• Title/Summary/Keyword: Clinical Practices

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Complementary and Alternative Medicine for Oral Health : a Literature Review of Randomized Controlled Clinical Trials (구강건강에 이용되는 보완대체의학 치료: 무작위대조임상연구를 통한 문헌적 고찰)

  • Kim, Da-Hee;Choi, Gwang-Ho;Hwang, Eui-Hyoung;Heo, Kwang-Ho;Kim, Yong-Deok;Shin, Byung-Cheul
    • Journal of Society of Preventive Korean Medicine
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    • v.18 no.3
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    • pp.23-39
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    • 2014
  • Objective : This review aims at analyzing Complementary and Alternative Medicine (CAM) therapies, using for oral health to know current use of CAM in dental area by analyzing randomized controlled clinical trials (RCTs). Method : We searched the following 6 electronic databases until 1 July 2014. : Pubmed, Medline, Embase, Allied and Complementary Medicine Database(AMED), Cumulative Index to Nursing and Allied Health Literature(CINAHL), the Cochrane Library. We included parallel RCTs and cross-over RCTs that assessed the efficacy of CAM regardless of blinding and language. Results : A total of 154 RCT articles were included. There were 2-arm parallel study design(69.5%), 3-arm parallel study design(20.8%), 4-arm parallel study design(4.5%) and Cross-over design(5.2%). Complementary and alternative medicine RCTs in oral health tend to increase in the early-2000s and in the mid-2010s. In addition, 154 citations were classified according to diseases and interventions that categorized Natural Products studies(68.2%), Mind and Body Practices studies(31.8%). We classified in detail that vitamin and mineral therapies(29.9%), dietary supplements(24.7%), acupuncture(23.3%), Herbal medicine(13.6%), homeopathy (2.6%), energy therapies(2.6%), Massage(1.9%), biofeedback(0.6%), traditional medicine(0.6%). Conclusion : Increasing publications and diverse interventions regarding CAM for oral health is observed by analyzing RCTs from the literature review. Further studies are needed to be performed as systematic reviews to verify their effectiveness and the research to inquire into side effect.

A Search for Analogous Patients by Abstracting the Results of Arrhythmia Classification (부정맥 분류 결과의 축약에 기반한 유사환자 검색기)

  • Park, Juyoung;Kang, Kyungtae
    • KIISE Transactions on Computing Practices
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    • v.21 no.7
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    • pp.464-469
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    • 2015
  • Long-term electrocardiogram data can be acquired by linking a Holter monitor to a mobile phone. However, most systems are designed to detect arrhythmia through heartbeat classification, and not just for supporting clinical decisions. In this paper, we propose an Abstracting algorithm, and introduce an analogous pateint search system using this algorithm. An analogous patient searcher summarizes each patient's typical pattern using the results of heartbeat, which can greatly simplify clinical activity. It helps to find patients with similar arrhythmia patterns, which can help in contributing to diagnostic clues. We have simulated these processes on data from the MIT-BIH arrhythmia database. As a result, the Abstracting algorithm provided a typical pattern to assist in reaching rapid clinical decisions for 64% of the patients. On an average, typical patterns and results generated by the abstracting algorithm summarized the results of heartbeat classification by 98.01%.

Adaptation of the Evidence Based Nursing Practice Guideline (근거중심 급성 뇌졸중 간호 가이드라인 수용개작)

  • Kim, Ji Hyun;Song, So Lee;Kim, Mi Kyung;Cho, Myoung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.176-191
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    • 2011
  • Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.

A Study about the Medical Communication Proficiency of Korean Traditional Medical Students Using Standardized Patients of Menopausal Disorder (표준화 갱년기장애환자를 활용한 한의대생의 진료 및 의사소통 수준연구)

  • Park, Kyung-Mi;Cho, Seong-Hee;Yang, Seung-Jung;Shin, Heon-Tae;Choi, Yu-Jin
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.100-118
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    • 2019
  • Objectives: The purpose of this study is to analyze clinical performance examination (CPX) ability using standardized patient (SP) in Korean traditional medical school. Methods: Standardized middle-aged female patients were used for clinical examination of 53 medical students, grade 6. The SP and professors assessed their communication skills and level of medical interviews. Results: 1. There is no statistically significant difference between SP score, communication skill score, medical skill score and inter-test score at the extracurricular activities level. 2. There is no statistically significant difference between SP score, communication skill score, medical skill score and inter-test score at number of medical service. 3. There is no statistically significant difference between SP score, communication skill score, medical skill score and inter-test score at personality type. 4. There is a statistically significant positive correlation between SP score, communication skill score and medical skill score. Conclusions: A variety of educational programs and practices should be conducted to improve the level of medical care and communication of Korean traditional medicine students.

