• 제목/요약/키워드: General Practice

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A 20-Year Update on the Practice of Thoracic Surgery in Canada: A Survey of the Canadian Association of Thoracic Surgeons

  • Sami Aftab Abdul;Frances Wright;Christian Finley;Sebastien Gilbert;Andrew J. E. Seely;Sudhir Sundaresan;Patrick J. Villeneuve;Donna Elizabeth Maziak
    • Journal of Chest Surgery
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    • 제56권6호
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    • pp.420-430
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    • 2023
  • Background: This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada. Methods: An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer. Results: Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%-34% reported an on-call ratio of 1:4-1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps. Conclusion: This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.

치과치료시 고혈압적 응급상황 관리 -증례 보고- (Management of Hypertensive Crisis Emergency -A Case Report-)

  • 황재호;김기덕;우은정;이민혜;담추금;박원서
    • 대한치과마취과학회지
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    • 제10권2호
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    • pp.183-189
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    • 2010
  • Medical emergencies are not rare in dental practice but when an emergency does occur it can be life-threatening. Medical emergency such as hypertensive crisis can be encountered in dental practice and the dentist should be competent in emergency management by taking life support courses. This report shows 3 cases of hypertensive crisis during dental treatment and we discuss proper management of the patients. The medical and dental management for the hypertensive crisis included a correct diagnosis, pharmacological usages for pain control and stress relieving environment making.

Low-cost model for pancreatojejunostomy simulation in minimally invasive pancreatoduodenectomy

  • Hiang Jin Tan;Adrian Kah Heng Chiow;Lip Seng Lee;Suyue Liao;Ying Feng;Nita Thiruchelvam
    • 한국간담췌외과학회지
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    • 제27권4호
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    • pp.428-432
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    • 2023
  • Minimally invasive pancreatoduodenectomy (MIS PD) is a well reported technique with several advantages over conventional open pancreatoduodenectomy. In comparison to distal pancreatectomy, the adoption of MIS PD has been slow due to the technical challenges involved, particularly in the reconstruction phase of the pancreatojejunostomy (PJ) anastomosis. Hence, we introduce a lowcost model for PJ anastomosis simulation in MIS PD. We fashioned a model of a cut pancreas and limb of jejunum using economical and easily accessible materials comprising felt fabric and the modelling compound, Play-Doh. Surgeons can practice MIS PJ suturing using this model to help mount their individual learning curve for PJ creation. Our video demonstrates that this model can be utilized in simulation practice mimicking steps during live surgery. Our model is a cost-effective and easily replicable tool for surgeons looking to simulate MIS PJ creation in preparation for MIS PD.

치위생과 학생의 임상실습 스트레스 영향 요인 (Influencing Factors of stress in clinical practice in dental hygiene students)

  • 민희홍
    • 한국치위생학회지
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    • 제17권1호
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    • pp.39-47
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    • 2017
  • Objectives: Identifying influencing factors of stress in clinical practice of dental hygiene students through controlling the amount of stress in clinical practice. Methods: A self-reported questionnaire was filled out by 226 dental hygiene students in Daejeon, Cheongju and Jeolla province from March 2 to 30, 2016. The contents of the questionnaire included general characteristics (6 items), clinical practice characteristics (4 items), clinical practice stress (16 items), quality of life (24 items), health promotion behavior (20 items), OHIP (14 items), and critical thinking disposition (15 items). Data was analyzed using SPSS 19.0. for one way ANOVA, scheffe' posthoc test, Pearson correlation coefficients, and multiple regression analysis. Cronbach's alpha of clinical practice stress, quality of life, health promotion behavior, OHIP, and critical thinking disposition were 0.827, 0.913, 0.896, 0.921 and 0.778, respectively. Results: Clinical practice stress was 3.38 points, quality of life was 3.40 points, health promotion behavior was 3.21 points, OHIP was 4.21 points and critical thinking disposition was 3.17 points. Conclusions: Factors that had impact on clinical practice stress include sleeping state, satisfaction of clinical practice, practice number, and the quality of life, and they appeared statistically significant (p<0.05). This exercise showed the necessary manuals and system implementations in clinical practice, which can reduce the amount of stress in dental hygiene students.

간호대학생의 임상실습 스트레스와 소진의 관계: 영적 안녕의 매개효과 (The Relation between Stress of Clinical Practice and Burnout among Nursing Students: The Mediation Effect of Spiritual Well-being)

  • 이도영;박진경;최미영
    • 한국간호교육학회지
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    • 제23권3호
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    • pp.300-308
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    • 2017
  • Purpose: The purpose of this study is to examine the factors that influence the clinical practice of nursing students and to identify the mediating effects of spiritual well-being in the relation between stress of clinical practice and burnout caused by clinical practice. Methods: Data were collected by self-report questionnaires targeting 420 nursing students in three nursing colleges located in Gyeonggi and Chungnam province. Results: Burnout of clinical practice according to general characteristics of the study subjects showed significant difference in religion (t=1.895, p=.049). Stress of clinical practice and burnout of clinical practice showed positive correlation (r=.42, p<.001), existential spiritual well-being showed negative correlation between stress of clinical practice (r=-.17, p<.001) and burnout of clinical practice (r=-.47, p<.001). In addition, religious spiritual well-being in spiritual well-being showed no mediating effects and existential spiritual well-being showed mediating effects between burnout in clinical practice stress. Conclusion: In order to alleviate the stress of clinical practice for burnout of clinical practice prevention of nursing students, solutions to improve the existential spiritual well-being will be required in the future.

