• Journal of Hospice and Palliative Care
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• 제24권3호
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• pp.184-193
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• 2021

Purpose: This study attempted to develop clinical guidelines to help patients use hospice and palliative care (HPC) at an appropriate time after writing physician orders for life-sustaining treatment (POLST) by identifying the characteristics of HPC use of patients with terminal cancer. Methods: This retrospective study was conducted to understand the characteristics of HPC use of patients with terminal cancer through decision tree analysis. The participants were 394 terminal cancer patients who were hospitalized at a cancer-specialized hospital in Seoul, South Korea and wrote POLST from January 1, 2019 to March 31, 2021. Results: The predictive model for the characteristics of HPC use showed three main nodes (living together, pain control, and period to death after writing POLST). The decision tree analysis of HPC use by terminal cancer patients showed that the most likely group to use HPC use was terminal cancer patients who had a cohabitant, received pain control, and died 2 months or more after writing a POLST. The probability of HPC usage rate in this group was 87.5%. The next most likely group to use HPC had a cohabitant and received pain control; 64.8% of this group used HPC. Finally, 55.1% of participants who had a cohabitant used HPC, which was a significantly higher proportion than that of participants who did not have a cohabitant (1.7%). Conclusion: This study provides meaningful clinical evidence to help make decisions on HPC use more easily at an appropriate time.

• 한국임상약학회지
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• 제32권2호
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• pp.133-143
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• 2022

E-cigarettes were considered safe at the early stage of market entry because they were thought not to contain harmful ingredients such as nicotine and because the smoke emitted was vapor. For this reason, the use of e-cigarettes as a safer alternative to tobacco cigarettes or as a smoking cessation aid has emerged. However, the study results on the effectiveness of e-cigarettes for smoking cessation are mixed. In response to the increased use of e-cigarettes, foreign countries have implemented various regulations, such as utilizing e-cigarettes for smoking cessation with a prescription in Australia; however, South Korea is still standing firm on recommending not to use e-cigarettes at all. Therefore, the effectiveness of e-cigarettes for smoking cessation and the regulatory trends of e-cigarette use overseas will be reviewed to discuss the future direction in South Korea needs to take.

• 한국응용약물학회:학술대회논문집
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• 한국응용약물학회 2006년도 Proceedings of The Convention
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• pp.23-39
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• 2006

The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of supporting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

• Biomolecules & Therapeutics
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• 제15권1호
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• pp.1-6
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• 2007

The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of sup-porting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

• 대한간호학회지
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• 제16권3호
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• pp.123-130
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• 1986

This Study is aimed at showing the effect of relaxation technique on reduction of anxiety of nursing students in the first clinical practice. The samples of this research were eighty fresh-man students of Dong San Junior College of Nursing. Of them thirty-eight were experimental group and remaining forty-two were control group. This study has been conducted from October 14 to 22, 1985. Subjects in all two groups had measured their trait anxiety, after then, the researcher carried out Byun's relaxation technique with experimental group every other day After the experimental period, subjects in all two groups had measured their state anxiety. The tools of this study were two kinds: Spielberg, Gorsuch & Lushene's STAI, and Byun's relaxation technique. To test the statistical difference in the subjects' trait anxiety, score of lecture in pre-clinical practice and score of practice pre-clinical practice, t-test was performed. To verify the hypotheses, ANCOVA was performed. Results of this study were as follows: The main hypothesis that the nursing students who use relaxation technique will have less degree of anxiety in the first clinical practice than the nursing students who don't use relaxation technique was accepted (P<.005). Conclusively, the researcher thinks that it is necessary that nursing students were prepared with relaxation technique to reduce anxiety in their first clinical practice.

• Clinical and Experimental Reproductive Medicine
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• 제47권4호
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• pp.245-262
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• 2020

In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an indepth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.

