Cheol-Hyeong Lee;Eun Young Lee;Miyoung Yang;Hyung-Sun Won;Yeon-Dong Kim
The Korean Journal of Pain
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제36권4호
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pp.458-464
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2023
Background: Fibromyalgia (FM) is a complex disorder characterized by widespread chronic pain and tenderness in the muscles, ligaments, and soft tissues. It is a chronic pain condition often accompanied by other symptoms and comorbidities. To effectively manage FM, it is crucial to obtain fundamental epidemiological data pertaining to the target population. Therefore, this study was conducted to elucidate the epidemiological characteristics of FM in the Korean population. Methods: Population-based medical data of 51,276,314 subscribers to the National Health Insurance Service of Korea from 2014 to 2018 were used in this study. Results: The overall incidence of FM ranged from 441 (2014) to 541 (2018) cases per 100,000 person-years, with a higher prevalence observed among female patients compared to male patients. The incidence gradually increased until middle age, followed by a decrease. The highest incidence rates were observed in the fifth decade of life for females and the sixth decade of life for males. When categorizing the affected parts of the body, the shoulder region was observed to be the most frequently affected. A comparison of the drug prescriptions based on medical specialty showed that antidepressants were the most commonly prescribed medications. The management of FM leads to consistent increases in medical expenses, regional disparities, and variations in prescription patterns across different medical specialties. Conclusions: The findings of this study will not only contribute to the understanding of FM characteristics but also provide a vital foundation for efficient management of FM in Korea.
Mongolia is suffering from the inadequate capacity of medical doctors due to a poor education and training system. The purpose of this article is to evaluate the effect of a clinical training program for capacity building of medical doctors in Mongolia, and to suggest an effective model for continuing professional development in developing countries. Based on the results of a needs assessment, Korean and Mongolian medical experts developed a clinical training program and trained the trainers on 32 topics regarding major clinical problems in 6 specialties, including cardiology, endocrinology, pediatrics, obstetrics and gynecology, neurology, and emergency medicine. Surveillance survey and pre/post-test were used on every topic to evaluate the satisfaction and achievement, respectively, of the trainees. Six months after the clinical training program, we interviewed a sample of medical professionals to evaluate the change and impact. A total of 612 (person-year) medical doctors participated in the training, and the average score for satisfaction was 7.69 out of 8. The average score of the pre-test was 46.9 out of 100, while the post-test was 82.4. After the training, the medical doctors were applying their new knowledge and skills to their practice, and using the materials as guidelines, which improved their practice and increased patient satisfaction. They also started their own training program and adopted new equipment at their hospitals. The satisfaction and achievement of the trainees were very high, and there was significant change in the medical practice, education system, and infrastructure after the training program. This training program can be an effective model for capacity building of medical doctors in developing countries.
Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.
This study was planned to investigate the relationship between development levels of learning organization and organization effectiveness in Hospital. Data were collected from 285 respondents who have participated in 'Learning Organization Project'(response rate =$50.5\%$). Structured questionnaire were applied by self administrated survey for two weeks since 2003 May. Main results were as follows; In the result of factor analysis, four factor were created and almost questionnaire items were classified into as same categories as theoretical concepts. Cronbach's a coefficient also showed over 0.7 in all categories. This result means that measurement tool to evaluate the development level of learning organization is valid and reliable. In the comparison of the development level of learning organization by participants' specialties, managerial workers perceived the lowest construction level, while medical technicians evaluated it as the highest level. In regression analysis, the perception levels of work environment, task and human aspect showed positive relationship with job competency significantly. For job satisfaction, levels of task and human aspects had positive relationship significantly. In addition, for organizational commitement, levels of organization and human aspect were positive predictors. Finally, for the satisfaction about experience of learning organization project, levels of environment, task and hmm aspects were related positively. We concluded from these result that the positive relationship between construction levels of learning organization and organization effectiveness was extended to hospital, besides industrial fields. We recommend the introduction and facilitation of learning organization project in various settings to improve the competency of knowledge management in individual and organizational levels.
