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*

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

BACKGROUNG: In spite of the harmfulness of smoking, the smoking rate of adult males is high in Korea and those of adolescents and women have risen recently. Although the number of smoking-cessation clinic has risen year by year in Korea, it is not easy for a smoker to attend because of time and economic constraints. This project was performed to allow easy access to on-line smoking counselling center on the internet. METHODS: Smoking cessation homepage (www.xsmoke. net) containing smoking counselling and e-mailing services was developed by Namo web editor, Photoshop 7.0, and MySQL database program. RESULTS:This program was divided into two major categories: part one was a library of various kind of information on smoking such as articles, lecture notes, pictures, slides, mp3 and motion files. The other part was an autonomous smoking cessation prescription program. This program analyzed smokers' smoking pattern (using WHY test), nicotine addiction level (using Fagerstrom score), stress level (using BEPSI test), and smokers' confidence level. After the input of smoker's history by the applicant, the program showed its smoking cessation prescription automatically and required to give and decide on a quitting day. The next step was automatic e-mailing service containing information on smoking cessation methods. CONCLUSION: Internet smoking cessation center that provides a library of smoking cessation materials, automatic prescription and e-mailing program has been developed for Korean smokers.
Adolescent ; Adult ; Electronic Mail ; Female ; Humans ; Internet* ; Korea ; Male ; Nicotine ; Prescriptions ; Smoke* ; Smoking Cessation* ; Smoking*

BACKGROUND: Cigarette smoking is a major risk factor for cancer and vascular disease but, a correctable habit. Despite widespread recognition of the hazardous health effects of smoking, Korean men and adolescents' smoking rates are not decreasing and is, emerging as a public health problem. Health care managers in schools and factories are expected to play a critical role in smoking cessation. Health education is one important area that will benefit from using a personal computer (PC). To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of smokers. METHODS: This smoking cessation software (CD-Rom) was developed for health care managers in schools and factories using Microsoft Visual Basic and Access. RESULTS: This program divided into two major categories. Part one is a library of various kinds of information about smoking such as articles, lecture notes, pictures, slides, mp3 and motion files. The other part was an autonomous smoking cessation prescription program. This program analyzed smokers' smoking pattern (using WHY test), nicotine addiction level (using Fagerstrom score), stress level (using BEPSI test), and smokers' confidence level. After input of smoker's history by oneself, the program showed smoking cessation prescription automatically in monitor or printer. CONCLUSION: Health care managers in schools and factories can be experts of smoking cessation easily with this program in their work places.
CD-ROM ; Delivery of Health Care* ; Health Education ; Humans ; Male ; Microcomputers* ; Motivation ; Nicotine ; Prescriptions ; Public Health ; Risk Factors ; Smoke* ; Smoking Cessation* ; Smoking* ; Vascular Diseases ; Workplace

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

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*

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