• 제목/요약/키워드: General practitioner

검색결과 114건 처리시간 0.028초

국제표준은행관행(ISBP)의 의의 및 실무 적용상의 문제점에 관한 연구 (A Study on the Significance and Problems in the Application of Business Practice of International Standard Banking Practice for the Examination of Documents under Documentary Credits)

  • 박석재
    • 무역상무연구
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    • 제22권
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    • pp.49-70
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    • 2004
  • UCP 500 has introduced new words "International Standard Banking Practice" as the basis of the examination of documents under documentary credits. However, the words have caused confusion among parties concerned with letter of credits. So, at its May 2000 meeting, ICC Banking Commission established a task force to document international standard banking practice for the examination of documents presented under documentary credits(ISBP). The publication is the product of two and a half years of work by a task force of the ICC Banking Commission. It was approved by the full Commission at its meeting in Rome in October 2002. The ISBP is a practical complement to UCP 500. It explains how the rules are to be applied on a day-to-day basis. As such, it fills a needed gap between the general principles announced in the rules and the daily work of the documentary credit practitioner. But, ISBP have two problems. First, ISBP impose more responsibilities than before the ISBP existed on banks. Second, ISBP have some problematic articles like the problem of maturity, letter of credit language, term. Consequently, all parties concerned with documentary credits need to armour themselves with knowledge for ISBP. Also, it should be noted that any term in a documentary credit which modifies or affects the applicability of a provision of the UCP may also have an impact on international standard banking practice. Therefore, in considering the practices described in this publication, parties must take into account any term in a documentary credit that expressly excludes or modifies a provision in an article of the UCP.

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Survival of Patients with Ewing's Sarcoma in Yazd-Iran

  • Akhavan, Ali;Binesh, Fariba;Shamshiri, Hadi;Ghanadi, Fazllolah
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4861-4864
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    • 2014
  • Background: The Ewing's sarcoma family is a group of small round cell tumors which accounts for 10-15% of all primary bone neoplasms. The aim of this study was to evaluate the survival of Ewing's sarcoma patients in our province and to determine of influencing factors. Materials and Methods: All patients with documented Ewing's sarcoma/primitive neuroectodermal tumor(PNET) family pathology were enrolled in this study during a period of eight years. For all of them local and systemic therapy were carried out. Overall and event free survival and prognostic factors were evaluated. Results: Thirty two patients were enrolled in the study. The median age was 17.5 years. Twenty (65.2%) were male and 9 (28.1%) were aged 14 years or less. Mean disease free survival was 26.8 (95%CI; 13.8-39.9) months and five year disease free survival was 26%. Mean overall survival was 38.7 months (95%CI; 25.9-50.6) and median overall survival was 24 months. Five year overall survival was 25%. From the variables evaluated, only presence of metastatic disease at presentation (p value=0. 028) and complete response (p value =0. 006) had significant relations to overall survival. Conclusions: Survival of Ewing's sarcoma in our province is disappointing. It seems to be mostly due to less effective treatment. Administration of adequate chemotherapy dosage, resection of tumor with negative margins and precise assessment of irradiation volume may prove helpful.

Survival of Rectal Cancer in Yazd, Iran

  • Akhavan, Ali;Binesh, Fariba;Soltani, Amin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4857-4860
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    • 2014
  • Background: Colorectal cancer is common in Iran. However our knowledge about survival of rectal cancer in our province is low. The aim of this study is to evaluate this question. Materials and Methods: Patients with documented pathology of adenocarcinoma of the rectum and rectosigmoid junction referred to our center from September 2004 to September 2012 were enrolled in this study. Metastatic and recurrent patients were excluded. A questionnaire including clinicopathologic parameters, quality and sequence of treatment modalities was filled in for each patient. Patients treated with a combination of surgery, chemotherapy and radiation therapy were divided into standard and non-standard treatment groups, according to the sequence of treatment. Results: One hundred and nineteen patients were evaluated. Mean age was 60.8 year. The median overall survival was 62 months and five year survival was 55%. TNM staging system was not possible due to (Nx) in 21 (17.6%) patients. The others were in stage I, 20 patients (16.8%), II, 35 (29%.5) and III, 43(36.1%). According to our definition only 25 patients (21%) had been treated with standard treatment and 79% had not received it. A five year survival in patients with standard treatment was 85% and in the non-standard group it was 52%.Age, sex, stage and grade of tumor did not show any significant relation to survival. Conclusions: Our study showed a five year survival of rectal cancer in our patients was about 10% lower than the rate which is reported for developed countries. Preoperative concurrent chemoradiation significantly improved local control and even overall survival.