의사 특성에 따른 외래 진료내용의 변이 (A Study on the Practice Variations According to Physician Characteristics)

  • 정은경;문옥륜;김창엽
    • Journal of Preventive Medicine and Public Health
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    • 제26권4호
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    • pp.614-627
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    • 1993
  • It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

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종합병원 의료종사자의 병원감염관리 인지도 및 실천도 연구 (A Study on the Awareness and Practice of Hospital Infection Control among Medical Workers in General Hospitals)

  • 강연희;구재흥
    • 한국방사선학회논문지
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    • 제15권3호
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    • pp.361-370
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    • 2021
  • 본 연구는 부산 시내에 있는 종합병원에 근무하는 종사자들을 대상으로 병원감염관리에 대한 인지도 및 실천도에 대해 파악하여 병원감염관리 방안 및 교육 등에 대한 기초자료를 제공하고자 설문조사를 실시하고 이를 분석하였다. 일반적인 변수의 차이를 보기 위한 t-test 및 일원분산분석(one way ANOVA)을 실시한 결과 대체적으로 개인 위생관리에 대한 인지도와 실천도가 낮게 나타났고, 장비 위생관리의 인지도와 실천도는 높게 나타났다. 남성의 개인위생관리를 제외한 전 영역에서 인지도가 실천도보다 높게 나타나 병염감염관리의 인지도에 비해 실천도는 부족하다는 것을 확인하였다. Pearson 상관분석을 통한 결과로는 감염관리에 관한 인지도가 높은 사람이 실천도도 높은 결과를 나타내 병원 종사자들의 감염관리에 대한 인지도를 높이는 것이 병원감염예방에 효과적인 것으로 생각되었다. 따라서 병원감염관리에 대하여 지속적인 교육으로 종사자들의 감염관리에 대한 인지도를 상승시키고, 이를 실천하기 위한 병원 종사자들의 노력도 필요한 것으로 사료된다.

2016년 YAR의 적용에 따른 공동해손 정산 실무에 관한 시사점 (A Study on the Adjustment Practice of General Average according to the Application of YAR 2016)

  • 한낙현;최병권
    • 무역상무연구
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    • 제72권
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    • pp.81-113
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    • 2016
  • The adoption of the YAR 2016 brings to an end the 12 years of uncertainty for shipowners and Marine insurers which followed the adoption of the YAR 2004, which did not have the support of shipowners, and which were very rarely used in preference to the well-established and well understood YAR 1994. The development and finalisation of the YAR 2016 is the product of an extensive review undertaken by the IWG with input from the International Group, international average adjusting community, National Maritime Law Associations, the International Chamber of Shipping, BIMCO and IUMI amongst others. The Group clubs welcome and support the adoption of the YAR 2016 and recommend its incorporation in members' future shipping contracts. The Club will be taking steps to adopt logical changes to the 2017 Rules. In the meantime, this circular serves as confirmation Club cover extends to all shipping contracts incorporating YAR 2016. This study analyse the adjustment practice of general average according to the application of YAR 2016.

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응급구조(학)과 학생의 구급차 동승실습 술기시행 관련 요인 (Related factors involved in the direct practice of practical procedures during the ambulance ride practice of paramedic students)

  • 김성주
    • 한국응급구조학회지
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    • 제19권3호
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    • pp.87-101
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    • 2015
  • Purpose: The purpose of this study was to provide an appropriate direction for an effective field practice program by analyzing the factors related to practical procedures in the ambulance ride practice of paramedic students in Korea. Methods: Questionnaires were answered by 202 paramedic students from March 28 to April 15, 2014. The collected data were analyzed with SPSS WIN 18.0 program. Results: The general level of procedural exposure during ambulance ride practice was 59.0% on average. Considering the practice of specific areas, vital sign checking, patient assessment, and oxygen supply showed relatively high percentages of 92.3%, 77.4% and 72.6%, respectively, whereas the areas of fluid and drug, airway, and cardiopulmonary resuscitation recorded relatively low percentage of 25.8%, 24.1% and 50.2%, respectively. The level of direct practice was significantly high in the group that included the largest number of paramedics. Conclusion: For an effective field practice, the place of practice needs to have various cases of patients to ensure a wide experience of procedures during the practice, and ambulance workers with a high level of expertise should be selected to ride with students.

Differences in the relationship, learning perception and satisfaction of nursing students before and after clinical practice

  • Lee, Mi-Ok
    • 한국컴퓨터정보학회논문지
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    • 제24권4호
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    • pp.145-151
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    • 2019
  • The purpose of this study was to find out whether there was a meaningful change in the learning perception and interpersonal relations of nursing students after completing clinical practice. Participants were 32 nursing students in the third grade. The research data were collected by questionnaire consisting of interpersonal relations and learning perception. The analysis of data was analyzed by SPSS 21 Version. General characteristics were analyzed by descriptive statistics, correlation between variables was analyzed by Pearson's relation, and differences of variables before and after clinical practice were analyzed by paired t-test. The results of the study are as follows. In clinical practice, interpersonal abilities showed a significant correlation with learning outcomes (R =.351, p =.049). The interpersonal abilities of nursing students improved significantly(t =2.264, p =.13) after completion of clinical practice. Nursing college students recognized that their interpersonal abilities had improved after completion of clinical practice, and the improvement of interpersonal abilities was statistically supported. Considering that the interpersonal relationship was an important factor in the clinical practice related stress of the nursing college students, it was meaningful that the interpersonal ability improved after the clinical practice. The positive correlation between interpersonal abilities and learning perceptions in clinical practice of nursing college students suggests future directions for future research. The results of this study will provide basic data on education that will enhance the satisfaction of students' clinical practice and improve their learning outcomes.