Physicians should take advantage of each contact with smokers to encourage and support smoking cessation. Once a patient is identified as a smoker, tools are available to assess readiness for change. Using motivational interviewing techniques, the physician can help the patient move from the precontemplation stage through the contemplation stage to the preparation stage, where plans are made for the initiation of quitting smoking. Continued motivational techniques and support are needed in the action stage, when the patient stops smoking. Major treatment guidelines emphasize that three treatment elements in particular are effective for smoking cessation intervention : nicotine replacement therapy, social support for cessation, and skills training/problem solving. Guidelines emphasize the dose-response relationship between the intensity and duration of treatment and its effectiveness. In general, the more intense the treatment, the more effective it is in producing long-term abstinence from tobacco. Group or individual behavioral counselling can facilitate smoking cessation and improve the cessation rates. A plan should be in place for recycling the patient through the appropriate stages if relapse should occur.
Evidence-Based Medicine ; Humans ; Motivational Interviewing ; Nicotine ; Recurrence ; Recycling ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco

No abstract available.
Bioethics* ; Curriculum* ; Humans

No abstract available.
Korea* ; Strikes, Employee*

BACKGROUD: The lack of standardization in measuring bone mineral density (BMD) is generally recognized as an important and unresolver issue. The National Health Insurance System in Korea covers the cost of asteoporosis treatment according to the relative value ( T score < -1.0) of normal BMD. Consideriong this issue, we are concerned about whether Korean women have a normal value of BMD. We analyzed numerous research papers published in Korea which related to BMD, and calculated the normal BMD of Korean women using cross calibration equipment on three different DEXA scanners (Lunar/Norland Hologic). METHODS: We searched for key words such as 'osteopcsis' and 'bone mineral densito' in the Korean Medical Journal CD- ROM from 1987 to 1997. We received 145 full texts, and analyzed 114 original artides all of which used one af the above three scanners, over 100 normal Korean women as sub and focused an the lumbar spine. We found five artides that fit the criteria. Among the scanners used in the five artides are three were Lunar, one Hologic and one Norland. We substituted the results of Norhnd and Hologic with Lunars using a cross calibration equation, and calculated the mean BMD according to age by using a weighted average. Standard deviations of the calibrated data were calculated by using pooled estimates af variance equation. RESULTS: The lumbar spire BMD values of narmal Korean women were 1.181+/-0.683(g/cm2) in their thirties, forties, fifties, sixties were 1.128+/-0.144, 0.989+/-0.161, 0.862+/-0.162, respectively in Lunar scanner, 1.020+/-0.586, 0.974+/-0.124, 0.854+/-0.139, 0.746+/-0.139, respectively in Norland seanner. CONCLUSIONS: We calculated the lumbar spine BMD values for normal Korean women among three major companies using DEXA scanners. Further studies on BMD in randomly selected healthy adult women are needed
Absorption* ; Adult ; Bone Density* ; Calibration ; Female ; Humans ; Korea ; National Health Programs ; Reference Values ; Spine

BACKGROUND: This study was designed to evaluate medical instrument purchases by Korean family practitianers in private practice. We then proposed guidelines for purchasing equipment for new physicians who are just beginning their private practice. METHODS: A questionnaire was sent to 646 family practitioners managing their private clinics. The questiannaire assessed current medical equipment purchases. They were then asked which instruments they would recommend or discourage others from purchasing. We analysed 123 returned questionnaires (19%). RESULTS: The number of instruments they have was between 4 to 26, and the average was 13. The most frequently owned items included in descending order: otoscope (89.9%), electrocardiograph(82.5 %), ophthahnoscope(78.9%), ultrasound(78%), ultraviolet sterihzer(73.2%) and microscope(69.9%). The instruments they recommended avoiding were sigmoidoscope(27.3%), cryo-therapy kit(25%), laser therapy kit(21.1%), thermo-hemorrhoidectomy instrument(20%), and defibrillator (20%). Instruments they recornmended purchasing were otoscope(87.0%), electrocardiograph (83.0%), ultrasound(74.8%), gastrofiberscope(65.9%), ultraviolet sterilizer(63.4%), microscope(57.7%), and plain radiographic unit(<100mA, 56.1%). The most frequent advice given in purchasing medical instruments was "Avoid over (purchasing) at the beginning". Some instruments were different in possession rate according to sex, age, and practice patterns. CONCLUSIONS: This study evaluated medical instrument purchases of Korean family practitianers in private practice. This compiled list may be of benefit to new physicians who are just opening their own clinic.
Defibrillators ; Electrocardiography ; Humans ; Laser Therapy ; Otoscopes ; Physicians, Family ; Private Practice* ; Surveys and Questionnaires

