Kim, Bo-Young;Seo, Bok-Nam;Park, Ji-Eun;Yang, Chang-Sop;Kim, Ick-Tae;Im, Ji-Won;Kim, Young-Eun
Korean Journal of Acupuncture
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v.34
no.1
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pp.8-36
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2017
Objectives : The aim of this study is to review the methodology of clinical trials conducted with the acupuncture and moxibustion treatment on functional dyspepsia. Methods : We searched four international databases and three Korean databases including English, Korean and Chinese, through March 2016 for randomized controlled trials(RCT) and non-randomized case-control trials(CCT) that evaluated the effects of the acupuncture and moxibustion on functional dyspepsia. We abstracted the designs of the trials and the method of acupuncture and moxibustion treatment according to the Standards for Reporting Interventions in Clinical Trials of Acupuncture. Results : A total 117 papers were reviewed. The 106 studies were conducted in China. There were 111 RCTs(95%), and 6 CCTs(5%). Sixty eight studies(59%) were conducted with the manual acupuncture, 29 studies of electro-acupuncture(25%), 11 studies of moxibustion(9%), 5 studies of acupoints embedding therapy(4%), 4 studies of acupoint injection therapy(3%) were conducted. ST36, CV12, ST25 were most frequently used for acupoints to treat functional dyspepsia. In 59 studies(50%), western medication was used in the control group, and the effects of acupuncture and moxibustion were evaluated with the symptoms in most studies. Conclusions : These results suggest that it is necessary to develop more detailed reporting standards about acupuncture and moxibustion treatment method as the method of acupuncture and moxibustion is getting more diverse, and more objective tools are needed in evaluating functional dyspepsia.
Purpose : This study explores the professional status of Advanced Practice Nurses (APNs) in Korea, who, despite being legally certified, face instability in their professional standing, including their scope of practice and compensation. Method : The study uses Flexner's professional characteristics as a framework to analyze and project the future trajectory of Korean APNs. Results : First, to ensure social accountability, professional bodies need to establish uniform nursing policies related to job roles, and healthcare institutions must adhere to these policies. Second, nursing leaders should spearhead the creation of nursing knowledge essential for the profession's advancement, aiming to establish it as the foundation for nursing practice through a consensus process within the nursing community. Third, the curriculum for APNs should enhance the quantitative and qualitative aspects of practice in response to societal needs. Fourth, professional bodies should formulate consistent nursing policies based on a thorough analysis of the healthcare environment and legal considerations, and guide their implementation in clinical practice through a consensus process within the nursing community. Lastly, guidelines should be established for professional standards suitable for the Korean context. Conclusion : Based on this review, it is recommended that all APNs adhere to the professional standards set by their respective organizations, actively participate in personal quality improvement initiatives, and fulfill their duties and roles as members of these professional bodies. Furthermore, these organizations should devise practical strategies to solidify the APN system and should spearhead a systematic consensus process that garners the agreement of all members within the nursing community.
Objectives This systematic review aimed to analyze the effectiveness, safety and the reporting quality of scalp acupuncture (SA) treatment for musculoskeletal disease (MSD). Methods Eleven databases were systematically searched up to July 12th 2023. Randomized controlled trials (RCTs) of SA treatment for MSD were selected manually by the inclusion criteria. The risk of bias of RCTs was assessed using the Cochrane's Risk of Bias (RoB) 1.0 and the reporting quality of studies was evaluated using Consolidated Standards of Reporting Trials (CONSORT) 2010 statement and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) 2010 checklist. Results Ten clinical studies were met the inclusion criteria. Most of studies reported SA treatment significantly alleviated pain and functional disability of MSD patients and no serious adverse effects were reported. In RoB assessment, blinding of participants and personnel was found to have the highest RoB and allocation concealment was found to have the most unclear RoB. In CONSORT 2010 statement evaluation, all studies reported 15.3 items (41.4%) on average. In STRICTA 2010 checklist evaluation, all studies reported 11.2 items (65.9%) on average. Conclusions The systematic review found that SA treatment may alleviate pain and functional disability of MSD patients and have little severe adverse effect. The reporting quality of included studies was mainly low, therefore, further studies with strict adherence to the CONSORT and STRICTA checklist should be encouraged.
