Background: Evidence for associations between dietary factors and breast cancer risk is inconclusive among Chinese females. To evaluate this question, we conducted a systematic review of relevant case-control and cohort studies. Methods: Studies were systematically searched among 5 English databases (PudMed, ScienceDirect, Wiley, Clinicaltrials.gov, and Cochrane) and 3 Chinese databases (CNKI, WanFang, and VIP) until November 2012. Random effects models were used to estimate summary odds ratios (ORs) and the corresponding 95% confidence intervals (CIs). Results: Thirty one case-control studies and two cohort studies involving 9,299 cases and 11,413 controls were included. Consumption of both soy and fruit was significantly associated with decreased risk of breast cancer, with summary ORs of 0.65 (95% CIs: 0.43-0.99; I2=88.9%, P<0.001; N=13) and 0.66 (95% CIs: 0.47-0.91; $I^2$=76.7%, P<0.001; N=7), respectively. Consumption of fat was significantly associated with increased risk of breast cancer (OR=1.36; 95% CIs: 1.13-1.63; $I^2$=47.9%, P=0.088; N=6). There was nonsignificant association between consumption of vegetables and breast cancer risk (OR=0.72; 95% CIs: 0.51-1.02; $I^2$= 74.4%, P<0.001; N=9). However, sensitivity analysis based on adjusted ORs showed decreased risk of breast cancer was also associated with consumption of vegetables (OR=0.49; 95% CIs: 0.30-0.67). Conclusion: Both soy food and fruit are significantly associated with decreased risk of breast cancer among Chinese females, and vegetables also seems to be protective while dietary fatexerts a promoting influence.
In this study, the effects of a 12-month multidisciplinary education program on the health status, dietary quality, and eating habits of children and adolescents attending community childcare centers were investigated. A total of 88 participants aged 7 to 17 years from 7 community childcare centers in Gyeonggi-do were enrolled. The intervention consisted of 12 multidisciplinary education sessions covering topics such as nutrition, exercise, and psychological education. All participants received the same education, and the effectiveness of the program was evaluated by categorizing them into a high participation group (HPG) and a low participation group (LPG) based on their participation rates. After intervention, in physical activities, moderate-intensity exercise was significantly reduced in the LPG, and there was no significant difference in psychological parameters. However, notable differences were observed in nutritional data. After intervention, intakes of calorie, carbohydrate, protein, and fat were significantly increased in both groups, and in particular, the change was found to be greater in HPG. Additionally, dietary fiber intake compared to the 2015 Korean Dietary Reference Intakes was increased in both groups. Daily food intake also increased dietary fiber intake in HPG, and meat and fruit intake was increased in LPG. In the nutrition quotient, there was a significant difference in HPG's pre- and post-scores in the diversity category, and in nutrient adequacy ratio (NAR), the NAR of phosphorus was increased in both groups. The findings of this study suggest that multidisciplinary education implemented at community childcare centers primarily enhanced nutrition-related factors rather than physical activity or psychological aspects.
The present study aimed at evaluating and comparing the diagnostic performance of B-mode ultrasound (US), elastography score (ES), and strain ratio (SR) for the differentiation of breast lesions. This retrospective study enrolled 431 lesions from 417 in-hospital patients. All patients were examined with both conventional ultrasound and elastography. Two experienced radiologists reviewed ultrasound and elasticity images. The histopathologic result obtained from ultrasound-guided core biopsy or operation excisions were used as the reference standard. Pathologic examination revealed 276 malignant lesions (64%) and 155 benign lesions (36%). A cut-off point of 4.15 (area under the curve, 0.891) allowed significant differentiation of malignant and benign lesions. ROC (receiver-operating characteristic) curves showed a higher value for combination of B-mode ultrasound and elastography for the diagnosis of breast lesions. Conventional ultrasound combined elastography showed high sensitivity, specificity, and accuracy for group II lesions (10mm${\leq}20mm$). Elastography combined with conventional ultrasound show high specificity and accuracy for differentiation of benign and malignant breast lesions. Elastography is particularly important for the diagnosis of BI-RADS 4 and small breast lesions.
Objectives : This paper aims to study the educational meaning of Shanghanjiushilun in Shanghanlun education focusing on purgation therapy. Methods : Clinical medical records in Shanghanjiushilun associated with purgation therapy were chosen, analyzed and its educational meaning was studied. Results & Conclusions : 1. Xushuwei's clinical medical records are significant as it helps the readers think of various disease mechanisms by not omitting mistreatment of the other doctors. 2. Xushuwei's clinical medical records are significant as it helps the readers become aware of the importance of a differential diagnosis through questions and answers. 3. Xushuwei's clinical medical records are significant as it helps the readers avoid looking at one side of things through taking a comprehensive look at disease syndrome in various fields. 4. Xushuwei's clinical medical records are significant as it helps the readers escape unreasonableness by suggesting practical aspect managing the patient. 5. Xushuwei's clinical medical records are significant as it enable the readers to draw a new disease mechanism interpretation by making up for explanations of the pathogenesis quoting medical classics. 6. Consequently, in learning and teaching Shanghanlun, Xushuwei's clinical medical records have enough educational meaning as mentioned above.
