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A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder (한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구)

  • Park, Jae-Hong;Kim, Bung-Nyun;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Dong-Won;Shin, Yun-Mi;Yang, Su-Jin;Yoo, Hanik-K.;Yoo, Hee-Jeong;Lee, Soyoung Irene;Cheon, Keun-Ah;Hong, Hyun-Ju;Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.1
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    • pp.25-37
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    • 2011
  • Objectives:This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods:Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results:Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion:We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

The Effects of Leader's Attitude and Job Characteristics on Subordinate's Creative Performance (상사의 태도와 직무 특성이 창의적 성과를 일으키는 과정에 관한 연구)

  • Ryu, Jeong-Ran
    • Management & Information Systems Review
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    • v.33 no.3
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    • pp.129-154
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    • 2014
  • We are making products and services that we didn't easily think or even imagine when young and living using them. Consumer needs become more diversified, markets and technologies are being constantly changed, and corporate global competitiveness is getting intensified. Now, companies that don't change nor create new values cannot survive. The cycle of new products is faster, and therefore corporations should improve previous products continuously or create new values according to such a trend. This era requires 'creativity' for companies to overcome uncertainty and survive. Corporate creativity is not easily activated as financial and physical compensation unlike the work ability or performance. When there is an environment that people with various abilities, experiences and backgrounds can express their opinions freely, it becomes possible. Despite the importance, the studies have focused on creativity education so far instead of the viewpoint of corporate business administration. In addition, most studies have dealt with job characteristics and employees' personality factors rather than the process that is connected to actual performance. In other words, the studies on environmental factors that can lead motivation as situational characteristics of the employee's company in a current non-monetary and non-physical way are very insufficient. Therefore, this study aims to comprehensively examine the process of creating creative performance in the environment inside the company that the employee could approach most closely from the corporate deinstitutional perspective. As the major variables, job characteristics and supervisor's ethical leadership were selected, and the process that is connected to the creative performance was explained by means of motivation necessary to understand creativity of the organization and creative process engagement(CPE). The summary of the verification results is following. First, job characteristics and supervisor's attitude(ethical leadership) had positive effects on intrinsic motivation and creativity process engagement. Second, intrinsic motivation and creativity process engagement had positive effects on creative performance. Third, intrinsic motivation and creativity process engagement had mediated the relationship between job characteristics, supervisor's attitude and intrinsic motivation, creativity process engagement

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A Study on Effective Smoking Cessation Policy of Smoker Patients (흡연환자의 효과적인 금연정책에 대한 연구)

  • Hwang, Ji-Min;Kim, Eung-Gwon;Park, Yong-Duk;Han, Ji-Hyoung
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.77-82
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    • 2013
  • The purpose of this study was to examine the subjective awareness of smoker patients about the preparation of smoking cessation plans in an effort to lay the foundation for smoking cessation policy setting. The subjects were the selected patients at a dental clinic. A self-administered survey was conducted to grasp their personal characteristics, and the selected answer sheets from 236 respondents were analyzed. The findings of the study were as follows: 1. As for the extension of existing smoking cessation plans, the largest group (32.6%) preferred smoking cessation education, followed by smoking cessation counseling (28.8%), prescription of an smoking cessation aid (18.6%). 2. Concerning the necessity of a smoking cessation law, the men and the women respectively gave 2.37 and 3.00 to that, and the gender gap was significant. The patients had a significantly different opinion on the necessity of a rise in tobacco price according to their occupation and monthly mean household income, and their took a significantly different view of the necessity of smoking cessation counseling according to their residential area. 3. As a result of analyzing the correlation between their on effective smoking cessation policies and the related variables, all the variables had a statistically significant correlation to each other. 4. As a result of analyzing their opinions on what institution should be in charge of smoking cessation plans, the biggest group answered that dental clinics should be responsible for smoking cessation-aid prescription (50.0%), and the largest group replied that smoking cessation education and smoking cessation counseling should respectively be provided by public dental clinics (37.3%) and dental clinics (44.1%).The above-mentioned findings suggest that the preparation of new smoking cessation measures and the extension of existing smoking cessation plans are urgently required, and that dentists and dental hygienists should make a concerted effort to offer counseling and education to stimulate dental patients to abstain from smoking.