간호사가 인식하는 간호본질에 대한 탐색적 연구 - 환자중심 병원서비스 전략구축을 위한 기초단계 (An Study on the Nature of Nursing as Perceived by Clinical Nurses)

  • 서문자;김혜숙;김금순;임난영;김귀분;성옥희;주혜주
    • 대한간호
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    • 제35권1호
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    • pp.66-80
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    • 1996
  • Reacently one the main issues has been to develop useful strategies to improve hospital services for patients in the health care delivery system in our rapidly changing society. This study has focused on exploring the perceptions that the clinical nurses have concerning who they are and what they are going to become in the days ahead as medical care reaches a new stage of advancement centered around the patient and hospital services. This study in also based upon the premise that the role of the clinical nurse practitioner. is central to the progress of any patient centered nursing program. This study was carried out by the members of the academic committee of Seoul Branch of Korean Nurses Association from January 1995 to February 1995. The interview method was a semi-structured questionnaire used to collect data from 25 staff nurses who were working more than 3 years at 3 different university hospitals in Seoul. The 6 interviews were selected from each hospital and they were trained for the interviewing techniques. The data were analysed qualitatively and 10 elements of the nurse's responsibilities classified such as caring for the patients (which includes specific medical care as well as general); assessing; diagnosing; coordinating with other health personnel; careful listening; teaching and the patient guiding; administering the prescriptions; giving information and counseling the patient; ward management. Although the premise of this study was based on a wholistic concept, the overall behavioral aspects of hospital clinical nursing were the major thrust of the questionnaire. Broad philosophical questions regarding the nature of nursing need to be further explored. The data gathered for this questionnaire should be useful as a reenforcement tool in educating nursing students as well as in continuing education for clinical nurses. For the future, another study should be done to determine the nursing/patient relationship.

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중환자실 전문간호사의 전문간호행위 분류와 수행분석 (Analysis on Performance and New Classification of Advanced Practices by Critical Care Nurse Practitioners)

  • 김진현;김명애;김미원;김경숙;유정숙;이은희
    • 간호행정학회지
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    • 제15권4호
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    • pp.527-538
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    • 2009
  • Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.

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악안면 결손 환자에서 3D printing을 이용한 보철 수복 증례 (Application of 3D printing technology for rehabilitating maxillary defects)

  • 조영은;;박은진
    • 대한치과보철학회지
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    • 제58권4호
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    • pp.349-355
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    • 2020
  • 외상, 구강암, 선천적 요인 등에 의한 구강 결손시 음식물의 섭취, 흡입성 폐렴 방지, 안모 지지를 위하여 치과용 obturator가 제작된다. 그러나 기존의 전통적인 인상 채득 방법을 이용한 obturator제작 시, 제작 과정에서 술자와 환자, 기공사 모두 번거로운 과정을 거쳐야 하며, 환자는 악안면 보철 치료가 가능한 치과 보철 전문의가 있는 병원을 찾아 방문해야 하는 어려움이 있다. 그러나, 3D printing을 포함한 CAD-CAM 기술을 이용하면 비교적 간단하게 hollow obturator를 제작할 수 있고, 보철 전문의가 없는 지역에서도, 지역 치과의사와 멀리 떨어져 있는 보철 전문의 간의 협진을 통해 수월한 치료가 가능할 수 있다. 본 연구에서는 한국의 상악 구개 결손 환자들의 치료를 위해, 일본에서 obturator를 디자인하고 한국에서 3D printing하여 성공적으로 obturator를 제작하였고, 더불어 원격 치료의 가능성을 확인하였기에 보고하는 바이다.

한국 노인의 상지근력과 인지기능 사이의 상관관계 융복합 연구 (Convergence Study on the Corelation between Upper Limb Muscle Strength and Cognitive Function in Older Korean Adults)

  • 최원재
    • 한국융합학회논문지
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    • 제11권2호
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    • pp.37-43
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    • 2020
  • 본 연구의 목적은 한국 노인의 상지 근력과 인지기능 사이의 상관관계를 알아보기 위해서 실시하였다. 지역사회에 거주하는 노인 중 독립적으로 일상생활이 가능한 130명이 본 연구에 참여하였다. 참여자들의 상지 근력은 악력과 아령 들기 검사로 평가하였고 인지 기능은 몬트리올 인지평가 도구와 실무자용 노인인지기능 사정도구를 사용하여 평가되었다. 연구 결과 130명의 노인 중 26명(20%) 만이 인지 기능이 정상이었고 104명(80%)은 경증인지장애를 가지고 있는 것으로 나타났다. 노인의 상지 근력 중 경증인지장애 유무에 따라 악력에서 유의한 차이가 있었고(p<.05), 악력은 몬트리올 인지평가 도구와 실무자용 노인인지기능 사정도구와 유의한 상관관계가 있었다(p<.05). 본 연구 결과, 노인의 신체적 능력과 인지기능 사이에 상관관계가 있기 때문에 정신건강을 향상시키기 위한 운동프로그램의 개발을 추후 필요할 것이다.

