BACKGROUND : Lipoprotein(a)[Lp(a)] may be an independent risk factor for macrovascular disease in middle aged populations, but in elderly populations, Lp(a) levels to predict macrovascular risk is controversial. The purpose of this study is to evaluate the association of macrovascular disease with Lp(a) levels and lipid change in the elderly. METHODS : We have examined Lp(a) levels, lipid change and clinical, biochemical profile in 114 patients with macrovascular disease and 55 control subjects. Macrovascular disease was defined as ishemic heart disease and/or peripheral vascular disease, peripheral vascular disease was defined as arteriosclerosis obliterans, diabetic foot and/or cerebrovascular disease. RESULTS : Hypertension, diabetes were more prevalent and median Lp(a) levels, fasting blood glucose and HDL-cholesterol were significant higher in patients with macrovascular disease than control subjects, but there were no significant differences in age, body mass index, total cholesterol and triglycerides levels. Lp(a) levels were positively weak correlated with fibrinogen levels, but not correlated with age, body mass index, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides levels. In logistic regression analysis, there was no independent risk factor for ischemic heart disease, whereas diabetes, hypertension and low HDL-cholesterol levels were independent risk factors for peripheral vascular disease. CONCLUSION : Serum Lp(a) levels was not independent risk factor for macrovascular disease, but diabetes, hypertension and low HDL-cholesterol levels were independent risk factors for peripheral vascular disease. Therefore, the relationship between Lp(a) and lipid change and macrovascular disease in the elderly were different from middle aged subjects.
Aged* ; Arteriosclerosis Obliterans ; Blood Glucose ; Body Mass Index ; Cholesterol ; Diabetic Foot ; Fasting ; Fibrinogen ; Heart Diseases ; Humans ; Hypertension ; Lipoprotein(a)* ; Logistic Models ; Middle Aged ; Myocardial Ischemia ; Peripheral Vascular Diseases ; Risk Factors ; Triglycerides

Recent advances in understanding insulin secretion, action and signaling have led to the development of new pharmacological agents. Several new emerging drugs and drug classes for the management of diabetes are under development, including the incretin mimetic agents (exenatide, dipeptidyl peptidase 4 inhibitors, and glucagon-like peptide 1 analogues), the amylin analogue pramlintide, the cannabinoid-1 receptor antagonist rimonabant, the mixed peroxisome proliferator-activated receptor agonists muraglitazar and the inhaled insulin preparation Exubera. New drugs and technologic advances being made available will help achieve the goals of treating patients with diabetes to all the appropriate metabolic targets. Longer term studies will help providers weigh the benefits, adverse effects, cost, and unknown long-term risks of these medications.
Dipeptidyl-Peptidase IV Inhibitors ; Glucagon-Like Peptide 1 ; Humans ; Incretins ; Insulin ; Islet Amyloid Polypeptide ; Peroxisomes

Background: The purpose of this study is to conduct a teamwork program for pre-medical students using a table-top simulation game called Friday Night at the ER®, and to investigate the effect. Methods: This is a one group pretest-posttest design study 34 students. The tools were understanding of interpersonal relationships (11 questions), problem-solving initiative (8 questions), and system thinking (20 questions) were used. Satisfaction with the program was investigated, and a self-reflection essay was written. For the analysis, paired t-test, frequency analysis, and content analysis were used. Results: After participating in the program, interpersonal understanding, proactivity in problem-solving, and systems thinking all significantly improved (p<.001), and the effect size of the program was also above medium (Cohen’s d= 0.580∼1.019). As a result of analyzing the contents of the self-reflection journal, it was classified into 7 themes and 3 categories; Teamwork competency, systems thinking skills, interpersonal skills. Students were generally satisfied with the program. Conclusion The simulation game-based teamwork program was effective in improving students’ teamwork. These results can be used as basic data for medical schools designing such programs.

PURPOSE: There has been limited research on physicians’ perceptions of the specialty characteristics that are needed to sustain a successful career in medical specialties in Korea. Medical Specialty Preference Inventory in the United States or SCI59 (specialty choice inventory) in the United Kingdom are implemented to help medical students plan their careers. The purpose of this study was to explore the characteristics of the major specialties in Korea. METHODS: Twelve physicians from different specialties participated in an exploratory study consisting of qualitative interviews about the personal ability and emotional characteristics and job attributes of each specialty. The collected data were analysed with content analysis methods. RESULTS: Twelve codes were extracted for ability & skill attributes, 23 codes for emotion & attitude attributes, and 12 codes for job attributes. Each specialty shows a different profile in terms of its characteristic attributes. CONCLUSION: The findings have implications for the design of career planning programs for medical students.
Great Britain ; Humans ; Korea ; Students, Medical ; United States

PURPOSE: The purpose of this study was to develop and examine a program that was designed to improve the presentation skills of medical school students. METHODS: The program was implemented in 2-day workshops for 36 third-grade medical students in 2009, using the following procedures in order: needs assessment; an initial group presentation and peer evaluation; an initial self-evaluation with video recording; viewing of a model presentation; a second presentation in a group and peer evaluation; and a second self-assessment. Two types of survey questionnaires were used: a self-evaluation checklist and a questionnaire on workshop satisfaction and confidence of presentation. RESULTS: Eighty-three percent of the students recognized the importance of presentation skills. There were significant differences in 3 factors of self-evaluation-constructing contents, utilizing audio-visual media, and delivery skills- but not with regard to understanding content. In the post workshop satisfaction survey, participants reported that the workshop was helpful in improving their own presentation skills. They also stated that presentation in a group, peer feedback, and video analysis of the recording were helpful. After the workshop, students claimed that their confidence scores in utilizing audio-visual media were the highest. CONCLUSION: Medical students realize the importance of presentation skills training and workshops in increasing presentation skills and improving confidence in presenting. Video analysis and feedback of each participant's presentation within the group was effective in upgrading the student's presentation skills.
Checklist ; Diagnostic Self Evaluation ; Education, Medical ; Humans ; Peer Group ; Schools, Medical ; Self-Assessment ; Students, Medical ; Surveys and Questionnaires

