• 제목/요약/키워드: Primary health physicians

검색결과 73건 처리시간 0.023초

Oncologists Experience with Second Primary Cancer Screening: Current Practices and Barriers and Potential Solutions

  • Shin, Dong-Wook;Kim, Yeol;Baek, Young-Ji;Mo, Ha-Na;Choi, Jin-Young;Cho, Ju-Hee
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.671-676
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    • 2012
  • Objectives: Screening for second primary cancer (SPC) is one of the key components of cancer survivorship care. The aim of the present study was to explore oncologists' experience with promoting second primary cancer screening. Methods: Two focus group interviews were conducted with 12 oncologists of diverse backgrounds. Recurrent issues were identified and placed into thematic categories. Results: Most of the oncologists did not consider SPC screening promotion as their responsibility and did not cover it in routine care. All of the study participants had experience with unexpected SPC cases, and they were under emotional tress. There was no systematic manner of providing SPC screening. Oncologists usually prescribe SPC screening in response to patients' requests, and there was no active promotion of SPC screening. Short consultation time, limited knowledge about cancer screening, no established guideline for SPC screening, and disagreement with patients about oncologists' roles were major barriers to its promotion. An institution-based shared care model was suggested as a potential solution for promoting SPC screening given current oncology practices in Korea. Conclusion: Oncologists could not effectively deal with the occurrence of SPC, and they were not actively promoting SPC screening. Lack of knowledge, limited health care resources, and no established guidelines were major barriers for promoting SPC screening to cancer survivors. More active involvement of oncologists and a systematic approach such as shared-care models would be necessary for promoting SPC screening considering increasing number of cancer survivors who are vulnerable.

경상북도 문경군 산북면 국민학생의 머릿니 감염 상황(1985) (Head Louse Infestation among School Children in Sanbuk-myon, Mungyong-gun, Kyongsangbuk-do (1985))

  • 배기수;허선
    • Parasites, Hosts and Diseases
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    • 제25권1호
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    • pp.85-86
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    • 1987
  • In order to know the prevalence of head louse among the school children in rural area, we visited 3 primary schools and a kindergarten in Sanbuk-myon, Mungyong-gun, Kyongsangbuk-do in July 1985, and examined the children to identify the adult worms of head louse and/or its nits on the hair. The overall infestation rate was 91.9% among 420 children examined, and there was a difference between schools (P<0.05). The school girls' rate, 96.1% was higher than that of boys' 88.9%(P<0.05). By grade, the rate of infant school was 88.5% and 1st to 6th grade were 100, 100, 95.8, 90.4, 89.7, 80.0% respectively. Above result indicates that the head louse is an important health problem in this community. Therefore, the chemotherapy and the effort to improve the hygiene are necessary in this community by physicians, teachers and health administrators.

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Complex Regional Pain Syndrome (CRPS type-1) in an Adolescent Following Extravasation of Dextrose Containing Fluid-an Underdiagnosed Case

  • Subedi, Asish;Bhattarai, Balkrishna;Biswas, Binay K.;Khatiwada, Sindhu
    • The Korean Journal of Pain
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    • 제24권2호
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    • pp.112-114
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    • 2011
  • Due to its complex pathophysiology and wide spectrum of clinical manifestations, the diagnosis of CRPS is often missed in the early stage by primary care physicians. After being treated by a primary care physician for 5 months for chronic cellulitis, a 16-year-old girl was referred to our hospital with features of type-1 CRPS of the right upper extremity. Inability to diagnose early caused prolonged suffering to the girl with all the consequence of CRPS. The patient responded well with marked functional recovery from multimodal therapy. Ability to distinguish CRPS from other pain conditions, referral for specialty care at the appropriate time and full awareness of this condition and its clinical features among various healthcare professionals are essential in reducing patient suffering and stopping its progression towards difficult-to-treat situations.

대전.충남지역 산업장의 보건관리 실태 (A Study on the Status of Health Management in Industries Located in Taejon and Chungnam Province)

  • 홍춘실;김현리
    • 지역사회간호학회지
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    • 제4권1호
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    • pp.38-44
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    • 1993
  • The purpose of this study was to identify the status of health management from Dec 5, 1992 to March 10, 1993. The data. was. collected from 30 industrial nurses, through a structured questionnaire. The results were as follows : 1. 1.50%. of the companies surveyed were manufacturing companies, 24% of them were research center. 2. The sizes of the companies were as follows: 300-499 employees 11(37%). more than 1,000 employees 4(13%). 3. 18 companies(60%) had organized safety and health committees. 4. 25 companies(83%) had there own health clinics. 5. 60% of companies had a Health center assigned as were hospitals 83%. 6. Practical nurses were employed by all industries, 10 companies had their own physicians, and 3 had their own industrial hygienist. 7. The primary health examination rate was 96% and workers who took follow up examinations were 8.5% out of them, 73.6% were evaluated at the C & D grade. Follow Up management to D. evaluations was performed about 50%. 8. 13 personnel(43%) required, special examinations. 9. The relation between the workers health score and the health status, score was negative and not significant. Therefore the better health management the higher health level score.