Few studies have examined burnout among the faculty of medical schools in the Republic of Korea. The aim of this study was to determine the level of burnout and its associated factors among the faculty members of three medical schools in the Busan-Gyeongnam area, and to summarise the available literature on burnout. We conducted the survey using a validated questionnaire that incorporated the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) as well as questions about demographic characteristics, working experience, health, lifestyle, most time spent and most difficult work, and suicidal ideation and job quitting ideation of the survey participants. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (De), and personal accomplishment (PA). Through the survey, the 186 professors, 49% among the total, provided data which were included in the present analysis. More than thirty per cent (37.1%) of the professors reported at least 1 symptom of burnout. For burnout dimensions, 11.8% of the respondents scored high for EE burnout, 25.3% for De, and 14.5% for PA, with 1.6% scoring high on all three dimensions of burnout. High burnout was found to be strongly associated with several of the variables under study, especially hours worked per week, self-rated health, career (range, 4 to 9 years), and age (range, 50 to 59 years). The EE score was highest for the professors who chose 'patient care' as the most difficult type of work. This study showed that just over one-third of professors have at least 1 symptom of burnout and working more hours per week, short length of work (years), and especially suicidal ideation seem to be associated with the burnout of medical school faculty members in the Busan-Gyeongnam area. In summary, a greater risk of burnout of physicians (including medical professors) seems to be associated with specialties at the front line of care, working more hours per week, work-life imbalance, low self-efficacy, depression, and conflicts with colleagues and patients.
Jafarzadeh-Kashi, Tahereh Sadat;Mirzaii, Marzieh;Erfan, Mohmmad;Fazel, Akbar;Eskandarion, Solmaz;Rakhshan, Vahid
The Journal of Advanced Prosthodontics
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제3권4호
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pp.216-220
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2011
PURPOSE. Heat of composite polymerization (HP) indicates setting efficacy and temperature increase of composite in clinical procedures. The purpose of this in vitro experimental study was to evaluate the effects of 5 temperatures on HP of two new composites. MATERIALS AND METHODS. From each material (Core Max II [CM] and King Dental [KD]), 5 groups of 5 specimens each were prepared and their total HPs (J/gr) were measured and recorded, at one of the constant temperatures $0^{\circ}C$, $15^{\circ}C$, $23^{\circ}C$, $37^{\circ}C$ and $60^{\circ}C$ ($2{\times}5{\times}5$ specimens) using a differential scanning calorimetry (DSC) analyzer. The data were analyzed using a two-way ANOVA, a Tukey's test, an independent-samples ttest, and a linear regression analysis (${\alpha}=0.05$). RESULTS. No polymerization reactions occurred at $0^{\circ}C$; then this temperature was excluded from statistical analyses. The mean HP of the remaining 20 KD specimens was $20.5{\pm}14.9$ J/gr, while it was $40.7{\pm}12.9$ J/gr for CM. The independent-samples t-test showed that there were significant differences between the HP of the two materials at the temperatures $15^{\circ}C$ (P=.0001), $23^{\circ}C$ (P=.0163), $37^{\circ}C$ (P=.0039), and $60^{\circ}C$ (P=.0106). Linear regression analysis showed statistically significant correlations between environment temperatures and HP of CM ($R^2=0.777$). CONCLUSION. Using CM is advantageous over conventional composite because of its better polymerization capacity. However due to its high HP, further studies should assess its temperature increase in vivo. Preheating KD is recommended. Refrigerating composites can negatively affect their polymerization potential.