의약분업 전후 의원의 건강보험 진료비 분포변화 및 결정요인분석 (Distributional changes in Physicians' Medical Care Expenses from the National Health Insurance and its Determinants After the Separation of Prescription and Dispensing)

  • 이애경;정현진
    • 보건행정학회지
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    • 제14권3호
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    • pp.20-44
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    • 2004
  • The National Health Insurance Expenditure has been increased rapidly since the introduction of the separation of prescription and dispensing in 2000, and this trend of rapid growth in overall spendings rate has been observed predominantly among medical practitioners. This study was conducted to investigate the growth rate and distributional changes in private medical practitioners' expenses from 1999 to 2002 and its determinants using the National Health Insurance claims data. The total increasing rate of all medical practitioners' expenditure paid by the National Health Insurance between 1999 and 2002 was $41.71\%$, which exceeding that of general hospitals by $20\%$p. But the income distribution among each practitioner was improved as the changes in Gini coefficient(from 0.40 to 0.38) and decile distribution ratio(from 0.25 to 0.29) during the same period showed. However, this improvement in distributional patterns is not enough since even in 2002 it turned out that the highest $10\%$ income group earned 33times more than the lowest $10\%$ income group did. Also, higher Gini coefficient was observed in larger cities and some department like plastic surgery, obstetrics and gynecology. The major causes of this differentials in medical practitioners' expenses were factors related to medical demand like proportion of old population, residential economic status in a given area. In addition, providers' economic incentives also played an important role in determining their income distribution. The large income differentials among physicians may imply a skewed distribution of patients and thus long waiting time, inefficient utilization of resources and potential inadequate quality of care. In this sense, unreasonable distributional gaps should be reduced, so effective measures as well as ongoing monitoring would be necessary to correct current distributional problems.

침치료 이상반응에 대한 고찰 (Review of Adverse Events in Acupuncture Treatment)

  • 박지은;오달석;최준용;정소영;김애란;구창모;정희정;최선미
    • 한국한의학연구원논문집
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    • 제13권3호
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    • pp.79-85
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    • 2007
  • Objective : To investigate documented surveys about adverse events of acupuncture therapy. Methods: We searched Medline with the terms of 'acupuncture/adverse event(s)', 'acupuncture/side effect(s)' and 'CAM/adverse event(s)' using Pubmed and set the limits to human study. Results: There were 5 prospective studies, 3 reviews and 3 surveys in our searching. There were 3 reports about acupuncture related adverse events in UK ranging from 10.7% to 15% of which the rate of significant events were from 0.13% to 0.14%. In Germany, there were 11% of acupuncture related adverse events in one report and 7.5%(significant events were 45 in 190,924 patients) in another report. In Australia, one study reported that every adverse event associated with acupuncture occurred in 8-9 month per one practitioner. In Japan, 0.14% of acupuncture related adverse events in 48 practitioners were reported in one systemic review. A cumulative review about significant adverse events associated with acupuncture reported 715 adverse events of which most frequent accidents were pneumothorax and central nervous system injury. Conclusion : The risk of adverse event associated with acupuncture is far lower than that associated with other general medical interventions. However, some safety guidelines about the acupuncture performance are needed.

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정부 홍보담당자들의 언론 관계와 오보에 대한 인식 조사: 노무현 정부와 이명박 정부 홍보담당자 비교 연구 (Government Public Relations Practitioners' Perceptions toward Media Relations and False Reports: A comparative Study between the Noh Moo Hyun and Lee Myung Bak Governments)

  • 임유진;김영욱
    • 한국언론정보학보
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    • 제55권
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    • pp.119-139
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    • 2011
  • 이 연구는 노무현 정부 홍보담당자들과 이명박 정부 홍보담당자들의 언론 관계에 대한 인식과 오보에 대한 전반적인 인식을 살펴보고, 정권 교체로 인한 홍보 환경의 변화에 따라 홍보담당자들의 이러한 인식에 어떠한 차이가 있는지 알아보았다. 또한 홍보담당자들이 갖고 있는 언론 관계에 대한 인식은 오보에 대한 전반적인 인식에 어떻게 영향을 미치는지 함께 살펴보았다. 분석 결과, 두 집단의 언론 관계에 대한 인식이나 오보 개념, 원인에 대한 인식 등이 집단 간 뚜렷한 차이를 나타냈으며, 그들의 언론 관계에 대한 인식은 오보에 대한 인식에 영향을 미친 것으로 밝혀졌다. 하지만, 두 집단의 오보 방지 노력에 대한 인식의 차이는 크지 않게 나타났다.

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