Frege's Critiques of Cantor - Mathematical Practices and Applications of Mathematics (프레게의 칸토르 비판 - 수학적 실천과 수학의 적용)

  • Park, Jun-Yong
    • Journal for History of Mathematics
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    • v.22 no.3
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    • pp.1-30
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    • 2009
  • Frege's logicism has been frequently regarded as a development in number theory which succeeded to the so called arithmetization of analysis in the late 19th century. But it is not easy for us to accept this opinion if we carefully examine his actual works on real analysis. So it has been often argued that his logicism was just a philosophical program which had not contact with any contemporary mathematical practices. In this paper I will show that these two opinions are all ill-founded ones which are due to the misunderstanding of the theoretical place of Frege's logicism in the context of contemporary mathematical practices. Firstly, I will carefully examine Cantorian definition of real numbers and Frege's critiques of it. On the basis of this, I will show that Frege's aim was to produce the purely logical definition of ratios of quantities. Secondly, I will consider the mathematical background of Frege's logicism. On the basis of this, I will show that his standpoint in real analysis was much subtler than what we used to expect. On the one hand, unlike Weierstrass and Cantor, Frege wanted to get such real analysis that could be universally applicable. On the other hand, unlike most mathematicians who insisted on the traditional conceptions, he would not depend upon any geometrical considerations in establishing real analysis. Thirdly, I will argue that Frege regarded these two aspects - the independence from geometry and the universal applicability - as those which characterized logic itself and, by logicism, arithmetic itself. And I will show that his conception of real numbers as ratios of quantities stemmed from his methodological maxim according to which the nature of numbers should be explained by the common roles they played in various contexts to which they applied, and that he thought that the universal applicability of numbers could not be adequately explicated without such an explanation.

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Effects of Purchasing Factors through Social-commerce of Beauty Service on the Consumer Satisfaction and the Repurchasing Intention (소셜커머스를 통한 뷰티서비스 구매요인이 고객만족과 재구매 의도에 미치는 영향)

  • Hong, Soo-Nam;Lee, Han-Joo
    • Journal of Internet Computing and Services
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    • v.15 no.6
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    • pp.133-144
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    • 2014
  • As the Internet and smartphones prevail, this study investigated the purchasing factors of a new beauty marketing method, the social commerce, and verified the relationship of such purchasing factors to consumer satisfaction and repurchasing intentions. In order to verify the validity of purchasing factors, five sub-factors, such as service, price, interaction, convenience, and interest were classified, while consumer satisfaction and repurchasing intentions are grouped into one factor, using data about 20-39 years old. According to results of this study, purchasing factors in the beauty service markets through social commerce that had effects on the consumer satisfaction were price, service, convenience, and interest, but no relationship was found with interaction. We can predict that consumers buy not based on community activities among buyers or purchasing comments of others, but rather his/her own subjective thoughts and opinions about the services. As the result of repurchasing intention according to purchasing factors, affecting sub-factors were price, service, and convenience. Repurchasing intention is an positive response that reflects satisfactions. Since low price, satisfaction on the service, and convenience for busy modern people should be met, repurchasing intentions are not affected by interest, but rather systematic and professional service. Also, higher satisfaction on service raises repurchasing intention. In this study, it is clear that not only purchasing factors through social-commerce effect the satisfaction and the repurchasing intention, but also consumer satisfaction mediates partly purchasing factors and the repurchasing intention. And as sub-factors of purchasing factors, price, service, or convenience are more important to the consumer satisfaction than community or replies activities. Thus differentiated and professional customer service, the establishment and enhancement of trendy marketing should improve long term repurchasing intentions. This will lead to the increasing revenue of personal-shop and the developments of beauty markets, so strengthening product sourcing and promotion suitable for mobile shoppers are essential.

Issues and Considerations surrounding Revocation Physician's Medical License Arising from Criminal Offenses (의사의 형사범죄에 따른 면허취소처분의 쟁점과 고려사항)

