• Title/Summary/Keyword: Integrated Medicine

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The Concept and Background for Introducing Longitudinal Integrated Clerkships (지속형 통합임상실습의 도입 배경과 개념)

  • Lee, Young-Mee
    • Korean Medical Education Review
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    • v.20 no.1
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    • pp.1-5
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    • 2018
  • A traditional clerkship consists of a series of short rotations in specialty disciplines and is usually based in tertiary, urban teaching hospitals. Shortened inpatient stays and the shift toward ambulatory management have had a negative impact on student learning. There have been growing concerns that the traditional specialty-based clerkship in fragmented and highly specialized clinical environments may not be the optimal choice for basic clinical education. As a result, a new model of clinical clerkship called longitudinal integrated clerkships (LICs) has emerged. There is increased interest in LICs due to the growing evidence of positive outcomes for students, patients, and supervising clinicians. Emphasizing continuity as one of the main organizing principles of an LIC, this article reviews the introduction of LICs into medical education, the key concepts and educational theories which underpin LICs, and the typology of LICs. The author also offers some personal suggestions for contemplation before clerkship programs in Korea adopt LICs.

Development and Operation of Longitudinal Integrated Clerkship Programs in Overseas Medical Schools (외국 의과대학에서의 장기추적통합임상실습 개발과 운영사례)

  • Yeo, Sanghee
    • Korean Medical Education Review
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    • v.20 no.1
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    • pp.6-14
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    • 2018
  • In recent years, Korean medical schools have shown a growing interest in the longitudinal integrated clerkship (LIC) as a means of improving clinical education. Some overseas medical schools have tried the LIC since the 1970s. In the 1990s, several universities in the United States, Canada, and Australia introduced LICs. A variety of studies have confirmed positive results of the LIC. Traditional block-rotation is a discipline-based, inpatient-centered practice. Instead, under the LIC system, a medical student responsible for a panel of longitudinal patients observes developments of their diseases, serving several departments simultaneously. Overseas medical schools have different LIC models depending on their affiliate hospitals' sizes and characteristics. The purpose of this study is to introduce LIC practices in Harvard Medical School and University of California San Francisco, which could be applied by Korean medical schools. This paper also aims to find out the strategies that have been able to help the two US medical schools implement the LIC successfully.

Stem cell behaviors on periodic arrays of nanopillars analyzed by high-resolution scanning electron microscope images

  • Jihun Kang;Eun-Hye Kang;Young-Shik Yun;Seungmuk Ji;In-Sik Yun;Jong-Souk Yeo
    • Applied Microscopy
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    • v.50
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    • pp.26.1-26.3
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    • 2020
  • The biocompatible polyurethane acrylate (PUA) nanopillars were fabricated by soft lithography using three different sizes of nanobeads (350, 500, and 1000 nm), and the human adipose-derived stem cells (hASCs) were cultured on the nanopillars. The hASCs and their various behaviors, such as cytoplasmic projections, migration, and morphology, were observed by high resolution images using a scanning electron microscope (SEM). With the accurate analysis by SEM for the controlled sizes of nanopillars, the deflections are observed at pillars fabricated with 350- and 500- nm nanobeads. These high-resolution images could offer crucial information to elucidate the complicated correlations between nanopillars and the cells, such as morphology and cytoplasmic projections.

Comparative Study on the Expertise, Convenience, and Interaction of Medical Treatment Systems Applied by Geriatric Hospital (요양병원 진료시스템에 따른 진료전문성, 편의성, 상호작용성의 역할 비교연구)

  • Yoon, Sung-Wook;Ryu, Jeong-Geon;Kim, Su-Bae
    • Journal of Distribution Research
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    • v.11 no.3
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    • pp.1-22
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    • 2006
  • Medical treatment for the aged has become an increasingly important concern as the aged population continues to grow. However, little research has been done on the issue. This study examines the roles of the expertise, convenience, and interaction of medical treatment systems applied by geriatric hospital. Medical treatment systems include oriental medicine, western medicine and integrated(oriental and western) medicine practices. The empirical results of the study are as follows. First, the relative impacts of the expertise, convenience and interaction on customer satisfaction are different depending upon the medical treatment systems. Second, convenience and interaction are shown to be more important factors in western medicine, while interaction is the case in oriental medicine. As for the integrated medicine practices, expertise is considered more important. Thus, it is necessary for the western medicine to make more efforts on interaction and convenience, while it is critical to enhance medical personnels' service quality in the oriental medicine. In the integrated medical treatment, actual and effective cooperation should be achieved to secure expertise. Third, the data demonstrate that customer satisfaction has a positive influence on relationship quality which, in turn, impacts on repurchase intention. Finally, relationship quality has a negative influence on intention to switch in the western medicine, whereas the impact of relationship quality is not significant in the oriental and integrated medicine practices.