Purpose: This study aimed to reach a consensus among experts on the global health competencies for medical students in Korea. Methods: A global health competency model was developed to identify domains and competencies for medical education, and a three-round modified Delphi method was used to reach consensus among 21 experts on the essential global health competencies. The degree of convergence, degree of consensus, and content validity ratio of the model were used to reach a consensus. Results: A list of 52 competencies in 12 domains were identified according to a literature review. In the first-round Delphi survey, the global health competencies were refined to 30 competencies in eight domains. In the second round, the competencies were reduced to 24. In the final round, consensus was reached among the expert panel members, and the competencies were finalized. The global health competency domains for medical students include global burden of disease (three items), globalization of health and healthcare (five items), determinants of health (two items), healthcare in low-resource settings (two items), global health governance (three items), health as a human right (four items), cultural diversity and health (three items), and participation in global health activities (two items). Conclusion The group of experts in global health achieved a consensus that 24 global health competencies in eight domains were essential for undergraduate medical education in Korea. The domains and competencies identified herein can be used to develop an undergraduate medical education curriculum in global health.

This study investigated the current status and educational needs of global health education (GHE) at medical schools in Korea. Among the 40 medical schools nationwide, 32 schools that agreed to participate in the study collected data through a survey in 2022, and the results were examined by frequency analysis and content analysis. In total, 87.5% of medical schools included global health-related graduation outcomes. In the curriculum, global health lessons within courses were present at 71.9% of medical schools. Regarding extracurricular activities, 66.7% and 63.0% of medical schools offered overseas clerkships and overseas volunteer work, respectively. Although there were not many medical schools with a global health-related educational environment, 96.9% of schools agreed with the necessity of GHE in medical education. The prevailing opinion was that it was appropriate to continuously cover GHE as lessons within courses throughout all years of the program in medical education. The main opinions regarding the improvement of GHE related to curriculum development, personnel expansion, and awareness improvement at medical schools. These findings are expected to serve as a basis for identifying the current status of GHE at Korean medical schools and specifying future directions of GHE.

Purpose: This study aims to determine the impact of helicopter parenting and respectful parenting on medical students’ mindset, grit, self-directedness, and college adjustment. Methods: This study constructed a hypothetical model based on the relationship between helicopter parenting, respectful parenting, mindset, grit, self-directedness, and college adjustment. It set up a structural model to test the fit of the model based on empirical data. The significance of the mediating effects of the paths was tested using multiple mediation analysis. Results: The fit of the initial measurement model did not meet the goodness-of-fit acceptance criteria; therefore, revised models were established. The revised models all showed good fit indices, and the overall path coefficients were significant. Helicopter parenting and respectful parenting are inversely correlated and affect the mindset of medical students, which, in turn, affects their adjustment to college through grit and self-directedness. The results of the multimodal effects of each pathway showed that helicopter parenting negatively affects college adjustment, while respectful parenting has a positive mediating effect on college adjustment. Conclusion Parenting attitudes have a significant impact on medical students’ mindset, grit, and self-direction, which affects their college adjustment. Parents need to respect their children’s autonomy and independence and avoid excessive interference.

Purpose: This study aims to determine the impact of helicopter parenting and respectful parenting on medical students’ mindset, grit, self-directedness, and college adjustment. Methods: This study constructed a hypothetical model based on the relationship between helicopter parenting, respectful parenting, mindset, grit, self-directedness, and college adjustment. It set up a structural model to test the fit of the model based on empirical data. The significance of the mediating effects of the paths was tested using multiple mediation analysis. Results: The fit of the initial measurement model did not meet the goodness-of-fit acceptance criteria; therefore, revised models were established. The revised models all showed good fit indices, and the overall path coefficients were significant. Helicopter parenting and respectful parenting are inversely correlated and affect the mindset of medical students, which, in turn, affects their adjustment to college through grit and self-directedness. The results of the multimodal effects of each pathway showed that helicopter parenting negatively affects college adjustment, while respectful parenting has a positive mediating effect on college adjustment. Conclusion Parenting attitudes have a significant impact on medical students’ mindset, grit, and self-direction, which affects their college adjustment. Parents need to respect their children’s autonomy and independence and avoid excessive interference.

Purpose: This study aims to determine the impact of helicopter parenting and respectful parenting on medical students’ mindset, grit, self-directedness, and college adjustment. Methods: This study constructed a hypothetical model based on the relationship between helicopter parenting, respectful parenting, mindset, grit, self-directedness, and college adjustment. It set up a structural model to test the fit of the model based on empirical data. The significance of the mediating effects of the paths was tested using multiple mediation analysis. Results: The fit of the initial measurement model did not meet the goodness-of-fit acceptance criteria; therefore, revised models were established. The revised models all showed good fit indices, and the overall path coefficients were significant. Helicopter parenting and respectful parenting are inversely correlated and affect the mindset of medical students, which, in turn, affects their adjustment to college through grit and self-directedness. The results of the multimodal effects of each pathway showed that helicopter parenting negatively affects college adjustment, while respectful parenting has a positive mediating effect on college adjustment. Conclusion Parenting attitudes have a significant impact on medical students’ mindset, grit, and self-direction, which affects their college adjustment. Parents need to respect their children’s autonomy and independence and avoid excessive interference.