• 한국약용작물학회:학술대회논문집
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• 한국약용작물학회 2006년도 Proceedings of The Convention of The Korean Society of Applied Pharmacology
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• pp.23-39
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• 2006

The application of the knowledge from the Human Genome Project to clinical medicine will be through both industrial drug development and the application of pharmacogenomics (PG) to patient care. The slow uptake of clinical innovations into clinical practice can be frustrating, but understanding the history of acceptance and sustaining medical innovation is critically important to position PG to succeed. This primarily means that PG tests must have legitimacy; they must be thoroughly validated, must be cost-effective, must be widely accepted by medical practitioners, must be supported by public policy, and must have a way of being easily incorporated into current medical practice. They must also lead to actionalble decisions by health care providers for their patients. Innovative PG assays should be tested in the best US laboratories, and reimbursement for testing must be accepted at the federal and state level. The companies providing these PG tests should be capable of supporting the interpretation and use of the test throughout medical practice. Advances such as the addition of PG information to drug labeling and the routine use of validated biomarkers to determine choice of cancer chemotherapy have been made. The PG research community must pay attention to the principles that have been previously described for acceptance and sustaining medical innovations in order for PG to be widely accepted in clinical medical practice.

• 한국임상약학회지
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• 제22권4호
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• 한국임상약학회지
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• 제22권2호
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• pp.137-142
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• 2012

Background & Purpose: It is well known that Extrapyramidal symptoms (EPS) is induced by atypical antipsychotic agents less frequently than by typical antipsychotic agents. The purpose of this study was to evaluate differences in rates of the use of antiparkinson agent, most commonly prescribed for the management of EPS, between patients with atypical agents and those with typical agents. Methods: This cross-sectional study was conducted in a retrospective way with the Electronic Medical Record (EMR) of the 312 patients for whom the Antipsychotics were prescribed by the Psychiatry Department of the Inje University Ilsan Paik Hospital, from January of 2005 to February of 2011. They received either typical agents (N=15) or atypical agents (N=297) and those 2 groups were compared in terms of antiparkinson agent use. Also, we assessed the difference between individual atypical antipsychotic agents regarding antiparkinson agent use. Results: There was no significant difference in the rates of antiparkinson agent use between the two groups (the typical agent 13.33% vs. the atypical agent 9.76%, p = 0.6512). Meanwhile, the rates of antiparkinson agent use with aripiprazole versus quetiapine (aripirazole 25% vs. quetiapine 3.57%, p = 0.003) were significantly different, Also the rates of antiparkinson agent use with aripiprazole versus risperidone (aripiprazole 25% vs. risperidone 9.52%, p = 0.0216) had a statistical meaning. Conclusions: There was no significant difference in the rates of antiparkinson agent use between patients with atypical agents and those with typical agents. However the rate of antiparkinson agent use was significantly lower with aripiprazole compared with quetiapine or risperidone.

• 보건행정학회지
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• 제7권1호
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• pp.125-154
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• 1997

The hospital, clinical department and the physician factor in explaining variations of hospital resource use in surgically admitted patients was compared. This analysis was based on 6, 361 discharges in 28 hospitals for three surgical conditions - lens procedures anal and stomal procedures, uterine and ovarian procedures using medical insurnce claim data. The results were as follows: 1. Regression analysis indicated that the hospital and clinical department characteristics, such as hospital ownership and size, were more significant predictors of the resource use indicators than the physician and patients' social characteristics. 2. Regarding to the physician factors, the hospital where the physician received the residency training and the medical shool where he/she graduated had less effect compared to the hospitals where he/she currently works. Between the residency trained hospital and medical school, the is more important than the latter. 3. When the hospital charges were divided into type of service provided i. e. room, drug, laboratory & radiologic, procedure & operation, and anesthesic charges, variance due to the hospital factor was larger than that due to the physician factor in each item. In summary, the hospital and clinical departmental factor played an important role than physician factor ; indicating to reduce the variation in hospital resource use, the policy that affects hospital behavior would be more effective than that targets individual physician behavior.