• Title/Summary/Keyword: graduate medical education

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Drug Use Evaluation of Antihypertensive Agents by JNC VI Guidelines (고혈압 치료 지침 Vl에 의한 항고혈압제의 사용평가)

  • Kim, Kyung Hwa;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.1
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    • pp.29-38
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    • 2002
  • Hypertension is an important public health problem because it increases the risk of stroke, angina, myocardial infarction, heart failure, and end-stage renal disease. If it is not actively treated, morbidity and mortality increase with hypertension-induced complications and quality of life decreases. This study was to evaluate the use of antihypertensive drugs and blood pressure changes and to compare algorithms chosen (or the 1st and 2nd line therapy of hypertension based on the JNC VI recommendations. The medical charts of 222 patients with essential hypertension at St. Vincent's Hospital in Suwon from January 1997 to January 2000 were reviewed retrospectively. Data collection and analysis included baseline BP underlying diseases and complications, administered antihypertensives, BP changes, changes of antihypertensive regimen, and adverse effects with treatments. As results, the higher BP the patients had, the more frequent they had target organ damages and clinical cardiovascular diseases. Mean duration to reduce blood pressure less than 140/90 mmHg was 8 weeks in $85.3\%$ of the patients. The rate of control in BP was $82.4\%$ at 6 months. The major antihypertensive drugs prescribed were calcium channel blockers $(61.8\%)$ , ACE inhibitors $(19.1\%),\;\beta-blockers\;(13.7\%)$ and diuretics $(5.3\%)$ as the 1st-line monotherapy. The methods of treatment used as the 1st-line therapy were monotherapy$(59\%)$ and combination therapy $(41\%)$. Blood pressure change was significantly greater for combination therapy than monotherapy$(-26.2\pm21.4\;vs.\;-18.56\pm16.7$ mmHg for systolic blood pressure; P<0.003, $-16.9\pm13.2\;vs.\;-9.2\pm12.8$ mmHg for diastolic blood pressure; p<0.001). When blood pressure was not completely controlled with the first antihypertensive selected, the 2nd line therapy had 4 options: addition of 2nd agent from different class; $66.2\%$, substitution with another drug, $21.9\%$ increase dose $11.9\%$ continue first regimen $27.9\%$ Calcium channel blockers were the most frequently prescribed agents. This was not comparable to the JNC VI guideline which recommended diuretics and $\beta-blockers$ for the 1st-line therapy. Most of patients achieved the goal BP and maintained it until 6 months, but the remaining patients should be controlled more tightly to improve their BP with combination of life style modification, patient education, and pharmacotherapy.

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The Relations of the Life Style and Housing Selection Attributes of the Middle-aged People (중년층의 라이프스타일이 은퇴 후 주거선택속성에 미치는 영향)

  • Lim, Sun-Mi;Ha, Kyu-Soo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.8074-8088
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    • 2015
  • In this study, main focus was analyzing whether the retired middle-aged people's life style and personal characteristics affect house selection attributes and there are any differences according to their life styles. The finding and implications of this study were as follows. The middle-aged people were trying to pursue leisurely and healthy life. Therefore, they prefer the high service quality of health, medical facilities, culture, leisure, and entertainment facilities. These trends were caused by the expansion of the five-days working styles, the improvements of the smart consumptions, the high levels of the education, and the high social and economic participations of the females. The overall changes in social, cultural, economical circumstances made them different from other generations. Also current middle-aged people were more challenging and active and they thought themselves young compared with the people of the older generation. In the future those middle-aged people's life style will be more diversified. Therefore new housing plans are necessary for the middle-aged popple to satisfy their diverse housing needs and housing circumstances. Based on the results of this study for the middle-aged people's life style and housing selection attributes after their retirement, more studies are necessary in new and different views. Furthermore diverse house supplies, housing marketing, housing policies should be provided for the middle-aged people for their retirement and need to study more their future housing satisfaction and their housing needs.

