• Safety and Health at Work
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• 제5권3호
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• pp.165-167
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• 2014

The Dutch construction industry has introduced a compulsory preemployment medical examination (PE-ME). Best-evidence contents related to specific job demands are, however, lacking and need to be gathered. After the identification of job demands and health problems in the construction industry (systematic literature search and expert meeting), specific job demands and related requirements were defined and instruments proposed. Finally, a work ability assessment was linked to the instruments' outcomes, resulting in the modular character of the developed PE-ME. Twenty-two specific job demands for all Dutch construction jobs were identified, including kneeling/squatting, working under time pressure, and exposure to hazardous substances. The next step was proposing self-report questions, screening questionnaires, clinical tests, and/or performance-based tests, leading to a work ability judgment. "Lifting/carrying" is described as an example. The new modular PE-ME enables a job-specific assessment of work ability to be made for more than 100 jobs in the Dutch construction industry.

• 한국간호교육학회지
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• 제26권4호
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• pp.402-411
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• 2020

Purpose: The purpose of this study is to explore the trends of research related to ethical topics in Korean nursing students. Methods: A total of 131 articles that were published from 2000 to 2020 were analyzed and summarized according to publishing type, research design, subject, data analysis method, main research topic, research variables and instrument. Results: Most studies were journal articles (93.9%) and their most frequent research design was survey (75.7%). The research subjects covered all grades (35.1%) or they were divided between clinical nursing practicum (29.8%) or not (21.4%). The main research topics were biomedical ethics, ethical values, moral judgment and ethics education. Recently, ethical decision making and practical ability in nursing practice were reported. The instruments for measuring variables were limited and the same tools were used several times. Conclusion: Based on the findings of this study, it is suggested that the selection of various research topics and the application of research methods related to ethics for nursing students will continue in response to rapidly changing social phenomena in the future. In particular, it is necessary that research related to ethical and practical ability as well as ethical attitudes and perceptions of nursing students be actively carried out.

• 사상체질의학회지
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• 제14권3호
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• pp.74-84
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• 2002

The purpose of study is 584 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 1 year from February 2001 to January 2002. We proceeded the judgment of Sasang constitution by 'Questiinaire of Sasang Constitution Classification(I)' and 'Questiinaire of Sasang Constitution Classification II(QSCCII)'. The following conclusion were made in comparison with Sasang Constitution and Questiinaire about disease and style of symptoms. 1. The subject of 'increase of the weight of a body(gain weight), cough, nasal discharge(rhinorrhea), stuffed nose, sweatier, more like fat food, more like salty food', has significant differences in sasang constitution classification. The frequency of Taeum group is more than of Soeum group and Soyang group. 2. The subject of 'the complextion is bad, anorexia, indigestion, nervousness, sonitus', has significant differences in sasang constitution classification. The frequency of Soeum group is more than of Taeum group and Soyang group. 3. The subject of 'urodynia, otic discharge', has significant differences in sasang constitution classification. The frequency of Soyang group is more than of Taeum group and Soeum group.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(역학)
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• pp.164-168
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• 1994

Single serologic tests may occasionally influence clinicians in making diagnoses. The antistreptolysin O (ASO) test is a frequently used tool for detecting recent Streptococcus pyogenes infection and is helpful in the diagnosis of diseases like rheumatic fever. Using data from a 1989 prospective study of 600 healthy male military recruits, in which 43% experienced S. pyogenes upper respiratory tract infection (2-dilution rise in ASO), this report compared two methods of interpreting a single ASO titer. Using the 'upper limit of normal' (80 percentile) method, recruits with an ASO titer of greater than 400 showed evidence of recent S. pyogenes infection. This method had a sensitivity and specificity of only 65.9 and 81.9% respectively. In contrast to the 'yes-no'. dichotomy of the 'upper limit of normal' method. the likelihood ratio method statistics were ASO value specific, more consistent with clinical judgment, and better emphasized the caution clinicians must use in interpreting a single ASO test.

• Journal of Hospice and Palliative Care
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• 제24권3호
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• pp.135-143
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• 2021

End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

• 대한통합의학회지
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• 제6권4호
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• pp.191-206
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• 2018

Purpose : This study investigated the correlation between speech intelligibility and acoustic measurements of speech sounds produced by the children with speech sound disorders and children without any diagnosed speech sound disorder. Methods : A total of 60 children with and without speech sound disorders were the subjects of this study. Speech samples were obtained by having the subjects? speak meaningful words. Acoustic measurements were analyzed on a spectrogram using the Multi-speech 3700 program. Speech intelligibility was determined according to a listener's perceptual judgment. Results : Children with speech sound disorders had significantly lower speech intelligibility than those without speech sound disorders. The intensity of the vowel /u/, the duration of the vowel /${\omega}$/, and the second formant of the vowel /${\omega}$/ were significantly different between both groups. There was no difference in voice onset time between the groups. There was a correlation between acoustic measurements and speech intelligibility. Conclusion : The results of this study showed that the speech intelligibility of children with speech sound disorders was affected by intensity, word duration, and formant frequency. It is necessary to complement clinical setting results using acoustic measurements in addition to evaluation of speech intelligibility.

• Journal of Preventive Medicine and Public Health
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• 제52권5호
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• pp.316-322
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• 2019

Objectives: This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea. Methods: In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared. Results: The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively. Conclusions: Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.

• 한국발생생물학회지:발생과생식
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• 제27권1호
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• pp.47-56
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• 2023

Despite the commercialization of Next generation sequencing (NGS) gene testing, only a few studies have addressed the various ethical and legal problems associated with NGS testing in Korea Here, we reviewed the normative issues that emerged at each stage of the wet analysis and bioinformatics analysis of NGS gene testing. In particular, it was in mind to apply various international guidelines and the principles of bioethics to actual clinical practice. Considering the characteristics of NGS testing, wet analysis of additional testing can be justified if presumptive consent is recognized. Furthermore, the medical relationship between diseases needs to be established and it should be clear that the patient would have given consent if the patient had been aware of the correlation between genes. At the stage of bioinformatics analysis, the question of unsolicited findings arises. In case of unsolicited and relevant findings, according to American College of Medical Genetics and Genomics (ACMG), a recognized relationship between genes and diseases needs to be established. In case of unsolicited and not-relevant findings, it is almost impossible to determine whether knowing or not knowing the findings is more beneficial to the patient. However, it seems to be certain that the psychological harm an individual may suffer from such information is likely to be greater if the disease is severe and if there is no cure. The list of genes for which the ACMG guidelines impose reporting obligations is a good reference for judgment.

• 대한영상의학회지
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• 제83권4호
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• pp.771-775
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• 2022

최근 의사들이나 연구자들은 진료나 연구에서 독자적으로 수행하기보다는, 회사, 연구기관, 보건의료기관, 및 학술 저널의 관련인들과 관계를 맺게 된다, 혹은 그들이 관련 회사에서의 자문 및 주주 참여 등과 같은 다중적 이해관계(multiple interests)를 가지기도 한다. 그러한 이해관계가 연구자의 의사결정에 지대한 영향을 미치는 경우 이해상충이 발생할 수 있다. 이해상충은 연구 진실성을 침해하여 피험자나 환자를 위험에 빠뜨리기도 하고 공공에 대한 위험을 초래할 수 있고 과학에 대한 대중의 인식을 악화시킬 수도 있기에 매우 중요한 문제라고 할 수 있다. 이 종설에서는 이해상충의 개념과 구체적인 사례 및 이에 대한 해법을 살펴보고자 한다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.81-90
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• 2024

Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.