• Title/Summary/Keyword: Medicine in Practice

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Korean Surgical Practice Guideline for Pancreatic Cancer 2022: A summary of evidence-based surgical approaches

  • Seung Eun Lee;Sung-Sik Han;Chang Moo Kang;Wooil Kwon;Kwang Yeol Paik;Ki Byung Song;Jae Do Yang;Jun Chul Chung;Chi-Young Jeong;Sun-Whe Kim;Committee of the Korean Surgical Practice Guideline for Pancreatic Cancer
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.1-16
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    • 2022
  • Pancreatic cancer is the eighth most common cancer and the fifth most common cause of cancer-related deaths in Korea. Despite the increasing incidence and high mortality rate of pancreatic cancer, there are no appropriate surgical practice guidelines for the current domestic medical situation. To enable standardization of management and facilitate improvements in surgical outcome, a total of 10 pancreatic surgical experts who are members of Korean Association of Hepato-Biliary-Pancreatic Surgery have developed new recommendations that integrate the most up-to-date, evidence-based research findings and expert opinions. This is an English version of the Korean Surgical Practice Guideline for Pancreatic Cancer 2022. This guideline includes 13 surgical questions and 15 statements. Due to the lack of high-level evidence, strong recommendation is almost impossible. However, we believe that this guideline will help surgeons understand the current status of evidence and suggest what to investigate further to establish more solid recommendations in the future.

Factors related to empowerment of paramedic students who experienced clinical practice (임상실습을 경험한 응급구조(학)과 학생의 임파워먼트 관련 요인)

  • Song, Seo-Yeong;Han, Mi-Ah
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.1
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    • pp.17-30
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    • 2016
  • Purpose: This study investigated factors related to empowerment of paramedic students. Methods: A total of 208 students in the department of emergency medical services who experienced clinical practice at 5 universities were selected by convenience sampling methods. Differences in empowerment by general and major-related characteristics were evaluated using a t-test and analysis of variance. The association between satisfaction with clinical practice and empowerment was tested using correlation coefficients. Multiple linear regression analysis was performed to investigate the factors associated with empowerment. Results: The levels of overall satisfaction with clinical practice and empowerment were 107.48 and 99.46, respectively. In simple analysis, empowerment level was associated with general characteristics, major-related characteristics, characteristics of clinical practice, and satisfaction with clinical practice. Empowerment level was significantly higher in older subjects (${\beta}=5.282$, p = .023), subjects with very good (${\beta}=8.487$, p = .002) or fair (${\beta}=4.879$, p = .010) subjective health status, and high subjective school record (${\beta}=5.837$, p = .008) in multiple linear regression analysis. Satisfaction with clinical practice was positively associated with empowerment (${\beta}=0.250$, p < .001). Conclusion: Empowerment was associated with major-related factors and satisfaction with clinical practice. Increased satisfaction with clinical practice could positively influence empowerment for paramedic students.

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline (알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로)

  • Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.130-140
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    • 2019
  • Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

A Re-discussion on the Characteristics of Medicine (의료행위의 특질 재론)

  • HeeTae Suk
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.3-58
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    • 2024
  • It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.

A Survey on Korean Medicine Doctors' Recognition for Developing Korean Medicine Clinical Practice Guidelines for Gastric Cancer (위암 한의표준임상진료지침 개발을 위한 한의사 인식조사)

  • Dong-hyeon Kim;Jong-hee Kim;Ji-hye Park;Hwa-seung Yoo;So-jung Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.466-484
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    • 2023
  • Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey. Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM. Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation. Conclusion: In this study, we were able to understand the clinical KMDs' perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.

A Study on the Family Planning Practice of Some Urbanites (일부 도시지역 주민의 가족계획 실천에 관한 연구)