A Evaluation Parameter Development of Anesthesia Depth in Each Anesthesia Steps by the Wavelet Transform of the Heart Rate Variability Signal (HRV 신호의 웨이브렛 변환에 의한 마취단계별 마취심도 평가 파라미터 개발)

  • Jeon, Gye-Rok;Kim, Myung-Chul;Han, Bong-Hyo;Ye, Soo-Yung;Ro, Jung-Hoon;Baik, Seong-Wan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.9
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    • pp.2460-2470
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    • 2009
  • In this study, the parameter extraction for evaluation of the anesthesia depth in each anesthesia stages was conducted. An object of the this experiment study has studied 5 adult patients (mean $\pm$ SD age:$42{\pm}9.13$), ASA classification I and II, undergoing surgery of obstetrics and gynecology. Anaesthesia was maintained with Enflurane. HRV signal was created by R-peak detection algorithm form ECG signal. The HRV data were preprocessing algorithm. It has tried find out the anesthesia parameter which responds the anesthesia events and shows objective anesthesia depth according to anesthesia stage including pre-anesthesia, induction, maintenance, awake and post-anesthesia. In this study, proposed algorithm to analysis the HRV(heart rate variability) signal using wavelet transform in anesthesia stage. Three sorts of wavelet functions applied to PSD. In the result, all of the results were showed similarly. But experiment results of Daubeches 10 is better. Therefore, this parameter is the best parameter in the evaluation of anesthesia stage.

The Status of Managing Posttraumatic Stress in Life Managers for Elderly People Living Alone and Measures for its Improvement: Focusing on Employees in Seoul (독거노인생활관리사의 외상 후 스트레스 관리 실태와 개선 방안: 서울 지역 종사자를 중심으로)

  • Kim, Keun-Hong;Yang, Jae-seok;Lee, Gyeong-jin;Kim, Jeong-yeon
    • 한국노년학
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    • v.37 no.2
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    • pp.293-308
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    • 2017
  • This study aims to examine Life Managers for Elderly People Living Alone (LMEPLAs) in Seoul regarding their traumatic experience and the status of their posttraumatic stress disorder and also how they are coping with it in order to find out ways to improve it. As a study method, we investigated LMEPLAs in Seoul through a self-administered survey regarding whether they had faced any traumatic experience, types of their traumatic experience, diagnosis on posttraumatic stress, and the status of their coping with traumatic experience. According to the study results, 186 respondents (37.57%) have been found to indicate either partial or complete posttraumatic stress symptoms, but the status of their coping with it is very poor. The followings are the results of our discussion. First, it is needed to find out life managers suffering from posttraumatic stress disorder and build up a system to manage them consistently. Second, it is necessary to vitalize education about traumatic experience and posttraumatic stress management. Third, it is urgently needed to build up a system to support life managers who have faced any traumatic experience or been diagnosed to have posttraumatic stress disorder. Fourth, it is demanded to cultivate and arrange experts equipped with specialized knowledge and technique. Fifth, it is needed for them to build a network with medical institutes to receive a prompt diagnosis and specialized treatment.

Current Status and Development Direction Through a Review of Yoga Therapy Literature (요가치료 문헌 고찰을 통해 본 현황과 발전 방향)

  • Jung, Youn-Heui;Lee, Geo-Lyong
    • Journal of Naturopathy
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    • v.11 no.1
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    • pp.68-78
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    • 2022
  • Background: Integrative medical research is needed to explore the development direction of new yoga therapy. Purposes: A systematic literature review is conducted to analyze the current status of clinical research on yoga therapy into scientific categories, and to explore the content and development direction of yoga therapy. Methods: Through electronic databases such as RISS, NDSL, DBpia, e-article, and KISS, 530 domestic academic papers were selected from 2010 to 2018 and the final 28 were extracted based on PRISMA guidelines. Results: As a result of the study, in terms of quality, it remained at 3b of the CEBM level of evidence, and in terms of quantity, the number of experimental groups in the entire clinical study was 288, so domestic clinical studies of yoga therapy are insufficient. It was found that 80% of yoga therapy was exercise therapy focusing on asana movements. This seems to be due to a lot of researchers in the field of physical education. Conclusions: These results indicate that understanding and practice of the Ashtanga-yoga's training system and Pancha-kosha theory from the perspective of integrative medicine are necessary. In other words, yoga therapy is required to develop into an integrated mind-body therapy program that integrates holistic healing yoga based on individual mental and physical constitution, meditation therapy based on Ayurveda, and exercise therapy.

