• Title/Summary/Keyword: practice hours

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Nighttime administration of antihypertensive medication: a review of chronotherapy in hypertension

  • Hyun-Jin Kim;Sang-Ho Jo
    • The Korean journal of internal medicine
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    • v.39 no.2
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    • pp.205-214
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    • 2024
  • Hypertension remains a global health concern because of suboptimal blood pressure control despite advancements in antihypertensive treatments. Chronotherapy, defined as evening or bedtime administration of medication based on biological rhythms, is emerging as a potential strategy to improve blood pressure control and treatment outcomes. Clinical trials have investigated the potential effects of nighttime administration of antihypertensive medication in the improvement of 24 hours blood pressure control and reduction of cardiovascular risk. Implementing chronotherapy in clinical practice could have significant implications in enhancing blood pressure control and improving clinical outcomes in patients with hypertension, particularly those with resistant hypertension. However, recent trials have reported contradictory results, causing confusion in real-world practice. Herein we review, analyze, and critique the current evidence and propose suggestions regarding the clinical application and future directions of chronotherapy.

Epidural Ketamine for Control of Postoperative Pain (수술후 경막외강내에 주입한 케타민의 진통효과)

  • Choi, Ryung;Woo, Nam-Sick;Um, Dae-Ja;Kil, Hae-Keum
    • The Korean Journal of Pain
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    • v.1 no.1
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    • pp.87-90
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    • 1988
  • In recent years the use of epidural opiates has increased and although this method of pain relief has shown good results in clinical practice It is still subject to certain drawbacks, the most serious of which appears to be delayed respiratory depression. Since ketamine administered systemically is unlikely to produce respiratory depression it seemed worthwhile to investigate the possibility of exploiting the potent analgesic property to ketamine by its epidural administration. The analgesic effect of ketamine 4 mg, administered epidural space, was evaluated. The duration of pain relief varied from less than 3 hours in 20% to over 24 hours in 30% of the cases. In 62.5% of the cases pain relief exceeded 6 hours. There was no evidence of respiratory depression, and there no postoperative neurologic sequelae. The present results indicated the need for further studies to compare the efficacy and safety of epidural ketamine with the response to epidural opioids for the relief of postoperative pain.

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A STUDY ON TRANSFERENCE OF A CONTRAST MEDIA IN PULPAL CHAMBER (치수강내(齒髓腔內)에 있어서 조영제(造影劑)의 이행(移行)에 관(關)한 연구(硏究))

  • Kim, Yung-Hai
    • Restorative Dentistry and Endodontics
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    • v.8 no.1
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    • pp.133-137
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    • 1982
  • Radiography is one of the important tool adopted in daily dental practice and medical diagnosis. To visualize soft tissuechange various contrast media has Been introduced. Any cavity or space can be easily determined by increasing the X-ray absorption of the cavity using the radiopaque contrast media which widely employed in medical radiography to show much of the digestive, cardiovascular, pulmonary, and renal system. The essential part of any radiopaque medium is a heavy element that can absoarb most of the X-ray beam. The element must be noninjurious and easily eliminated. Both aqueous and oil suspensions of iodine containing compounds' are available to the dental profession, for example Lipiodol and Dionosil. The study was designed to determine toxic effect of Lipiodol to the vital pulp and to confirm visualization ioprovement in pulp canal. 1. Thin mixture of Calcium hydroxide and Lipiodol was applied to 19 deep vital cavities for 24 hours. Only one case complained slight pain for short time. 2. Cotton pellet over-saturated in Lipiodol was inserted in coronal chamber of which 6 were non vital and 5 were vital. The transference of Lipiodol was not noticed in every case after 24 hours. 5 cases with vital pulp tissue in the canals showed no clinical symptome. 3. Extracted 20 teeth were routinely prepared for endodontic treatment and applied Lipiodol in conjunction with cotton fiber as deep as midportion of the roots. After 24, hours the medicament reached to nearly the end of apex, but there were no evidence of penetration in dentine layer and migrate into ramified canal.