A comparative study of the prevalence of Helicobacter pylori in the oral biofilms of a group of dental and non-dental undergraduates from Sri Lanka

  • Mallikaarachchi, MADKS;Rajapakse, Sanath;Gunawardhana, KSND;Jayatilake, JAMS
    • International Journal of Oral Biology
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    • v.46 no.1
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    • pp.60-65
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    • 2021
  • Dental health care workers (DHCW) are at a risk of occupational exposure to Helicobacter pylori from the aerosolized oral biofilms and saliva of patients. We designed this study to investigate the prevalence of H. pylori in the oral biofilms of a group of dental and non-dental undergraduates from Sri Lanka. After obtaining informed consent, oral biofilms were collected from 38 dental undergraduates (19 males and 19 females) undergoing clinical training and 33 non-dental undergraduates (14 males and 19 females). The participants were in the age range of 22-27 years and had healthy periodontium. Total DNA from the oral biofilms were extracted, and H. pylori DNA was detected using polymerase chain reaction (PCR) amplification of 16S rRNA gene of H. pylori using JW22-JW23 primers, and the results were confirmed using PCR amplification of H. pylori-urease specific HPU1-HPU2 primers. Out of 71 participants, 11 (28.95%) dental and 3 (9.09%) non-dental undergraduates had H. pylori in their oral biofilms indicating an overall prevalence rate of 19.72% (14/71). Thus, the prevalence of H. pylori in oral biofilms was significantly higher in dental undergraduates than in non-dental undergraduates (p < 0.05). An odds ratio of 4.07 indicated that dental undergraduates were four times more likely to harbor H. pylori in their oral biofilms than non-dental undergraduates. Foregoing data support the fact that there may be greater occupational risk of exposure to H. pylori for dental undergraduates during clinical training than that for non-dental undergraduates, warranting meticulous infection control practices during clinical dentistry.

The Retrospective Study of Advanced Cancer Patients Receiving Integrative Cancer Treatments in single Comprehensive and Integrative Medicine Hospital

  • Jeonghyun Joo;Songha Chon;Kicheul Sohn;Sanghun Lee
    • The Journal of Korean Medicine
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    • v.43 no.3
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    • pp.16-26
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    • 2022
  • Objectives: Traditional Korean medicine (TKM) has been supplied as part of a national health care system in South Korea under a dual medical system, however it has been difficult to mix western medicine and TKM medical practices in existing hospitals. For the objective of innovative integration between them, Comprehensive and Integrative Medicine Hospital were founded in Daegu, South Korea. Here, we discussed the clinical outcomes of cancer patients who received integrative cancer treatment (ICT). Methods: A total of 678 patients previously diagnosed with cancer were retrospectively checked in our institution for 2 years. After applying inclusion/exclusion criteria, 573 patients were eligible for the final analysis. The overall survival (OS) of these patients in the aftercare period were determined. We looked at how clinical factors and treatments including chemotherapy, complementary and alternative medicine (CAM), and TKM affected the OS. Results: At the first visit, 212 subjects had no evidence of disease after tumor resection and 355 ones with advanced cancer, who receiving ICT including chemotherapy, CAM, and TKM showed better OS compared to the CAM including TKM or the best supportive care (median OS = 216, 78, and 46 days, respectively). The median OS was not reached in TKM only, even though the sample size was small (N=12). Even after adjusting for clinical factors associated to liver, renal, and hematologic manifestation, ICT still remained significant. Conclusions: We demonstrated that ICT might be beneficial for advanced cancer regardless of the performance status, liver and renal function, since it positively affected the OS.

A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines (소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구)

  • Bang Miran;Lee Sun Haeng;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.2
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    • pp.21-31
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    • 2024
  • Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

Present Situation of Korean Nursing (한국간호의 현재)