In the past twenty years, medical ethics has emerged as a priority within medical schools in Korea. This article contains important messages about the general overviews and current status, such as the educator, teaching method, and goals of medical ethics education in medical schools. The author suggests ideas of improvement and qualification of the medical ethics education in Korea. There are two points of view regarding the purpose of teaching medical ethics: (1) that it is a means of creating virtuous physicians; and (2) that it is a means of providing physicians with a skill set for analyzing and resolving ethical dilemmas. The field would benefit from further theoretical work aimed at better delineating the core content, core processes, and core skills relevant to the ethical practice of medicine. They are in agreement that a multidiciplinary team of ethicist-philosophers and physicians should teach medical ethics, and ethics education should be integrated longitudinally throughout the 4 years of medical school. Within a few decades the number of Korean medical schools requiring medical ethics has increased in volume. Further progress in ethics education may depend on medical schools' willingness to devote more curricular time and funding to medical ethics for faculty development and resources.
Education, Medical ; Ethics, Medical ; Financial Management ; Korea ; Quality Improvement ; Republic of Korea ; Schools, Medical ; Teaching

The Korean medical establishment has traditionally shown little concern for formal training in medical ethics; only recently have courses in medical ethics been included in the curricula of Korea's medical schools. The importance and effectiveness of such courses is still a matter of some debate. This study attempted to measure the effects of a course in medical ethics on senior medical students. For this study, a discussion based course was designed, which made considerable use of video-taped ethical situations. Students were requested to answer a series of ethics related questions both before and after taking the course. Prior to taking the course, students indicated that treatment refusal, abortion, sex pre-selection, and euthanasia are the most important ethical issues in contemporary medical practice in Korea. However, after taking the course, students modified this list slightly by replacing the issue of euthanasia with that of equal access to health care resources. No significant changes were observed in students' value systems. The students' response to the course was favorable.
Curriculum ; Ethical Theory ; Ethics ; Ethics, Medical* ; Euthanasia ; Health Services Accessibility ; Humans ; Korea ; Schools, Medical ; Students, Medical* ; Treatment Refusal

BACKGROUND: Among the various brands of herbal cigarettes currently available in Korea, Kumyeoncho is the most popular. However, there is no clinical evidence that these herbal cigarettes are effective in helping smokers quit smoking. This study was performed to determine the long term effectiveness of Kumyeoncho herbal cigarettes. METHODS: Two hundred smokers, all employees of the same company in Cheonan city, voluntarily participated in this study. They were divided into two random groups: 100 smokers used Kumyencho (herbal cigarettes), and the other 100 smokers used nicotine patches. Between July 2002 and February 2003, the smoking status of all participants was evaluated at one month, three months, and six months, after they stopped using regular cigarettes. RESULTS: The success rates at 1 month were 54.5% for the Kumyeoncho group and 50.7% for the nicotine patch group (P=0.643). The success rates at 3 month were 41.4% and 39.4%, respectively (P=0.875). And the success rates at 6 month were 38.8% and 35.2%, respectively (P=0.747). Statistical analysis showed that the success rate for the Kumyeoncho group was not less than that for the nicotine patch group in all periods. Thirty-seven cases of adverse effects were reported in the Kumyeoncho GROUP: 25 (25.5%) of nausea, 6 (6.1%) of coughing, 5 (5.1%) of dizziness, and 1 (1.0%) of palpitation; thirty-nine cases of adverse effects were reported for nicotine patch users: 18 (25.4%) of itching, 15 (21.1%) of skin irritation and erythema, 2 (2.8%) of dizziness and headache each, and 1 (1.4%) of nausea and palpitation each. CONCLUSION: With respect to the short and long term effects of herbal cigarettes, Kumyeoncho is considered similarly effective to nicotine patches.
Chungcheongnam-do ; Cough ; Dizziness ; Erythema ; Headache ; Korea ; Nausea ; Nicotine* ; Pruritus ; Skin ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Products* ; Tobacco Use Cessation Products*