  • Kim, Young-Ha;Cha, Hyung-Hun;Yum, Yong-Tae
    • Journal of agricultural medicine and community health
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    • v.9 no.1
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    • pp.27-38
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    • 1984
  • The Family Planning Project as a birthcontrol policy has been enthusiastically carried out by the government since 1962. But gradually it get less enthusiastic. Therefore, it is required to establish a more comprehensive and systematic plan and to carry out it thoroughly. And it is needless to say that people's knowledge about family planning, their attitudes and their practice should be concretly comprehended. Taking these things into consideration, this study surveys the general situation on family planning among 237 married women of less than 34 years in Guro 6-dong, one of target areas for Korea University Health Project from Sep. 17, 1984 to Oct. 13, 1984. The results are as follows; 1) Most of the subjects (62.8%) want 2 children and 13.6% want one child. But son-preference consciousness is remarkably revealed among them, which is thought to cause social inequality between man and woman. Therefore, it needs to change the traditional son-preference convention, for equality of all men regardless of sex. 2) The rate of induced abortion experience by person is 61.6% and the average frequency is 1.4. Almost all the induced abortion are carried out at clinics and hospitals during 2~3 months after conception. To prevent these unnecessary conception and induced abortion in view of maternal health, ethics and economics, proper contraceptive measures should be emphasized. 3) Temporary contraceptives should be sold more widely in the basis of free trade in order to practice the intensive and comprehensive family planning because the degree which Health Center has been utilized for buying temporary contraceptives is low. 4) There are serious problems such as the side effects and the lack of follow up care in permanent contraceptives. Those lower the practice rate of permanent contraception. Therefore it is necessary to improve the quality of permanent contraception practice and strengthen the follow-up care.

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Challenges and opportunities in integrating complementary and alternative medicine into mainstream of the Malaysian healthcare system

  • Tahir, Nurul Ain Mohd;Thomas, Paraidathathu;Li, Shu Chuen
    • CELLMED
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    • v.5 no.4
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    • pp.23.1-23.6
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    • 2015
  • Complementary and alternative medicine (CAM) practice is still popular among the Malaysian population nowadays although western or allopathic medicine is the first line of treatment. Dissatisfaction with health services and therapeutic effects of western medicine or preference for holistic, integrative approach in treatment are common reasons favouring the increasing popularity of CAM practices. The efforts toward integration of CAM and western medicine in Malaysia were rather slow and in a piece-meal fashion. Strategic efforts in strengthening government and self-regulation among practitioners, formalizing education, promoting research, and cultivating national and international networks are necessary to achieve an integrative system. Regulations to restrict the practice and sale of CAM products to licensed practitioners, strict and mandatory registration of the practitioners, inclusion of CAM in essential medicines list, and pricing regulations must be comprehensively discussed. Development of curriculum, offers of scholarship and incentives, promotion of courses and seminars for professionals is necessary to increase the numbers of CAM experts. Malaysia should follow the efforts of other countries on the production and documentation of local CAM data, allocation of funding, and establishment of research centres to assess the efficacy of potentially useful local products. Local and international collaboration in research and continuous education is important for exchange of knowledge and skills. In conclusion more coordinated efforts in regulation of CAM practice and products, formalizing CAM training and education would significantly move the process forward and allow the public to enjoy more health benefits from CAM practice in Malaysia.

A Study on the Knowledge, Attitude and Practice of Handwashing of Middle School Students (일부 중학생의 손씻기 지식, 태도 및 실천에 관한 연구)

  • Jang, Yun-Jeong;Na, Bak-Ju;Kim, Keon-Yeop;Bae, Seok-Hwan;Kim, Chul-Woung;Kim, Eun-Young;Lee, Moo-Sik
    • Korean Journal of Health Education and Promotion
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    • v.24 no.4
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    • pp.1-22
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    • 2007
  • Objectives: This study attempted to understand the relationship between handwashing knowledge, attitude and practice of middle school students and to provide the basic information for handwashing training of the students and help them to form a healthy habit. Methods: Data was collected by a standardized self-administered questionnaire between Sep. 20 to Oct. 6 2006 with a total of 710 students in 1, 2, 3 grades at 6 middle schools in metropolitan cities(490 students from four schools situated in an urban center, 220 from 2 in a suburban district). The data was then analyzed using the SPSS WIN 12.0 program, employing many statistical techniques such as chi-square($x^2$) test, t-test, ANOVA analysis with post hoc test, correlations analysis, and regression analysis. Results: The results of the study were as follows. First, total number of handwashing times of middle school students is 6.69 per day. 66.1% of the students used soap and most of the students washed hands for $6{\sim}10$ seconds(44.7%). Second, in the knowledge of handwashing, "both of the parents"(p<0.01), "catholic", "city"(p<0.05) were the highest and the practice of handwashing was active with "city", "high economic level"(p<0.05) and "both of the parents"(p<0.01). In the experience of teaching handwashing, "Yes" was 24.3% which was statistically significant with handwashing knowledge(p<0.05), attitude and practice(p<0.01). Third, in the correlation of handwashing knowledge, attitude and practice, there was statistical significancy between handwashing attitude and knowledge(p<0.01) and showed positive correlation with the knowledge(.534). The practice of handwashing has meaningful difference from the knowledge and the attitude and the coefficient of correlation shows positive co-relation in knowledge(.335) and attitude(0525). Fourth, based on the result for regression analysis with handwashing knowledge, attitude and practice as dependent variables, handwashing knowledge showed statistical significancy with sex, type of school(p<0.05) and residential area(p<0.01). There were also statistical significancy between handwashing attitude and knowledge(p<0.01) and between handwashing practice and religion, knowledge(p<0.05) and economic level, attitude(p<0.01). Conclusion: There were consistent results with handwashing knowledge, attitude and practice. If they had better knowledge, their attitude was more positive and if they had better knowledge and more positive attitude, their practice was active. The knowledge, attitude and practice of the students who learned about handwashing were higher than those of the students who had no experience of learning handwashing. To enhance handwashing habit of middle school students, the handwashing environment should be maintained. The training plans should also be made according to sex, type of school, economic level, residential area, and the consistent study on handwashing training is required.