Physicians should be able to address health-related issues of patients and populations from a multidimensional perspective. Therefore, medical schools have a social responsibility to develop and implement curricula that enable trainees to acquire the competencies needed to improve all aspects of patient care and healthcare delivery. This study explored the concept of health systems science concept as the third pillar of medical education (the other two are basic science and clinical medicine) in the Korean context, as well as related educational needs. The theoretical foundation of health systems science is the biopsychosocial conceptual model, which emphasizes the biological, psychological, and social factors surrounding patients. We concluded that the three domains (core functional, foundational, linking) and 12 subcategories of health systems science proposed by the Association of American Medical Colleges could be applied to Korean medical education. Health systems science education must be emphasized to solve the various healthcare problems facing Korea today and to train physicians to provide medical services in line with society's needs. Introducing a health systems science curriculum will be challenging in the Korean medical environment, which has traditionally emphasized basic science and clinical medical education. Health systems science education should begin in the basic medical education phase, where physicians' professional identity is formed, and continue through graduate medical education. It is essential to understand related educational needs, develop curricular content, conduct faculty development programs, and provide financial resources for the development of an integrated curriculum.
Building professional identity is the most basic purpose of medical education. Students who enter medical schools do not have an identity rooted in the medical profession, and universities should therefore take steps to help students form their identity as doctors, attitudes, beliefs, and values through the curriculum. However, while medical knowledge and clinical skills are fully reflected in basic medical education, issues persist regarding education on values, attitudes, and beliefs that are important for professional identity. Regarding the process of professional identity formation, it is important to keep in mind that rapid changes in modern society lead to corresponding changes in socio-cultural expectations and demands related to professional identity, resulting in discrepancies between the reality of medical education and the actual field of medicine. Medical schools need to prepare students for these discrepancies, and in-depth discussions should address what is important and what should be solved first at medical education sites. However, it is difficult to generalize the tasks of professional identity formation in the field of medical education because each medical school may have unique circumstances. This article discusses the tasks that medical education should solve for professional identity formation education in terms of five aspects: establishing learning outcomes, training educational experts, introducing transformative learning, utilizing self-directed learning, and developing evaluation methods.
Kim, Jung Tae;Kim, Jong Yoon;Kim, Myung Chun;Rhew, Ki Yon
Korean Journal of Clinical Pharmacy
/
v.23
no.1
/
pp.65-70
/
2013
Background: Colleges of Pharmacy in Korea have increased the number of years required for the degree from 4 years to 6 years in 2009. These changes are demanding revolution of education in pharmacology. The center of gravity is moving from medicine to application, theory to work. Problem-Based Learning is "learn to learn" working cooperatively in groups to seek solutions to real problems. PBL process cheers students to think critically to find optimal solution using appropriate learning resources. Method: Eighteen students in college of pharmacy are selected to participate in PBL lecture and take part in the survey about the effect of PBL in clinical pharmacy education. Results: General satisfaction score was high as four on a five-point scale, and students have improved on anxious about communication since the PBL classes compared to before of the lecture (P=0.037). Conclusion: PBL could be applied in clinical pharmacy education to progress student's participation and satisfaction. In addition this is improved communication skill in medical team during pharmacy practice.
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.
Jo, Hak-Jun;Jo, Na-Young;Roh, Jeong-Du;Park, Jeong-Su
Journal of Society of Preventive Korean Medicine
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v.25
no.3
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pp.101-115
/
2021
Objectives : This study compares clinical practice students' perception of Clinical Performance Examination (CPX) in a College of Korean Medicine using actors as Actor Standardized Patient (ASP) and enrolled students as Student Standardized Patient (SSP). Methods : Targeting the clinical practice students who completed the clinical practice education in the first semester of the fourth year in the Department of Korean Medicine, a survey was conducted on total six categories such as satisfaction with CPX using ASP and SSP, prior knowledge about clinical practice education, self-evaluation, difficulties in the process of performing the CPX, satisfaction with ASP/SSP, and familiarity with them. Results : In the results of the survey, the mean score of CPX program using SSP was higher than that of CPX program using ASP in every area. Among them, in the satisfaction with CPX itself and prior knowledge about various clinical practice education, the mean score of CPX program using SSP was statistically significantly higher than that of CPX program using ASP. Conclusions : Overall, the clinical practice students' satisfaction with CPX program using SSP was higher than that of CPX using ASP, and statistically significantly higher in some areas.
Piriformis syndrome is a common differential diagnosis related to sciatica. The following review provides a concise synopsis of the diagnosis, management, history, and alternatives to diagnosis of piriformis syndrome. A search of the literature for research articles related to piriformis syndrome and associated differential diagnosis of sciatica was conducted. A thorough review of the included articles found that the condition known as piriformis syndrome is over-diagnosed and that potential anatomic and biomechanical variations originating in the pelvic region might be related to the complaint of sciatica. The criteria for diagnosis are based on findings from both physical examination and radio imaging. Piriformis syndrome resembles a variety of clinical conditions; therefore, conduct of future studies should include development of a validated method for evaluation as well as clinical criteria for diagnosis of piriformis syndrome.
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