The Study of the Effect on the Improvement of Cognitive function by Cognitive Health Program (실버인지건강프로그램이 노인의 인지기능 향상에 미치는 영향에 대한 연구)

  • Kim, Neung Yeon;Jeong, Hyun Jong;Jang, Ah Ryoeng
    • 한국노년학
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    • v.39 no.4
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    • pp.801-824
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    • 2019
  • As becoming an aging society, there is a rising interest on dementia. But Dementia prevention program, executed at the national level, is in insufficient state. In this study, to design and diffuse Dementia prevention program, this study conduct Cognition improvement program and evaluate cognitive function in aspects of Discrimination, Organization, Thinking, Memorizing, and Concentration capacity. So that this study try to investigate how this Cognition improvement program will affect in detail to cognitive function in senior people. This study designed Silver Cognition program for 5 aspects of cognitive function; Discrimination, Organization, Thinking, and Concentration capacity. And this studyrecruited experimental group with control group, and conducted the program to them for 3 months. At the start and the end of the program, this study evaluated their MMSE-DS score, Geriatric depression scale, Quality of life score, and cognitive function test score by survey. Finally, this study compared and analyzed these first and second score to find the effects of this program to cognitive function. As the results compared between first and second score of MMSE-DS test, Geriatric depression scale, Quality of life scale, and cognitive function test, Silver Cognition program has a significant effects to improve cognitive function, MMSE-DS score and Geriatric depression scale. As the results of the test on cognitive function in 5 aspects, cognitive function is more improved in the order of Memorizing, Thinking, Concentration, Discrimination, and Organization capacity. After the Silver Cognition program, Memorizing and Thinking capacity have most improvement. But aging of brain function is faster in these two capacity, so if more concentrated education is conducted for these two capacity, then it will bring better effects for prevention of dementia.

Relationship between Depression and Health Care Utilization (우울과 의료이용의 관계)

  • Hyo Eun Cho;Jun Hyup Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.68-77
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    • 2024
  • Background: Depressive disorders can be categorized into daily depression and clinical depression. The experience of depressive disorder can increase health care utilization due to decreased treatment compliance and somatization. On the other hand, the clinical depression group may also experience social prejudice associated with the illness, which can limit their access to health care utilization. In terms of the significance of health care utilization as a factor in individual and social issues, this study aims to compare the health care utilization of the clinical depression group with that of the non-depressed group and the daily depression group. Methods: The analysis utilized the inverse probability of treatment weighting based on the generalized propensity score. Results: As a result of the analysis, clinical depression and daily depression were higher among women, low-income groups, individuals with low education levels, and so forth. The clinical depression group was also higher among individuals who were not economically active, did not have private health insurance, or had multiple chronic diseases. The number of outpatient department visits in the depression group was significantly higher than in the non-depressed group. In addition, the number of outpatient department visits for the clinical depression group was significantly higher than that for the daily depression group. Outpatient medical expenses were higher in the depression group than in the non-depressed group, and there was no significant difference between the clinical depression group and the daily depression group. Conclusion: Health care utilization was higher in the depression group than the non-depressed group, it was also higher in the clinical depression group than the daily depression group.