  • Kim, Sung-eun
    • The Korean Society of Law and Medicine
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    • v.19 no.1
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    • pp.113-142
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    • 2018
  • In recent years, there have been opinions in which physicians are liable to the revocation of their medical license if they are sentenced to above a certain level for criminal charges regardless of the types of offenses. Accordingly, a revised bill of law was submitted in the National Assembly, and related discussions are thus expected to commence. Considering the morality and ethics or the level of the rule of law that the general public expects of physicians, as well as the license revocation system in other professional sectors, it is assessed that medical license revocation due to criminal convictions of physicians is appropriate to some degree. However, if a poorly devised system is established based on unrefined inferences or emotional judgements, unexpected side-effects are likely to arise. With regard to serious criminal acts that society generally perceives as unacceptable, it can be assessed that the revocation of physicians' licenses would appropriately protect the general public from threats. However, given the life-saving characteristics of high-risk medical practices, higher malpractice exposures, and social values, it is difficult to assess charges of professional negligence resulting in death(or in injury) and minor offences in the same manner as anti-social criminal offences are handled. Physicians need to be treated the same as any other professions. At the same time, they are engaged in administering medical treatment to patients in the face of great risks as professionals. Under the circumstances, a discussion on the introduction of a more specific and empirical system is needed by considering the intrinsic characteristics of medical treatment and the need for an equitable health and medical policy. Accordingly, based on the above judgment and perception, this study explores the code of ethics for physicians and medical license revocation related to criminal offences at home and abroad, and examines various legislative alternatives appropriate for the Republic of Korea. In doing so, the purpose of the study is to contribute to the development of a reasonable system for handling criminal offences by physicians.

Policy suggestions for active reporting of medical professionals for early detection of child abuse (아동학대의 조기발견을 위한 제도적 개선 방안: 「아동학대범죄의 처벌 등에 대한 특례법」이 정한 의료인에 의한 신고를 중심으로)

  • Bae, Seung Min;Lee, Sun Goo
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.143-169
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    • 2017
  • The Act on Special Cases Concerning the Punishment, etc. of Child Abuse Crimes intends to encourage reporting and punishment of child abuse by using the concept of 'crime' in child abuse cases. Article 10 of the Act imposes duty to report child abuse on a number of different professions, including medical professionals. Currently, more than 80% of child abuse cases occur among family members and the detection rate of child abuse is as low as 0.5% in Korea. On the other hand, medical professionals can identify child abuse relatively clearly with specific medical opinions. Therefore, it is necessary that medical professions are informed of this duty and does not bear disincentive from reporting. This paper makes policy suggestions in this regard. First, it is necessary that medical students and medical professionals receive regular education about the obligation to report child abuse. Education should include details of the reporting duty, as well as the fact that there is legal obligation to report even if the child abuse is "suspicious", not certain. Second, it is imperative to establish and implement protective programs for medical professionals who report child abuse. The current law provides a rough framework for protection of people who report child abuse, but it is necessary to produce detailed guidelines that are applicable in the context of medical setting. Education for medical students and medical professionals should include the contents of these guidelines, so that they do not hesitate reporting because they fear the aftermath of reporting. Third, it is highly recommended that physicians use the national Baby/Infant Health Checkup Program as an opportunity to detect child abuse. In Korea, the Baby/Infant Health Checkup Program provides physicians to periodically monitor health condition of all babies and children until the age of 71 months. In order to utilize this program for early detection of child abuse, it is imperative that the bBaby/Infant Health Checkup Program is modified to involve child abuse experts and medical professionals who participate in the program are educated about child abuse.

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VCUG Studies on the Clinical Usefulness of Aids (VCUG 보조기구의 임상적 유용성에 관한 고찰)

  • Choe, Dea yeon;Kim, Dong hyun
    • Journal of the Korean Society of Radiology
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    • v.9 no.7
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    • pp.529-533
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    • 2015
  • VCUG(Voiding Cystourethrography) study is being performed to check urinary reflex symptom from bladder to ureter or kidney in the method of filling the bladder with radiation opaque contrast agent. However, VCUG study have been performed impersonally, patients have to be naked and open their legs and then void. This method is so impersonal that it is immediately needed to improve the way of testing and crete new aid. Therefore, this study through producing underwear for VCUG, analysis and compares the test time of VCUG, patient radiation dose and patient satisfaction. The target of this study was 79 Male and Female patients who visited genitourinary clinic of PNUYH for their VCUG tests AXIUM Iconos R200(Siemens Medical System : Germany) and self-produced plastic underwears made by vinyl and plasic molding machine were used. The 79 patient were divided into two groups : experiment of patient and comparison group of we patient (using aid) in order to compare, testing time, DAP (dose area product) and patient satisfaction. There was time reduction, from 35.3min of comparison group to 27.8min experimentation group by 7.5min decrease. And comparison group of $4566.6{\mu}Gym^2$(DAP) decreased experimental group (using aid) of $3411.9{\mu}Gym^2$ by $1154.7{\mu}Gym^2$. In the case of patients satisfaction study, anxiety had a drop by 3.45 of comparison group to 2.51 experimentation group by 0.94 decrease. in experimental group. And shame had a drop by 4.02 of comparison group to 3.08 experimentation group by 0.94 increase. in experimental group. Difference of the smooth voiding had a drop by 1.90 of comparison group to 2.84 experimentation group by 0.94 increase. in experimental group. In addition satisfaction had a rise by 1.19 in experimental group. There were also other opinions of uncomfortableness on it and troublesome to wear. VCUG is one of the sensitive care required test. Therefore staff and the aid can give patients such comfortable and the aid can consentive on voiding. As a result test time and DAP can be reduced. It is needed to make testing at more comfortable for patients.

