• Title/Summary/Keyword: graduate medical education

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Effect of Layer-by-Layer (LbL) Encapsulation of Nano-Emulsified Fish Oil on Their Digestibility Ex Vivo and Skin Permeability In Vitro

  • Jung, Eun Young;Hong, Ki Bae;Son, Heung Soo;Suh, Hyung Joo;Park, Yooheon
    • Preventive Nutrition and Food Science
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    • v.21 no.2
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    • pp.85-89
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    • 2016
  • Omega-3 rich fish oils are extremely labile, thus requiring control of oxidation and off flavor development. A recently proposed emulsification method, layer-by-layer (LbL) deposition, was found to be a plausible method to enhance the characteristics of bioactive ingredients, especially lipids. The present work was designed to test the possibility of enhancing the uptake and utilization of omega-3 fatty acids present in fish oil. The bioavailability of nano-emulsified fish oil was monitored in terms of intestinal absorption as well as skin permeability by using the everted intestinal sac model and Franz cell model. The skin permeability and intestinal absorption characteristics was significantly improved by LbL emulsification with lecithin/chitosan/low methoxypectin. Multilayer encapsulation along with nano-emulsification can be a useful method to deliver biologically active lipids and related components, such as fish oil. The protective effect of this tool from lipid oxidation still needs to be verified.

Change of Pain, Lumbar Sagittal Alignment and Multifidus after Sling Exercise Therapy for Patients with Chronic Low Back Pain

  • Park, Seung Jin;Moon, Ji Hyun;Shin, Yun A
    • The Journal of Korean Physical Therapy
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    • v.30 no.5
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    • pp.173-180
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    • 2018
  • Purpose: This study examined the effects of sling exercise therapy on vertebral alignment, VAS, muscle activity, and multifidus of patients with chronic low back pain. Methods: Simple random sampling was used to divide the patients (n=116) into the sling exercise therapy group (SETG) and conservative physical therapy group (CPTG), with each group provided a intervention program in 3 sessions a week for 12 weeks. The lumbar lordosis angle (LLA), lumbar intervertebral disc angle (LIVDA) for vertebral alignment, lumbar muscle activity, and multifidus atrophy were measured before and after the intervention. Results: SETG showed significant changes in LLA, LIVDA of rate of change (delta score), and in relieving pain. The right-left balance gap for the lumbar dynamic muscle activity decreased after the intervention. The SETG showed significant changes in the grade of lumbar multifidus atrophy. Conclusion: The sling exercise therapy program is an effective exercise therapy method on vertebral alignment, muscle activity, recovery from multifidus atrophy, and pain relief for patients with chronic low back pain.

Influence of working environment on infection control activities in dental hygienists (치과위생사의 근무환경이 감염관리활동에 미치는 영향)

  • Choi, Eun-Mi;Noh, Hie-Jin;Chung, Won-Gyun;Mun, So-Jung
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.2
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    • pp.313-319
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    • 2016
  • Objectives: The objective of the study was to infection control by analyzing the influence of working environment on infection control activities in the dental hygienists. Methods: The cross-sectional study was based on a survey on a total of 377 dental hygienists working in dental settings. Multiple linear regression analysis was performed to examine the relationship of general characteristics and infection control activities. All statistical analyses were performed using the SPSS for Windows version 20.0, and p<0.05 was considered to be significant. Results: Predictive powers(=Adjusted $R^2$ of the investigated factors such as operation room, sterilization disinfection laundry, dental unit waterline, staff individual, infection control system, personal protective equipment, medical waste, hand hygiene, oral surgical procedures, clinical contact surfaces were adjusted $R^2=0.394$, 0.306, 0.277, 0.244, 0.241, 0.177, 0.165,, 0.154, 0.134, 0.124 respectively. Conclusions: In order to enhance infection control activities, the program development and implementation for the aseptic procedure is very important. The program should include periodic reinforcement of infection control education and regular monitoring of infection control activities.