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Implementation of a care coordination system for chronic diseases

  • Lee, Jung Jeung;Bae, Sang Geun
    • Journal of Yeungnam Medical Science
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    • 제36권1호
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    • pp.1-7
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    • 2019
  • The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

일개 농촌지역주민의 면보건지소 이용실태에 관한 고찰 -경기도 남양주군 수동면- (A Study on the Utilization of a Rural Health Subcenter for Primary Health Care)

  • 김영복;위자형
    • 농촌의학ㆍ지역보건
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    • 제19권1호
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    • pp.31-39
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    • 1994
  • We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

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신체활동 현황과 국가수준의 정책 제안 (Current status of physical activity and policy proposals of the national level)

  • 양윤준
    • 보건교육건강증진학회지
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    • 제33권4호
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    • pp.47-54
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    • 2016
  • Objectives: The prevalence of insufficient physical activity is relatively high in the Republic of Korea and it is increasing. The national strategies to improve physical activity are essential and are suggested in this paper. Methods: National level of physical activity is compared globally by WHO statistics. Korean National Health and Nutrition Survey showed the level of physical activity. National strategies to improve physical activity were suggested referring to the other countries' strategies, public health books and Health Plan 2020. Results: Prevalence of insufficient aerobic exercise in 2010 were 33.4%, 94.8% in over and 18 years old, 11~17 years old, respectively. And it is increasing. Sufficient exercise to fit the national guidelines of physical activity were done by 15.6% of Korean older and 19 years old. Prevalence of insufficient physical activity was high in the elderly, female, adolescent, rural area and lower income. The national spread of the physical activity guidelines, primary care physicians involvement, supports for the physical activity programs, development of the evaluation protocol for the programs and environmental supports are suggested. Conclusions: The government induced various efforts to improve the level of physical activity is needed urgently.

한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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Colon Cancer among Older Saudis: Awareness of Risk Factors and Early Signs, and Perceived Barriers to Screening

  • Galal, Yasmine Samir;Amin, Tarek Tawfik;Alarfaj, Abdulelah Khalid;Almulhim, Abdulaziz Abdullah;Aljughaiman, Abdullah Abdulmohsen;Almulla, Abdulrhaman Khaled;Abdelhai, Rehab Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.1837-1846
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    • 2016
  • Background: Colon cancer screening (CRCS) uptake is markedly affected by public awareness of the disease. This study was conducted to assess levels of knowledge of CRC, to explore the pattern of CRCS uptake and identify possible barriers to screening among Saudis older than 50 years of age and primary care providers (PCPs) in Al Hassa region, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted in randomly selected primary health care (PHC) centers, 884 Saudis and 39 PCPs being enrolled for data collection. Structured interviews were conducted to obtain information regarding socio-demographic characteristics, personal information relevant to CRC, awareness about early signs/symptoms and risk factors, and barriers to CRCS. Also, a self- administered data collection form was used to assess barriers to CRCS from the physicians' perspectives. Results: More than 66% of participants were lacking knowledge about CRC. Participants with higher educational levels, having ever heard about CRC, and having relatives with CRC had a significantly higher awareness of the disease. The rate of reported CRCS was low (8.6%). After conducting a logistic regression analysis, it was observed that female gender (OR=0.28; 95% CI=0.14-0.57; P=0.001), being unmarried (OR=0.11; 95% CI=0.10-0.23; P=0.001), lower levels of education (OR=0.36; 95% CI=0.16-0.82; P=0.015), and having no relatives with CRC (OR=0.30; 95% CI=0.17-0.56; P=0.001) were significantly associated with a lower CRCS uptake. There was a significant difference between most of the perceived barriers to CRCS and gender. Exploratory factor analysis showed that personal fear (especially fear of the screening results and shyness) was the major factor that hindered CRCS with high loading Eigen value of 2.951, explaining 34.8% of the barriers of the included sample toward utilization of CRCS, followed by lack of awareness of both person and providers (high Eigen value of 2.132, and explaining 23.7% of the barriers). The most frequently cited barriers to CRCS from the physicians' perspectives were lack of public awareness, lack of symptoms and signs, and fear of painful procedures. Conclusions: Poor levels of knowledge about CRC were found among older Saudis attending PHC centers in Al Hassa, Saudi Arabia. It is crucial to implement an organized national screening program in Saudi Arabia to increase public awareness.

혈관질환 환자의 예방치료에 있어 메소글리칸의 안전성 및 유효성에 관한 시판 후 조사에 대한 연구 (Post-Marketing Surveillance Study of the Safety and Efficacy of Mesoglycan Prescribed in Primary and Secondary Care of Patients with Vascular Disease)

  • 김윤희;정영혜;이화정;곽혜선
    • 한국임상약학회지
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    • 제15권2호
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    • pp.94-99
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    • 2005
  • The aim of this study was to evaluate the safety and efficacy of treatment of mesoglycan. This study was conducted between September 2003 and May 2004. A total of 292 patients with vascular disorders including cerebral infarction were enrolled. The patients were administered with 50-100mg of mesoglycan by an oral route everyday for eight weeks. Subjective physicians' assessments of efficacy had ratings of 'improvement', 'invariability', 'exacerbation' and 'not being able to assess'. An improvement was observed in 241 patients out of 274; 18 patients were rules out. The efficacy rate was influenced statistically significantly by the duration of therapy (p=0.0392) and daily mean drug dose (p<0.0001). The adverse events were reported in 8 patients (9 cases) out of 292 patients: skin/appendages disorders (0.7%), liver/biliary system disorders (0.7%), cardiovascular system disorders (0.7%), neurologic disorders (0.3%). respiratory disorders (0.3%) and gastrointestinal system disorders (0.3%). There showed no serious adverse events. These results indicate that mesoglycan was well tolerated and effective for the prevention of vascular disorders.

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