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Discriminant Model V for Syndrome Differentiation Diagnosis based on Sex in Stroke Patients (성별을 고려한 중풍 변증진단 판별모형개발(V))

  • Kang, Byoung-Kab;Lee, Jung-Sup;Ko, Mi-Mi;Kwon, Se-Hyug;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.138-143
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    • 2011
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.

Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis (의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과)

  • Ahn, Yang Heui
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.32-45
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    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

MAP: Mutation Arranger for Defining Phenotype-Related Single-Nucleotide Variant

  • Baek, In-Pyo;Jeong, Yong-Bok;Jung, Seung-Hyun;Chung, Yeun-Jun
    • Genomics & Informatics
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    • v.12 no.4
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    • pp.289-292
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    • 2014
  • Next-generation sequencing (NGS) is widely used to identify the causative mutations underlying diverse human diseases, including cancers, which can be useful for discovering the diagnostic and therapeutic targets. Currently, a number of single-nucleotide variant (SNV)-calling algorithms are available; however, there is no tool for visualizing the recurrent and phenotype-specific mutations for general researchers. In this study, in order to support defining the recurrent mutations or phenotype-specific mutations from NGS data of a group of cancers with diverse phenotypes, we aimed to develop a user-friendly tool, named mutation arranger for defining phenotype-related SNV (MAP). MAP is a user-friendly program with multiple functions that supports the determination of recurrent or phenotype-specific mutations and provides graphic illustration images to the users. Its operation environment, the Microsoft Windows environment, enables more researchers who cannot operate Linux to define clinically meaningful mutations with NGS data from cancer cohorts.

Academic Medicine Is Patient-Centered Medicine (Academic Medicine은 환자 중심 의료이다)

  • An, Shinki
    • Korean Medical Education Review
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    • v.21 no.2
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    • pp.80-91
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    • 2019
  • The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

Screening of Chinese Herbal Medicines with Inhibitory Effect on Aldose Reductase (IV) (중국 약용식물 추출물의 알도즈 환원 효소 억제 효능 검색 (IV))

  • Lee, Yun-Mi;Kim, Young-Sook;Bae, Ki-Hwan;Kim, Joo-Hwan;Kim, Jin-Sook
    • Korean Journal of Pharmacognosy
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    • v.41 no.4
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    • pp.289-296
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    • 2010
  • Aldose reductase (AR), the principal enzyme of the polyol pathway, has been shown to play an important role in the development of the diabetic complications. Evaluating natural sources for ARI potential may lead to the development of safer and more effective agents against diabetic complications. Sixty four Chinese herbal medicines have been investigated for inhibitory activities on AR. Among them, thirteen herbal medicines, Inula helianthus-aquatilis C. Y. Wu ex Ling. (whole plant), Erigeron breviscapus (Vant.) Hand. Mazz. (whole plant), Lonicera hypoglauca Miq. (leaf, stem), Scutellaria orthocalyx Hang. Mazz. (whole plant), Berchemia floribunda Brongn. (leaf, stem), Michelia alba DC. (flower), Oroxylum indicum (seed), Punica granatum L. (peel), Elsholtzia capituligera (whole plant), Trachelospermum jasminoides (Lindl.) Lem. (whole plant), Elsholtzia strobilifera Benth. (whole plant), Agrimonia pilosa var. nepalensis (D. Don) Nakai (whole plant) and Aster poliothamnus Diels (whole plant) exhibited a significant inhibitory activity against AR. Particularly, Inula helianthus-aquatilis C. Y. Wu ex Ling. showed seven times more potent inhibitory activity than the positive control, 3,3-tetramethyleneglutaric acid (TMG).