A Survey on Doctor of Korean Medicine's Recognition for Developing Korean Medicine Clinical Practice Guideline of Sanhupung (산후풍 한의표준임상진료지침 개발을 위한 한의사 인식 조사)

  • Kim, Yu-Been;Hwang, Su-In;Yoon, Young-Jin;Kim, Dong-Il;Park, Jang-Kyung
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.4
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    • pp.1-18
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    • 2022
  • Objectives: This survey was conducted to research Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung, and to use it as a basic data for the development of Korean Medicine Clinical Practice Guideline for Sanhupung. Methods: From October 1, 2021 to November 1, 2021, a self-administered questionnaire was conducted on an online survey platform targeting Korean Medicine doctors belonging to The Association of Korean Medicine, and the responses were analyzed. Results: Patients most commonly visited Korean Medical clinic within 22 to 42 days of miscarriage or childbirth, and the average treatment period was 1 to 3 months. To diagnose Sanhupung, Korean Medicine doctors most frequently identified the characteristic symptoms of Sanhupung, and the symptoms complained by Sanhupung patients were common in the order of arthralgia, coldness, feelings like wind coming in and muscle pain. For the treatment of Sanhupung, 94.8% of the respondents used herbal medicine, followed by acupuncture 78.1%, moxibustion 50.1%, cupping 29.5%, and Chuna 12.6%. For the prevention of Sanhupung, 81.8% of the respondents prescribed herbal medicine, and 66.4% of the respondents provided education to prevent Sanhupung. Conclusions: We researched the characteristics of Sanhupung patients visiting Korean medicine clinic and Korean medicine doctors' recognition about diagnosis, treatment and prevention of Sanhupung and reflected them in the CPG for Sanhupung.

A Study on the Patient's Attitude of Korean Medicine by Social Classes (계층별 한방의료 이용 실태에 관한 연구)

  • Lee, Han-Wool;Chong, Myong-Soo;Lee, Ki-Nam
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.2
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    • pp.71-86
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    • 2007
  • This study aims at looking into the use of oriental medical services in treating disease and patient's attitude of oriental medicine by social classes. The first to be explored through this study is medical accessibility, classifying them by age, gender and job. Second is to examine kinds of oriental medical services and expenses incurred in treating the disease. Third is to compare satisfaction for the services offered and investigate into relations between disease and oriental medicine through cross-analysis by class, and provide fundamental materials for enhancing accessibility to oriental medical centers for treating chronic diseases. The 1,376 households for the period of time from Apr. to Jun. 2005, were asked to answer to the questionnaires offered. The conclusion from the survey can be summarized as follows. Medical services for the onset of disease were less offered to females, older group, low schooling, and low-income bracket. It is attributable to an economic cause, in both genders. The in- and outpatients' rate were found higher in groups of female, older age, low-income and blue-color workers. Use of oriental medical centers were higher in outpatients than inpatients probably for low-income brackets were less frequently put on regular physical checkups, more exposing to diseases. Each hospitalization was found over six days longer in average; 19.7 days for oriental medical hospitals, 12.5 for hospitals. The hospital charges that patients should pay for one hospitalization showed 909,000 won in oriental medical hospitals, much higher than 518,000 won in hospitals. Outpatients were also found to pay more for oriental medical services; 55,000 won for oriental medical hospitals, 19,000 for hospitals. As to outpatients' satisfaction, oriental medical hospitals were generally found to be a little more satisfactory than general hospitals; 11.2% of respondents answered Very Satisfactory. Satisfaction to services offered to outpatients showed 82.2% of respondents responded to Over Satisfactory for herb clinics, 76% for general hospitals. For future intention to use oriental medical services, females, over 51 years old, lower education and income, and blue color workers showed more intention to use them. To be more competitive in treating chronic diseases, it is necessary that oriental medical services become more accessible through extending its coverage of insurance into more medical herbs and their prepared packs, as well as mapping out extensive publicity strategies to make known to the public about high efficacy of medical herbs and their safety.

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A Comparative Study on Medical Utilization between Urban and Rural Korea (도시 농촌간 의료이용 수준의 비교분석)

  • Joo, Kyung-Shik;Kim, Han-Joong;Lee, Sun-Hee;Min, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.311-329
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    • 1996
  • This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

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Study on the relationship between the mindset of doctors and the meditation (concentrating on the buddhist meditation techniques) (한의사의 마음가짐과 명상수행에 대한 연구 (불교명상법을 중심으로))