Objectives : This study aimed to assess the differences in treatment behavior by reviewing data of a medical institution that studies treatment behavior in URI and assessing the treatment efficacy in Korea. Methods : We analyzed the behavior of medical customers and providers of upper respiratory infection medications using the NPS published by the Health Insurance Review Assessment Service. We created an operational definition for complications, and confirmed the difference in complication distribution between medical specialties. We also performed a multivariate analysis using a mixed model to elucidate the factors influencing the occurrence of complications. Results : The outcomes of analyzing factors to influence the difference in practice patterns of the diagnosing URI between the physicians are as follows; (1) Analysis of antibiotics prescriptions rate showed significant difference from medical departments (pediatrics; 49.7%, internal medicine; 54.2%, otorhinolaryngology; 69.6%, family medicine; 61.6%, general surgery; 57.5%, p<0.001). Analysis of steroid prescriptions rate showed significant difference from medical departments (pediatrics; 3.8%, internal medicine; 4.5%, otorhinolaryngology; 5.4%, family medicine; 3.0%, general surgery; 11.2%, p<0.001). (2) In patients who visited medical institutes with the common cold, the complication distribution differed according to the medical specialty, which suggests that specific complications arise depending on the particular medical specialty (p<0.001). (3) Moreover, through multivariate analysis, we found that the complication rate is higher in clinics than in hospitals, depending on the institute's size. (p<0.001; odds ratio of 4.67 in clinics than in hospitals, 95% CI 2.66-8.21) Conclusions : We observe a deviation between the behavior of patients diagnosed with URI and medication providers. This may arise from the interaction between providers and consumers, wherein the complications are associated with the choice of outpatient department and the prevention of cutting incentives. These findings suggest that the health policies should be improved to prevent inappropriate medical practice in the treatment of pediatric URI.
Purpose: The purposes of this study were to develop a workstation computer that allowed intraoperative touchless control of diagnostic and surgical images by a surgeon, and to report the preliminary experience with the use of the system in a series of cases in which dental surgery was performed. Materials and Methods: A custom workstation with a new motion sensing input device (Leap Motion) was set up in order to use a natural user interface (NUI) to manipulate the imaging software by hand gestures. The system allowed intraoperative touchless control of the surgical images. Results: For the first time in the literature, an NUI system was used for a pilot study during 11 dental surgery procedures including tooth extractions, dental implant placements, and guided bone regeneration. No complications were reported. The system performed very well and was very useful. Conclusion: The proposed system fulfilled the objective of providing touchless access and control of the system of images and a three-dimensional surgical plan, thus allowing the maintenance of sterile conditions. The interaction between surgical staff, under sterile conditions, and computer equipment has been a key issue. The solution with an NUI with touchless control of the images seems to be closer to an ideal. The cost of the sensor system is quite low; this could facilitate its incorporation into the practice of routine dental surgery. This technology has enormous potential in dental surgery and other healthcare specialties.
The considerable increase of the elderly with dementia is expected annually and when we think about the family members' and the patients' suffering, it could be painful. Above all things, it imposes heavy economic burdens on the family members that have patients who suffer from diseases of age like dementia or paralysis that caring them at home and also, it is not desirable for those old people in point of physical or environmental circumstances for medical care. Thus, it is needed urgently that the expansion of specified facilities and improvement of services for these old people. Under this present condition, it is the special feature that the subject of research is people/facilities that offer services, not the elderly with dementia-the main user of those facilities. Thus, it is the time that we need various accessing plans that can grasp the patiences' activities and specialties and solve these problems in view of designing interior space. So, I tried to make designs that manage the elderly with dementia effectively and adequate to run facilities with considerations on the state of domestic specialized long-term care facilities for the elderly with dementia and researched guiding principles on physical healing surroundings with analysis that focused on the patients' activities, especially.
The considerable increase of the elderly with dementia is expected annually and when we think about the family members' and the patients' suffering, it could be painful. Above all things, it imposes heavy economic burdens on the family members that have patients who suffer from diseases of age like dementia or paralysis that caring them at home and also, it is not desirable for those old people in point of physical or environmental circumstances for medical care. Thus, it is needed urgently that the expansion of specified facilities and improvement of services for these old people. Under this present condition, it is the special feature that the subject of research is people/facilities that offer services, not the elderly with dementia-the main user of those facilities. Thus, it is the time that we need various accessing plans that can grasp the patiences' activities and specialties and solve these problems in view of designing interior space. So, I tried to make designs that manage the elderly with dementia effectively and adequate to run facilities with considerations on the state of domestic specialized long-term care facilities for the elderly with dementia and researched guiding principles on physical healing surroundings with analysis that focused on the patients' activities, especially.
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