A Survey on the Certification and Curriculum Development for Hospice and Palliative Care Professionals (호스피스.완화의료 전문인력 자격인증방안과 교육과정개발을 위한 설문조사)

  • Kang, Jin-A;Kim, Do-Yeun;Shin, Dong-Wook;Kim, Si-Young;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.32-40
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    • 2010
  • Purpose: The survey was aimed to provide basic data to develop a certification system for hospice and palliative care professionals. Methods: National Cancer Center (NCC) and the Korean Society for Hospice & Palliative Care (KSHPC) conducted the survey for hospice and palliative care professionals who worked at 34 Palliative care units designated by the Ministry of Health, Welfare, and Family Affairs (MW) and the members of the KSHPC. The survey was conducted via e-mail from June 17 to 23, 2009. Total 220 professionals were surveyed. Results: Most of the hospice and palliative care professionals reported a great need for certification system: Physician, 90% (n=51) nurse, 84% (n=134) social worker, 89% (n=35). In regard with the requirement for the certification, a majority of physicians (46%) preferreddiploma course, while social workers (46%) preferred training course for medical social workers. Concerning the certification body, physician (45%) preferred the KSHPC and the MW almost equally, while nurses (50%) and social workers (60%) preferred the MW highly. As for the body to develop and accredit advance training course for each professionals, most of the physicians (51%) preferred the KSHPC, whereas nurses and social workers preferred collaboration of the MW (or NCC) with the professional society, such as the KSHPC (23%), the Korean Hospice & Palliative nurses association for nurses (21%), or the Korean association of (medical) social workers (37%). Lastly, all respondents preferred the course format of once a week, full day, and some field study at weekend. Conclusion: Korean hospice and palliative care professionals identified the great need for the certification system, therefore, the adequate system development must be followed to reflect their voice.

Recognition Level of Organization, Motivation and Job Satisfaction Factors of the Staff of Health Centers (보건소직원의 조직에 대한 인식과 동기부여요인 및 직무만족요인)

  • 남철현;위광복
    • Health Policy and Management
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    • v.10 no.3
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    • pp.19-49
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    • 2000
  • This study was conducted to help staff members of health centers manage personnel by examining the staff members' recognition level of organization structure of health centers, their motivation, their job satisfaction level and its related factors. Data were collected from 471 staff members of 14 health centers from March 3, 1999 to April 30, 1999. The results of this study are summarized as follows. In recognition levels of organization structure of health centers, the recognition level of necessity of discretion right was highest(3.55 points on the base of 5 points), while the recognition level of the location of decision making right was lowest(2.77 points). The general recognition of organization structure of health centers was 3.06 points, the suitability of division of duties was 3.05 points, and the optimum of manpower and budget was 2.93 points. The staff members' general recognition level of the organization structure appeared significantly higher in case of the groups of small and medium sized cities, above fifties, below high school graduate, above the sixth grade, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of one million, eight hundred and ten thousand won. In the recognition level of the location of decision making right, the groups of big cities, male, the married, above the sixth grade, health and administration posts, average monthly salary of one million, three hundred and ten thousand won to one million, and eight hundred thousand won were significantly higher than the other groups. The recognition level of necessity of discretion right was higher in case of the groups of the twenties, the unmarried, above college graduate, nursing post, public service experience of below 5 years, service period of below 2 years at present post, and average monthly salary of below eight hundred thousand won. In the recognition level of suitability of division of duties, the groups of small and medium sized cities, the married, medical technicians, public service experience of above 20 years, and service period of below 4 years at present post were significantly higher than the other groups. In the staff members' recognition levels of organization management, the recognition level of opinion response when making decision was highest(2.92 points). The recognition level of rationality of the target amount establishment method was 2.88 points and the recognition level of personnel management was 2.63 points. The recognition level of personnel management was significantly higher in case of the groups of small and medium sized cities, the forties, above the sixth grade, medical technicians, public service experience of above 20 years, service period of below 2 years at present post, and average monthly salary of above one million, eight hundred and ten thousand won. In the recognition level of opinion response when making decision, the groups of small and medium sized cities, female, the eighth grade, health and administration posts, and service period of below 2 years at present post were higher than the other groups. The recognition level of rationality of the target amount establishment method was significantly higher in case of the groups of above fifties, below high school graduate, above the sixth grade, medical service post, and public service experience of 15 to 20 years. The factors significantly influencing sanitation were sex, education level, the period of public service experience, general recognition of organization structure, recognition of necessity of discretion right, recognition of suitability of division of duties, and recognition of opinion response when making decision. The factors which significantly influenced motivation were marital status, grade, recognition of the location of decision making right, recognition of necessity of discretion right, recognition of division of duties, recognition of opinion response when making decision, and sanitation. Sex, education level, recognition of suitability of division of duties, recognition of the target amount establishment method, and motivation influenced job satisfaction significantly. The factors significantly influencing organization culture were age, the period of public service experience, service period at present post, recognition of optimum of manpower and budget, recognition of suitability of division of duties, recognition of opinion response when making decision, and recognition of rationality of the target amount establishment method. In the coming days, the staff members' job satisfaction level must be increased through motivation and efficient conduct of duty must be accomplished through rational organization structure and management. Moreover, change of the staff members' consciousness and administrative system which are suitable for local autonomy system have to be established with increase of local residents' consciousness level and education level. Forming organization culture by reformative idea which fits the new era, public health service by the Community Health Act and health education service by the Health Promotion Act must be carried out efficiently. In doing so, financial support of central government and active efforts and concerns of local governments have to be devoted in order to get public health service in which peculiarity of the community is considered to be pursued well.