  • Kim, Dae-Hwan;Kang, Jung-Soo
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.11-18
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    • 2006
  • At the age of materialism and ignorance for life, the introspection for the ethics problem of the doctors, is getting more and more attention. It seems that every doctors should have the basic virtues of modesty and benevolence. Such virtues have been stressed throughout the human history, and, apart from the Hipp. ocratic oath of ancient greece, the morality of a doctor is the essential virtue, even for the doctors of western medicine, whose medical technology is based on the materialism. Unlike western medicine, oriental medicine, for its holistic and relative nature, has more 'relative' factors generated from each individual doctors and therefore, tends to be influenced more by the doctors' attitudes. The diagnosis process itself can be influenced by the emotions of patients and doctors, and even the efficacy of the acupuncture treatment itself can be influenced by the conception a doctor has when he/she conduct the treatment. Therefore, in every classics of oriental medicine have stressed the basic 'attitudes of mind' a doctor should have. But, at the time when the western 'natural science' paradigm prevails, it seems to be difficult to educate such state of mind simply by 'understanding' it through books or media. It needs 'shift of concept' through the humane tools of education. Therefore, the present writer would like to consider the effects and influences of meditation as the tools to develop the virtues of oriental doctors, and to investigate the possibility that the virtues achieved by the meditation is the same one as mentioned in many oriental medical classics(not only the attitude for the patients, but also the state of mind a doctor should have during the diagnosis and treatment process).

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Development of Clinical Ladder System Model for Nurses: For Tertiary Care Hospitals (간호사 임상경력관리체계 모형 개발 - 상급종합병원 중심 -)

  • Cho, Myung Sook;Cho, Yong Ae;Kim, Kyung Hee;Kwon, In Gak;Kim, Mee Soon;Lee, Jung Lim
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.3
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    • pp.277-292
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    • 2015
  • Purpose: The purpose of this study was to develop a Clinical Ladder System (CLS) model for staff nurses working in inpatient units of tertiary care hospitals in Korea. Methods: The study was carried out in 2 steps. First, a nursing competence evaluation scale was developed. Second, evaluation of the nursing competences, qualifications, and professional activities of 230 nurses from five tertiary care hospitals was done by 49 head nurses between Feb. and Dec., 2014. Nurses were selected by head nurses according to their clinical experience and expected behavioral characteristics at each level of the ladder. Results: A nursing competence scale was developed consisting of 5 subcategories (clinical practice, ethical practice, education, leadership, and professional development) and 11 elements, and 5 levels of behavioral indicators for each element. Cronbach's alphas for the entire tool and subcategories were over .853 and stability of the scale was confirmed. There were significant differences in nursing competence according to the 5 levels of the ladder. Conclusion: The findings indicate that the proposed CLS model with a standard score for nursing competence, recommended or obligatory criteria for qualifications and professional activities provides a good tool for developing nurses' competences and retaining excellent nurses in clinical practice.

Health Concern Survey of Parents of School Children (건강문제에 관한 의견조사 -우리나라 학부모의 인식도를 중심으로-)

  • Kim, Myung-Ho;Baik, Jong-Hyun;Lee, Kyung-Ja
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.100-122
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    • 1986
  • Obtaining an available information on health concerns of parents of school-age children and furthermore developing the sound policy for the public on health education, this study was conducted during Nov.-Dec. 1985 in the four selected areas; Seoul, large, middle and small city, and farming and fishery villages for 3,337 parents of schoolchildren in Korea. In this study, parents complected a questionnaire containing 34 items related to health concerns(e.g. drinking alcohol, air pollution, cancer, etc. see Table 4 and Fig. 2). For each health items, respondents were asked to indicate a choice between three levels of concern; 'Very high concern,' 'Moderate concern,' 'Little concern', and 'No opinion'. An analysis of responses indicated that most of the top ten health concerns identified by parents as cancer, abortions among high school students, medical malpractice, water pollution, traffic accidents, air pollution, suicide of parents and homicide of offspring, heart disease, venereal diseases, and high blood pressure in that order. Those health problems about which respondents were least concerned were more closely related to the individual, such as drinking alcohol, smoking, tooth decay, gum disease, underweight, overweight. Of greater concern were more such as water pollution, abortions among high school students, air pollution, accidents, medical malpractice. For cancer, heart disease, high blood pressure, various accidents, environmental pollution, parents showed high concern, however, for health issues which contributed as causative influences such as lung cancer from smoking and liver cirrhosis and traffic accidents from drinking alcohol showed less concern. Relationship between parent's residential areas, educational level and sex distribution and health concern showed little difference, however, for these issues parents identified as relatively high concern. Most parents stowed more concern in sex-related of family-related health issues such as abortions among high school students, suicide of parents and homicide of offspring.

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Rivaroxaban in Patients Undergoing Hip Arthroplasty in Korean Patients: Implications in Clinical Practice (고관절치환술 후의 Rivaroxaban의 국내임상적용)

  • Liu, Yu Li;La, Hyen O;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.24 no.1
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    • pp.1-8
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    • 2014
  • Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.