sixty-two (11.3%) of the 550 surgeons queried responded to the survey. The responses to 9 (30.0%) of the total of 30 questions established a tendency. Answers exhibiting a tendency were as follows; additional diagnostic tools except for plain radiograph (magnetic resonance imaging), most common conservative treatment method (oral medication, rest), most important radiological factor in decision making for surgical treatment and method (size of the lesion, ankle instability, loose bodies), most important patient factors in decision making for surgical treatment and method (age, activity or occupation), infrequently requiring posterior arthroscopy (less than 3%), most common revision surgery for failed bone marrow stimulation procedure (osteochondral autograft transplantation [OAT]), not requiring additional procedure for donor site in OAT, the main reason for unsatisfactory result after OAT (persistent pain without radiological abnormality), no generalization of autologous chondrocyte implantation or chondrogenesis using stem cells. Conclusion: This study presents updated information on current trends in the management of OLT in Korea. Both consensus and variations in the approach to patients with OLT were revealed through this survey. Since recent biologic efforts to regenerate cartilage have been unsuccessful, further studies to identify clinical evidence would be needed.

Knowledge, Attitude and Behavior of High School Students Regarding Irradiated Foods (고등학생의 방사선조사식품에 대한 지식, 태도 및 행위)

  • Choi, Yoonseok;Song, Jongnam;Jeong, Moontaek;Choi, Namgil;Han, Jaebok
    • Journal of the Korean Society of Radiology
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    • v.8 no.6
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    • pp.309-315
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    • 2014
  • This paper presents basic supporting data necessary for planning an educational intervention strategy as part of a communication strategy that would form an extensive national consensus on and enhance national understanding of irradiated foods. A survey was conducted to collect data on the knowledge, attitude, and behavior with regard to irradiated foods among high school students, on whom education has a great ripple effect compared with the general public. The results show that 82.9% (627 students) have acquired no information, whereas 89.3% (675 students) have received no education on irradiated foods. The reason for these overwhelmingly large percentages is the lack of available opportunity for education(88.2%). Their level of knowledge on irradiated foods scores 1.71 points (out of 10 points), which is very low, whereas their attitude toward the safety of irradiated foods scores 2.76 points (out of 5 points), which is relatively low as well. As such, we predict that their tendency to purchase and consume irradiated foods is low, given their very low level of knowledge of and negative attitude toward irradiated foods. The students who have been educated on irradiated foods show a higher level of positive attitude (p<0.001) toward irradiated foods compared with those who have had no education. This result suggests the need to provide high school students with knowledge on irradiated foods as well as education in the same to help them form a proper attitude toward these food items.

Current Trends in the Treatment of Ankle Ligament Injuries: Analysis of the Korean Foot and Ankle Society (KFAS) Member Survey (족관절 인대 손상 치료 동향: 대한족부족관절학회 회원 설문조사 분석)

  • Cho, Byung-Ki;Cho, Jaeho;Lee, Myoungjin;Lee, Jun Young;Bae, Su-Young;The Academic Committee of Korean Foot and Ankle Society,
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.1
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    • pp.22-29
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    • 2022
  • Purpose: Despite continuous updates of standard treatment guidelines for acute ankle sprain and chronic ankle instability (CAI), in practice preferred treatment protocols vary widely. Based on a Korean Foot and Ankle Society (KFAS) member survey, this study reports current trends in the management of ankle ligament injuries. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in September 2021. Questions mainly addressed clinical experience and preferences for the diagnosis and treatment of ankle ligament injuries. Answers with a prevalence of ≥50% among respondents were considered to reflect tendencies. Results: Eighty-four of the 550 members (15.3%) responded. Answers that showed a tendency were as follows: commonest additional image study (ultrasound), conservative treatment modality (immobilization, oral medication), frequency of surgical treatment (<5 cases per annum), most important factor when deciding on surgical treatment (activity level, e.g., occupation or sport), and commonest surgical procedure (open ligament repair). Answers that showed a tendency for CAI were as follows: most important symptom (repeated sprain, giving way), radiological factors (talar tilt, osteochondral lesion, anterior talar translation), and patient factors (occupation, sports activities, recurrent instability after surgery, etc.). For decision making regarding surgical treatment and method, the most preferred surgical procedure was the modified Broström procedure, and the most common repair technique was suture anchor technique. The following were considered poor prognostic factors; generalized laxity, failed previous surgery, cavovarus, severe mechanical instability, heavy work, obesity, and dissatisfaction after surgery because of residual pain. Conclusion: This study updates information regarding current trends in the management of ankle ligament injuries in Korea, and reveals consensus opinions and variations in approaches to patients with an acute or chronic injury. The divergence of approaches identified indicates the need for further studies to determine standard guidelines and long-term results.