Aprotinin Therapy for Cardiac Operation in Adult -Full dose regimen- (개심술에서 아프로티닌의 효과 (고용량 요법))

  • 장운하;오태윤;김미혜
    • Journal of Chest Surgery
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    • v.32 no.4
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    • pp.358-363
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    • 1999
  • Background: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. Material and Method: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. Result: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186${\pm}$40cc, control group:409${\pm}$69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317${\pm}$53cc, control group: 671${\pm}$133cc, P=0.024). Conclusion: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.

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A Study of the Ethical Values of EMT students (응급구조과 학생의 윤리적 가치관에 관한 연구)

  • Kim, Mi-Seon
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.37-51
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    • 2001
  • This study is aimed at examining the ethical values of EMT students. The results below are based on the revised questionnaires, which can be applicable to EMT from the original questionnaires developed by Lee(1990), with a sample of 124 students consisting of 63 first and 61 second year students, conducted November 2-8, 2001. Data were analyzed using SPSS in terms of means, standard deviations, t-test, ANOVA, Pearson's correlation coefficient. The results are as follows: 1. In the area of Human life, all subjects showed utilitarian disposition. All respondents perceived the item "When patients recognizing there is no hope for survival ask for euthanasia, it is ethically right to accommodate their opinions." as the most utilitarian item, whereas they perceived the item "When an hopeless patient is on cardiac arrest, it is ethically right to do CPR as the most deontoogical item. 2. In the area of patient relationship, all students of two groups took on deontoogical characteristics, but there were no statistically significant differences between two groups. All students perceived an item "EMT have to keep it secret if patients disclose their suicide intentions and ask for absolute secrecy" the most utilitarian item, whereas they perceived an item "Even though patients act and speak in a very rude manner, EMT people should do their best to provide care for patients." as the most deontoogical item. 3. In the area of task relationship, first year students perceived an item "Given time limitations, it is ethically right to give priority to the patients who can be rehabilitated over the patients who can't be fully recovered." as the most utilitarian item, whereas second year students perceived an item "Under no circumstances should any placebo be administered to patients." as the most utilitarian item. All students perceived an item "When EMT students see an unconscious person lying in the street, they have to give him/her emergency treatment." as the most deontoogical item. 4. In the area of coworker relationship, all students of two groups took on deontoogical disposition, but there were no significant differences between two groups. All students of two groups perceived an item "Suppose you are regarded as the person who would be promoted. However, you think that your coworker is more competent than you. In that case you should tell your supervisor about your coworker." as the most utilitarian item. First year students perceived an item, whereas second year students perceived an item "When you observe coworkers' misconduct at work, it is ethically right to ignore their misdeeds." as the most deontoogical item. 5. This study demonstrated that for the first year students, there is a correlational relationship between areas of human life and task relationship, and between areas of task relationship and coworker relationship, whereas for the second year students, there is a correlational relationship between areas of human life and task relationship. 6. In areas of human life and task relationship, there are significant differences according to attitudes toward EMT and attendance at ethics training sessions. In the area of coworker relationship, there are significant differences according to religion, attendance at ethics training sessions, and a code of ethics. Recommendations for future research, 1. Sample items to measure ethical values and the instrument tailored to the needs of EMT should be developed. 2. A longitudinal study to track ethical value changes according to the amount of work experience is needed. 3. A code of ethics and/or ethics training, which could apply in actual situations, should be implemented.

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