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A study of quality of working life to dental hygienist's (치과위생사의 근로생활의 질(QWL)에 관한 연구)

  • Oh, Hye-Seung;Kim, Eun-Hee
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.2
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    • pp.375-392
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    • 2010
  • Objectives : Dental hygienist's work satisfaction and stress affect the overall quality of work life(QWL). Therefore, this research is intended to suggest fundamental data to improve QWL by finding out characteristics of each work satisfaction and stress element. To this end, a total of 327 dental hygienists working at general hospitals, university hospitals, dental hospitals and dental clinics across Seoul, Gyeonggi and Incheon were surveyed. Results of survey are as follows. Methods : The collected data were analyzed by using an SPSS 12.0 statistical program, obtaining the following results. The collected data conducted a questionnaire survey for 327 dental hygienists who work at the hospitals, university hospitals, dental hospitals, and dental clinics located at Seoul, Gyeonggi-do, and Incheon district from January until March, 2009, and drew the conclusions as follows. Result : 1. Demographic characteristics, income from 1.5 to 1.99 million were the whole lot, more than 2 million to less than 1.5 million was similar. Marital status Married Unmarried higher than the atheist religion, Christianity, Catholicism, Buddhism, and other, respectively. Classification by level of education in the college graduate, university graduate, graduate diploma, respectively. 2. Are working in a job-related characteristics of dentistry, dental hospital, general and university hospital, respectively. The making in position, Mount, contractor, responsible, senior, was an intern in the order. The five-day workweek whether working at night and is not going to care whether the conduct was similar. Classification of working hours and 8 hours, 8 hours, 8 hours or less orderly, and total of less than 1-3 years of clinical experience, 5 years, less than one year, less than 3-5 years, respectively. 3. There comes out a significant difference according to age, income, position, gross clinical experience, and whether to put night shift into practice in job stability in terms of the quality subsequent to general characteristics(p<.05). 4. There comes out a significant difference according to marital status, one's place of work, position, whether to put a five-day workweek into practice in work environment and benefits package in terms of the quality subsequent to general characteristics (p<.05). 5. There comes out a significant difference according to age, marital status, income, position, and gross clinical experience in education & training and benefits packages in terms of the quality subsequent to general characteristics(p<.05). 6. There comes out a significant difference according to whether to put night medical treatment into practice in social usefulness in terms of the quality subsequent to general characteristics(p<.05). 7. There comes out a significant difference according to marital status, income, one's place of work, gross clinical experience, work hours, and whether to put a five-day workweek into practice in leisure activity in terms of the quality subsequent to general characteristics(p<.05). 8. There comes out a significant difference according to income, one's place of work, and position in wage level in terms of the quality subsequent to general characteristics(p<.05). 9. There was no significant difference in all items related to human relations and free communication in terms of the quality subsequent to general characteristics(p>.05). Conclusions : It is necessary to analyze factors related to work satisfaction and stress in order to improve dental hygienist's quality of work life. Hospitals must support them systematically and institutionally and related organizations must conduct practical research.