  • Choi, Euy-Soon
    • Women's Health Nursing
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    • v.10 no.3
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    • pp.190-199
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    • 2004
  • This thesis explores the actual circumstances of Korean nursing by investigating its present situations. Ultimately, the intent of this study aims to establish a future direction of Korean Nursing. As such, the current conditions of Korean nursing is analyzed in the following categories: education, practice, research, nursing policy, expansion of nursing field, and entrepreneurship. In the final conclusion, an appropriate orientation of the future of Korean nursing is discussed. There are two primary Nursing programs, a three-year(63) and a four-year(53), in Korean Nursing education. Master's programs are available at 32 nursing schools or 32 professional graduate schools. A total of 15 nursing schools have a doctoral program in Korea. The ratio of graduates between the three-year and four year programs is 76:24. Hence, it is highly encouraged to expand four-year nursing programs, because it will help raise the social status of nursing professionals as well as the quality of nursing. In the clinical nursing field, independency and self regulation are critical. As such, organizational change, implementation of a standardized nursing m information system, appropriate workforce, and improvement of the reimbursement system in nursing is recommended. In community nursing, the following should be resolved to provide better nursing services: improvement of working condition and benefits, establishment of a law enforcing the hiring of nurses, and providing continuing education. The number of nursing research has increased and nursing studies are in great quantity. However, research in practices and theories are more in demanded. Hence, research that integrates theories and practices are very significant. Ultimately, it is critical to support nursing studies that will influence nursing policy. The Korean Nurses Association(KNA) is an organization that supervises the nation's nursing policy. The primary focus of KNA is to combine the three and four year undergraduate education systems into 4 years and to establish the Nursing Practice Act. The Ministry of Health and Welfare has adapted a system to educate and certify nurse specialists in 10 nursing areas in 21 nursing graduate schools expecting high-quality nursing services and a decrease of cost. The government also allowed nurses to operate facilities for health management or welfare agencies.

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Qualitative Study on Dietary Practices of Hemodialysis Patients (혈액투석환자의 식생활 실천에 관한 질적 연구)

  • Park, Hee-Jung;Jang, Eun-Young;Cho, Wookyoun
    • Journal of the Korean Society of Food Culture
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    • v.35 no.2
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    • pp.201-214
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    • 2020
  • This study was a qualitative investigation into hemodialysis patients' dietary practices. The purpose of this study was to explore the obstacles and requirements to maintain a recommended diet therapy in hemodialysis patients. Five patients undergoing hemodialysis in the renal chamber of the general hospital were interviewed individually. The interviews were based on an interview guide and analyzed by Giorgi's method of analysis. As a result of this study, five elemental factors and 12 subelemental factors were derived. Derived elements were "difficulty in dietary guidelines", "recognizing necessity of diet therapy", "awareness of importance of diet", "difficulty practicing diet therapy", and "looking for ways to practice diet therapy". Patients not only felt difficulties in practicing dietary guidelines but also recognized the need and importance of diet therapy. Patients seemed to have difficulty practicing meal therapy and eating with their families or others. They were also stressed by the limited selection of dietary components and rapid dietary changes before and after dialysis. However, patients showed a willingness to implement dietary management to improve their quality of life and to practice dietary therapy. In order to improve the practice of dietary management in hemodialysis patients, nutritional education should be focused on long-term dietary habits through continuous education and monitoring, not just one-off education. Moreover, patients should be educated that adherence to dietary control may be less burdensome on their families.

Cryoballoon Catheter Ablation in Korean Patients With Paroxysmal and Persistent Atrial Fibrillation: One Year Outcome From the Cryo Global Registry

  • Hong Euy Lim;Il-Young Oh;Fred J Kueffer;Kelly Anna van Bragt;Young Keun On
    • Korean Circulation Journal
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    • v.52 no.10
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    • pp.755-767
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    • 2022
  • Background and Objectives: Cryoballoon catheter ablation for the treatment of patients with symptomatic atrial fibrillation (AF) has been adopted globally, but there are limited multicenter reports of 12-month outcomes in the Korean patient population. This analysis evaluated the clinical performance and safety of cryoballoon ablation (CBA) according to standard-of-care practices in Korea. Methods: This evaluation of Korean patients with AF was conducted within the larger Cryo Global Registry, which is a prospective, multicenter, post-market registry. Freedom from a ≥30-second recurrence of atrial arrhythmias (after a 90-day blanking period until 12 months) and procedural safety were examined in subjects treated with CBA at 3 Korean centers. Results: Overall, 299 patients with AF (60±11 years old, 24.7% female, 50.5% paroxysmal AF) underwent CBA using the Arctic Front Advance cryoballoon. Of those, 298 were followed-up for at least 12 months. Mean procedure-, left atrial dwell- and fluoroscopy time was 76±21 minutes, 56±23 minutes, and 27±23 minutes, respectively. Freedom from AF recurrence at 12 months was 83.9% (95% confidence interval [CI], 76.9-88.9%) in the paroxysmal and 61.6% (95% CI, 53.1-69.0%) in the persistent AF cohort. Rhythm monitoring was performed on average 4.7±1.4 times during the follow-up period. Serious device- or procedure-related adverse events occurred in 2 patients (0.7%). The 12-month Kaplan-Meier estimate of freedom from repeat ablation and cardiovascular-related hospitalization was 93.8% (95% CI, 90.4-96.1%) and 89.7% (95% CI, 85.6-92.7%), respectively. Conclusions: CBA is an efficient, effective, and safe procedure for the treatment of AF patients when used according to real-world practices in Korea.