Hur, Yeoun;Tae, Sookil;Koh, Yun-Joo;Hong, Sung-Hyun;Yoon, Young Ho;Jang, Haejong;Kim, Sooji;Kim, Kyeong Ho;Kang, Seung Woo;Lee, Youngshin;Han, Sang Beom
Mass Spectrometry Letters
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v.5
no.2
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pp.42-48
/
2014
A specific and sensitive liquid chromatography-electrospray ionization tandem mass spectrometry method (LC-ESI-MS/MS) was developed and validated for the simultaneous quantification of porphyrins (coproporphyrin, pentacarboxylporphyrin, hexacarboxylporphyrin, heptacarboxylporphyrin, and uroporphyrin) in human plasma and urine. Acidified plasma samples and urine samples were prepared by using liquid-liquid extraction using ethyl acetate and protein precipitation with acetonitrile, respectively. The separation was achieved onto a Synergi Fusion RP column ($150mm{\times}2.0mm$, $4{\mu}m$) with a gradient elution of mobile phase A (0.1% formic acid in 2 mmol/L ammonium acetate, v/v) and mobile phase B (20% methanol in acetonitrile, v/v) at a flow rate of $450{\mu}L$/min. Porphyrins and the internal standard (IS), coproporphyrin I-$^{15}N_4$, were detected by a tandem mass spectrometer equipped with an electrospray ion source operating in positive ion mode. Multiple reaction monitoring (MRM) transitions of the protonated precursor ions and the related product ions were optimized to increase selectivity and sensitivity. The proposed method was validated by assessing selectivity, linearity, limit of quantification (LOQ), precision, accuracy, recovery, and stability. The calibration curves were obtained in the range of 0.1-100 nmol/L and the LOQs were estimated as 0.1 nmol/L for all porphyrins. Results obtained from the validation study of porphyrins showed good accuracy, precision, recovery, and stability. Finally, the proposed method was successfully applied to clinical studies on the autism spectrum disorder (ASD) diagnosis of 203 Korean children.
As the number of clinical trials conducted in Korea increases, the need of the Electronic Data Capture (EDC) system for effective clinical data management is also increased. Recently, the Korea Food and Drug Association published 'Guideline for the Electronic Clinical Trial Data Management and Processing' and it would be the foundation for establishing regulation of electronic clinical data management. In this research, we conducted the survey regarding adoption rate of EDC system in clinical trials in hospitals, Contract Research Organizations (CRO), and pharmaceutical companies. And the perceived importance and the ease of application for the Guideline were investigated. The adoption rates of EDC system was 77.6% but it mostly applied to less than five trials. Also EDC system was mostly used in phase I and phase II trials and the utilization rate of CRO was the highest. The perceived importance for the Guideline was high among all three organizations but, in case of the perceived ease of its application, CRO was the highest. Also, the perceived importance of the clinical data standard was high and the standard for data collection was mostly required. However, the comprehension for the global standard of the electronic data was relatively low, so that education is required. This result would be the foundation to increase the electronic clinical trials and develop proper regulation and principles for clinical data standards in Korea.
3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.
Objectives: This exploratory trial evaluated the possibility of quantitatively measuring several aspects during the "abdominal examination" of traditional Korean medicine. The main results of this study will be used to develop a new diagnostic device for abdominal examinations. Methods: Fifteen healthy volunteers were recruited for this study. Three certified Korean medical doctors assessed the existence of pressure pain, the elasticity of the abdominal muscle, and the tonus at CV12 as gold standards. Then, 2 well-trained investigators measured the pressure pain threshold (PPT), the indentation depth of a bar, and repelling force by pressing CV12. Each investigator measured the above 3 variables 2 times at 1 min intervals using a modified digital algometer. Reliability and validity tests of the 3 variables were performed. Results: There were statistically significant coefficients of intraclass correlation on the 3 variables both between and within the investigators (P<0.001). Also, PPT and repelling force showed statistically significant high sensitivity and specificity in a ROC curve. However, the indentation depth of the bar presented relatively low sensitivity. Conclusions: This new diagnostic method using a modified digital algometer could be a useful tool for quantitative measurement in "abdominal examinations". However, future rigorous clinical studies with a large population will be needed for the verification of its usefulness.