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Development of practical curriculum for dental coordinator based on DACUM (DACUM 기법에 의한 치과코디네이터 실무형 교육과정 개발)

  • Cho, Hye-eun;Choi, Choong-Ho
    • Journal of Korean Academy of Oral Health
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    • v.42 no.4
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    • pp.187-198
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    • 2018
  • Objectives: The purpose of this study was to analyze the duties of dental coordinators using the DACUM technique and to develop a practical training course for dental coordinators based on the results. Methods: The curricula for clinic coordinators across 20 educational institutions were analyzed. A board of DACUM specialists was assembled to analyze the role of dental coordinators and to develop a practical curriculum. Results: First, after analysis, we selected 8 duties and 34 tasks that should comprise the role of a dental coordinator, and the number of major tasks was 21. Second, the educational program for dental coordinators developed in this study consisted of a total of 60 hours, including 42 hours of lecture and 18 hours of practice. A pre-requisite curriculum and a final curriculum were developed, and the detailed educational contents and supplies were outlined for each subject. Third, after comparing it with the existing clinic coordinator curricula from 20 educational institutions, the curriculum based on DACUM contained 11 additional fields. Conclusions: This study developed a more specialized, detailed, and practical dental coordinator curriculum based on DACUM. It is expected that more dental coordinators could be trained more professionally with this curriculum, and it could lead to further improvement of the curriculum.

The Experience of Nursing Students' Moral Distress in Clinical Practice (임상실습 현장에서 간호대학생이 경험하는 도덕적 고뇌)

  • Kim, Chanhee;Choi, Heeseung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.3
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    • pp.355-365
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    • 2016
  • Purpose: This study explores the moral distress that nursing students experience during their clinical practice in Korea. Methods: Data were collected using focus group interviews, and analyzed using qualitative content analysis. Participants were recruited from three nursing schools in three different cities; each focus group interview lasted between one to two hours. Results: Twenty-two nursing students with more than one year of clinical practice experience participated. Three categories and ten themes were extracted. The following situational categories: "unprotected patients' right and dignity," "clinical settings in which standards of care are not upheld," "disrespectful hospital culture," and "inconsistent and unsystematic clinical education" caused moral distress. Types of responses to moral distress included: "shock and confusion over the gap between reality and moral standards," "powerlessness when cannot advocate patients," "fear and doubts about nursing career," and "moral desensitization and disappointment in oneself." "Expressions of moral distress and the need for advice" and "a search for meaning and hope" were identified as coping strategies. Conclusion: These results demonstrate the need for systematic clinical practicum and education programs to minimize moral distress. These programs may offer opportunities for students to turn moral distress into opportunities for learning and growth in the future.

An Exploratory Study on the Adolescents' Conception and Practice of Hyo (청소년의 효 인식과 실천에 대한 탐색적 연구)

  • 최영희
    • The Korean Journal of Community Living Science
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    • v.12 no.2
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    • pp.1-14
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    • 2001
  • This study was performed to explore the adolescents\` conception and practice of Hyo(filial piety). Fifteen teams of 500 adolescents were allowed to discuss about Hyo for two hours and the team leaders presented what they had discussed. The subjects were 330 elementary school students, 130 middle school students, and 40 high school students. The findings from the discussion and presentation were as follows: First, the adolescents\` conceptions of Hyo were different in the stages of schools. Elementary school students thought that they should do Hyo because they got lots of mercy from parents. Middle and high school students both thought that Hyo came from mutual(parent-children) understanding, but they showed somewhat different view about what disturbed the mutual understanding. Middle school students pointed the deficiency of parents'self-disclosure as a disturbing factor while high school students pointed the deficiency of adolescents'understanding of their parents. Second, the behavioral items that the subjects suggested as Hyo were analysed by the 12 Subvirtues of Adolescent's Hyo which was classified by Chung et al.(1996a). Adolescents could not propose any behavioral items for Thanks, Ancestor Worship, and Ecological Equilibrium, and some items for Advising Parents and Thrift. A lot of items were suggested for Moral Training, Supporting (Parents), Consorting (Parents), Respecting (Parents), Establishing Oneself, and Following Parents.

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Effects of an Individual Breast-feeding Promotion Program for Married Immigrant Women (결혼이주여성을 위한 개별적 모유수유증진프로그램의 효과)

  • Park, Mi Kyoung;Moon, So-Hyun
    • Journal of Korean Academy of Nursing
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    • v.46 no.1
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    • pp.128-139
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    • 2016
  • Purpose: This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. Methods: A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. Results: Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. Conclusion: The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.