Clinical Practice Guidelines of Korean Medicine for Gastric Cancer (위암 치료에 대한 한방 임상 가이드라인)

  • Kim, Hyo-Rin;Jeong, Hye-Ryon;Baek, Dong-Gi;Won, Jin-Hee;Moon, Goo
    • Journal of Korean Traditional Oncology
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    • v.19 no.1
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    • pp.1-24
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    • 2014
  • Objectives : The purpose of this study was to present the clinical guidelines for gastric cancer. Methods : The literature on Western and Oriental medical treatment of gastric cancer were collected, analyzed and summarized from the Google Scholar, KIOM OASIS and PUBMED from 1993 to 2014. Results : Gastric cancer is the second most common cancer in Korea. In recent studies, applying integrative oriental and western medicine can suppress the tumor, improve the survival, the immune system, and the quality of life in gastric cancer. But there isn't still a unified protocol for gastric cancer treatment, so we have difficulty in clinical application. This study will be helpful for understanding and building systems for integrative gastric cancer treatment. Conclusion : Further studies on integrative gastric cancer treatment are needed to improve the survival of gastric cancer patients and build the clinical practice guidelines of gastric cancer.

Speculation of the Correlationship between Public Health Practice, Consumption and Fatigue in Patients who Complain Fatigue (피로를 주소로 내원한 환자의 생활섭생, 허손 및 피로의 상관성에 대한 고찰)

  • Kim, Se-Hoon;Lee, Jang-Hoon;Lee, Seung-Bo;Choi, Mi-Young;Kim, Young-Chul;Woo, Hong-Jung
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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    • pp.219-230
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    • 2008
  • Objectives : Consumption is a chronic wasting disease, in oriental medicine concept. Fatigue is a common symptom experienced by many people who have consumption. However, there has been little study about the relationship between consumption and fatigue in the Oriental medicine. For this reason, we attempted to investigate the present status of fatigue of outpatients, and its relation with consumption index, public health practice index, Chalder fatigue scale and Subjective Symptoms of Fatigue Test. Methods : The subjects were 149 outpatients who complain fatigue between Nov. 1, 2006 and Oct. 31, 2007. We measured degree of consumption by consumption index. We measured degree of fatigue by Chalder fatigue scale and Subjective Symptoms of Fatigue Test. Public health practice were investigated by "Breslow's 7 health practice". Results : Studies have shown that a group who disregard public health practices have higher numerical value, in part of $q\grave{i}-x\bar{u}$, $xu\grave{e}-x\bar{u}$, and Physical symptoms than a group more concerned with public health practice. A group who has fatigue for a period over 6 months are more likely to be $q\grave{i}-x\bar{u}$, $y\bar{i}n-x\bar{u}$, Chalder fatigue scale, neuro-sensory symptoms than a group fatigued for less than 6 months. Among the subjects, 81 (55.5%) were considered as 'fatigue patients' by the Chalder scale. Chalder fatigue scale, according to the Subjective Symptoms of Fatigue Test, consumption also, The more increase of Subjective symptoms of fatigue test, the more of consumption scale. Conclusions : This study has shown that there is a link between consumption and fatigue. Moreover, oriental medicine's consumption is more concrete than fatigue scale, so consumption index will have wide application to the study of fatigue.

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