BACKGROUND: In spite of worldwide recognition of the hazardous effects of smoking, the adolescent smoking rate in Korea continues to increase. This study was performed to determine the smoking statistics for the Chonan area, and to evaluate the effectiveness of mass smoking cessation education based on Prochaska's trans-theoretical model in adolescents. METHODS: To obtain the smoking statistics, an on-site questionnaire survey was performed on 7,373 students from 5 middle and 6 high schools in the Chonan area from May to July, 2001. A logistic regression analysis was done on the variables in order to determine the factors related to smoking. Immediately after completing smoking cessation education, the second questionnaire, which included questions on the effectiveness and satisfaction of the education, was conducted in one high school. RESULTS: The smoking rates were 18.0% in males, 8.8% in females; 4.3% in middle school students, and 21.1% in high school students. The smoking rate in vocational high schools (30.7%) was higher than in general high schools (11.9%)(P<0.001). Multiple logistic regression analyses indicated that the smoking rate increased in males (OR= 2.28), father's smoking status (OR=1.55), mother's smoking status (OR=2.98), and sibling's smoking status (OR=3.57). Approximately 47% of smokers answered that "curiosity" was their most important motivational factor; 29.1% of smokers started smoking in second grade of middle school. The pre-education survey on the trans-theoretical stage of smoking cessation revealed that 38.1% fell into pre-contemplation stage, 36.8% into contemplation stage, and 25.1% into preparation stage. The post-education survey showed remarkable change to 20.8% of pre-contemplations stage, 47.6% of contemplation stage, and 31.6% of preparation stage. CONCLUSION: The mass smoking cessation education run by doctors did have an impact on the motivational stage of smoking cessation. Therefore, to improve adolescents' health, an active non-smoking campaign and education should be continued in various ways.
Adolescent ; Chungcheongnam-do* ; Education* ; Female ; Humans ; Korea ; Logistic Models ; Male ; Smoke* ; Smoking Cessation* ; Smoking* ; Surveys and Questionnaires

BACKGROUND: According to recent studies of smoking rates among adolescents, the age at which young people begin to smoke is decreasing. The present study reports the results of a survey, conducted by the Korean National Tuberculosis Association (KNTA) in 2002, of the smoking status of Korean middle school students. METHODS: From April to November 2002, the KNTA surveyed the present smoking status of middle school students (total 14,296: boys-8,697, girls-5,599) according to sex and grade in 125 schools in 12 provinces during a smoking cessation education program. RESULTS: The survey showed that 18.4% of the males (7th grade-15.8%, 8th grade-17.6%, 9th grade-21.8%) and 8.3% of the females (7th grade-6.2%, 8th grade-9.3%, 9th grade-9.5%) had smoking experience. Approximately 2.5% of the males (7th grade-1.2%, 8th grade-1.8%, 9th grade-4.6%) and 1.0% of the females (7th grade- 0.3%, 8th grade-1.2%, 9th grade-1.5%) smoked regularly. The boys' smoking rate was higher than that of the girls in all grades. Smoking rates varied among the provinces, with Chungbuk having the highest rate (2.8%) and Jeonbuk having the lowest (0.9%). The time when most smokers began to smoke was in 6th grade of elementary school for the boys (15.9%) and 7th grade of middle school for the girls (28.6%). Approximately 69.4% of smokers answered that "curiosity" was the most important motivational factor. Statistical analysis indicated that smoking rates were positively correlated with alcohol use and height of students, but were negatively correlated with parents' level of education. At the end of the smoking cessation education program, the number of smokers had reduced for the boys (from 2.6% to 2.2%), but had increased for the girls (from 1.8% to 2.0%). The pre- program survey on the trans-theoretical stage of smoking cessation revealed that 34.2% fell into a pre- contemplation stage, 34.2% into a contemplation stage, and 31.6% into a preparation stage. The post-education survey showed remarkable changes: 24.0% were in the pre-contemplations stage, 40.0% in the contemplation stage, and 36.0% were in the preparation stage. CONCLUSION: This study reports the results of a survey, conducted by the KNTA in 2002, concerning the national smoking status of middle school students, relating factors, and levels of motivation for quitting smoking. The smoking cessation education program run by the KNTA had an impact on the motivational stage of smoking cessation.
Adolescent ; Chungcheongbuk-do ; Education ; Female ; Humans ; Jeollabuk-do ; Male ; Motivation ; Smoke* ; Smoking Cessation ; Smoking* ; Tuberculosis