Development and evaluation of continuing education course in renal nutrition

  • Karavetian, Mirey;Rizk, Rana
    • Nutrition Research and Practice
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    • v.10 no.1
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    • pp.99-107
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    • 2016
  • BACKGROUND/OBJECTIVE: Competent renal dietitians are crucial for better patient compliance and clinical outcomes, specifically in critical settings. The aim of this study was to develop and evaluate an evidence-based course in renal dietetics for dietitians working in health care systems where dietetic specialization is absent. SUBJECTS/METHODS: Fifteen licensed dietitians working with hemodialysis patients in Lebanon were randomly recruited to participate in the course. The latter was developed by the study's primary investigator, according to evidence-based practice guidelines, and focused on all aspects of renal nutrition. Total course duration was 28 hours spread over a 2 month period. Dietitians' knowledge in renal nutrition was tested pre- and post-training through a 23-item questionnaire; the total score was expressed in percentage (< 60% score indicated insufficient knowledge). Paired-samples t test was used for statistical analysis. RESULTS: Overall knowledge of the dietitians significantly improved post-training and reached satisfactory levels (pre: $38.75{\pm}17.20%$, post: $62.08{\pm}21.85%$). Sub-analysis of the change in the knowledge showed significant and satisfactory improvement only in 3 topics: 1) correct body weight use in calculations, 2) energy estimation method and 3) phosphorus management. Knowledge in the fluid management significantly improved but did not achieve a satisfactory level. CONCLUSION: The course significantly improved dietitians' knowledge in renal nutrition. If adopted as part of the continuing education of dietitians in countries that lack dietetic specializations, it may serve the first step towards improving health care practice.

The Effects of Disaster Nursing Simulation on Attitudes toward Disaster Management, Disaster Preparedness, Learning Self-efficacy, and Nursing Practice Satisfaction in Nursing College Students (간호대학생을 위한 재난간호 시뮬레이션이 재난관리에 대한 태도, 재난 준비도, 학습 자기효능감, 실습 만족도에 미치는 효과)

  • Hyun-Ye, Lee;Yeongmi, Ha
    • Journal of the Korean Society of School Health
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    • v.35 no.3
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    • pp.104-112
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    • 2022
  • Purpose: The study aimed to examine the effects of disaster nursing simulation training on attitudes toward disaster management, disaster preparedness, learning self-efficacy and nursing practice satisfaction in nursing college students. Methods: The study is based on a one-group pretest-posttest design. A total of 95 nursing students were recruited from a nursing college. Disaster nursing simulation training for fire and earthquake situations were provided for 8 hours in one day. Results: There were significant differences in nursing students' attitudes toward disaster management (t=2.20, p=.030), disaster preparedness (t=7.88, p<.001), learning self-efficacy (t=3.69, p<.001), and nursing practice satisfaction (t=5.28, p<.001). Conclusion: Based on our findings, it is necessary to implement disaster nursing simulation training to improve disaster nursing competency of college students.

Comparison of Continuing Education Program for Emergency Medical Technician in Korea and Abroad (국내·외 응급구조사의 보수교육프로그램 비교조사)

  • Shin, Dong-Min;Jang, Mun-Sun;Kang, Bo-Ra;Yoon, Byeung-Gil;Tak, Yang Ju;Lee, In-Soo
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.3
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    • pp.95-105
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    • 2010
  • Purpose: This study aims to investigate the operation of continuing education system and continuing education program for emergency medical technician in Korea, Japan and United States and develop reasonable operating scheme of continuing education and curriculum in order to provide the base data for the improvement of continuing education for the improved practice capability and its maintenance, Method: The overall review of continuing education for domestic 1st class emergency medical technician was performed and also the content of continuing education for Emergency Medical Technician - Paramedic in the United States and Paramedics of Fire Department with the license for the paramedic in Japan, have been analyzed through literature, books, articles, agencies' data, laws, and internet date. Result: Hours for domestic continuing education was 4-8 hours and it was only 3-11% compared to 72 hours in the United States and 128 hours in the Japan. And with respect to the types and methods of programs, there were differences both in quantity and quality. Conclusion: As an education, providing and supplementing the changed content and technical information for the improvement of the capability and qualification of emergency medical technician, selection of education hours and various continuing education should be continuously and regularly provided and conducted. The introduction of various continuing education system and programs for this is considered to be required.

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