Purpose: This study was conducted to describe qualitatively the entities of nurse's experiences in general hospitals and to suggest basic data guiding research on developing Standards of clinical nursing practice in Korea. Method: Fourteen nurses working at general hospitals with over 300 beds in Seoul were interviewed in-depth until saturation using tape-recorders and transcription. Result: The central theme of clinical nursing practice experienced by subjects was "being with clients" that means accepting client's personal character, solving client's needs and providing client-centered nursing. A also "being with clients" was felt to be the responsibility of nurses which was learned from their nursing schools. The nursing strategies performed in order to be with patients were proving skillful nursing techniques, accepting, educating, emotional support, advocating, and self-reflecting, the subjects experienced somewhat problematic affects such as difficulties in interpersonal relationship, work overload, negative image of nursing, deficit of self-confidence for nursing actions, poor working conditions, and unfair treatment. Nurses at the hospital practiced with pride when they felt that they were accepted by clients. Conclusion: Further research is needed to analysis problems in clinical practice and the comparison of nurses' experiences of clinical practice, with nurses' experiences in various settings.
Education on the physician continues with undergraduate medical education, graduate medical education, and continuous medical education. The countries such as the United States, Japan, the United Kingdom, German, and others are required to undergo training in the clinical field for 2 years after completing the national medical examination, and to become doctors after passing the clinical practice license test. Korea can obtain a medical license and become a clinical doctor at the same time if it passes written and practical tests after completing 6 years of undergraduate medical education or 4 years of graduate school. About 90% of medical school graduates replace clinical practice with 4-5 years of training to acquire professional qualifications, but this is an option for individual doctors rather than an extension of the licensing system under law. The medical professional qualification system is implemented by the Ministry of Health and Welfare on the regulation. In fact, under the supervision of the government, the Korean Hospital Association, the Korean Medical Association, and the Korean Academy of Medical Sciences progress most procedures. After training and becoming a specialist, the only thing that is given to a specialist is the right to mark him or her as a specialist in marking a medical institution and advertising. The government's guidelines for professional training are too restrictive, such as the recruitment method of residents, annual training courses of residents, dispatch rule of the residents, and the quota of residents of training hospitals. Although professional training systems are operated in the United States, the United Kingdom, France, and Germany, most of them are organized and operated by public professional organizations and widely recognize the autonomy of academic institutions and hospitals. Korea should also introduce a compulsory education system after graduating from medical education and organize and initiate by autonomic public professional organization that meets global standards.
Kim, Min Young;Choi, Su Jung;Seol, Miee;Kim, Jeong Hye;Kim, Hee Young;Byun, Sook Jin
Journal of Korean Clinical Nursing Research
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v.23
no.2
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pp.131-141
/
2017
Purpose: This study was to investigate the nationwide operational status of the professional medical support staffs (PMSS) who practice the expanded roles in the hospital setting. Methods: The data were obtained through survey from 36 hospitals with over 500 beds from 25th May to 12th July 2016. Data from 1,666 PMSS were analyzed. Results: Since the job titles varied, we classified them into 5 groups according to their roles; advanced practice nurse, clinical nurse expert, PA (physician assistant), coordinator, and others. There were differences in the operation status of PMSSs depending on the region, nurse staffing grade and number of hospital beds. Qualification criteria varied from hospital to hospital, and almost half of the hospitals didn't have any qualification standards for them. There were differences in age, educational level, clinical careers, rewards, and job satisfaction in 5 groups. Especially PA group had low salary, poorer working conditions, more difficulties in performing their work, and lower job satisfaction than other groups. Most PMSS (99.5%) were using a delegated prescription authority, however only 68.3% had job description and 19.9% had documented delegated role. Conclusion: Adequate training curriculum, documented delegated roles, and the protocols for legal protection and efficient medical services are needed.
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